Case Studies
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Case of the month
A 15 yr old girl presented with left abdominal pain after being accidently being kicked by her horse. 1. This is the CT scan (A and B) – what does it show? 2. How are these injuries classified? 3. How can this be managed? 4. How should urinary leaks be managed? 5. This patient was... Read more
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Case of the month October 2012
This 62 yr old male was referred to the haematuria clinic with visablehaematuria. What are the 2 main findings on the CT? What is the incidence of the congenital anomaly? How does it arise? What genetic conditions can this be associated with? What symptoms do these patients... Read more
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Sep 2012
A 36 year old female presented to her local A&E department with sudden onsetof right sided loin pain. Blood tests revealed a haemoglobin of 9. 1. What do her 2 CT images labelled A & B show ? 2. Whose syndrome is this? 3. What is the underlying diagnosis and what genetic disease... Read more
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July 2012
This 55 year old female was seen in the urology clinic with an incidental finding of a right renal masswhich on CT imaging contains a significant amount of fat. 1) In A and B, what is the diagnosis and what genetic disease can this be associated with? 2) How do they present? 3)... Read more
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23rd March 2012
A 53 year old man presented to A+E with a 2 week history of testicular swelling. He had complained of left inguinal swelling and pain 2 weeks prior and was admitted with a suspected incarcerated inguinal hernia. He was subsequently discharged on antibiotics. The swelling in his left groin disappeared... Read more
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July 2011
A 56 year old gentleman presented 3 weeks after having had a low anterior resection, partial cystectomy and loop ileostomy for diverticular disease with abdominal pain. His bloods were normal, with a creatinine of 123 and normal inflammatory markers. He underwent a CT scan. What do the CT images show? How could... Read more
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May 2011
A 72 year old man presents with acute renal failure and uraemic symptoms. His creatinine on admission is 790 micromol/litre and his potassium is 7.6. He has a past history of prostatic carcinoma for which he had external beam radiotherapy and is currently on a LHRH analogue with a stable... Read more
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March 2011
A 72 year old man presented to his GP with a one week history of a painless left testicular lump found on self examination. What do the ultrasound images show? What are the differential diagnosis of testicular lesions in this age group? What investigations are needed? What is the first treatment step for each... Read more
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January 2011
A 72 year old man sent by his GP to the medical admission unit with few weeks history of bilateral flank pain, generalized malaise and loss of appetite. Initial blood tests by the GP showed serum Creatinine of 633 and an ESR of 120. Abdominal USS showed empty bladder with... Read more
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November 2010
A 34 year old lady who was 26 weeks pregnant presented to the maternity unit with a 5 day history of gradual onset right loin pain. Her right loin pain worsened over a period of a few hours and an urgent ultrasound of the kidneys was arranged. What does the above... Read more
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October 2010
This 32 year old lady presented with left loin pain. What does the CT scan show (the rest of the CT is unremarkable)? What is the diagnosis? What may the other symptoms and signs have been? What are the most common organisms causing this condition? What treatment would you... Read more
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February 2010
This is a CT scan from a 71-year-old woman who had undergone urinary diversion more than 20 years earlier, now presenting with signs of left pyelonephritis and a metabolic acidosis What does the CT show? How may this be related to her urinary diversion? How should she be... Read more
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December 2009
This is a 69-year-old woman with a history of left renal calculi who presented with recurrent left flank pain and a Proteus urinary infection. What does the CT scan show? What further investigations need to be performed? How should the condition be... Read more
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November 2009
This is a plain abdominal X-ray in a 24-year-old Indian man with admitted as an emergency with an 8-week history of left flank pain. What does the X-ray show? What other investigations are needed? What treatment is... Read more
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October 2009
This is a CT scan in an 84-year-old man who presented with haematemesis and was found, on upper GI endoscopy, to have a posterior duodenal ulcer with a duodenal diverticulum. What abnormality is shown on the CT scan? How can this abnormality be explained? What treatment is... Read more
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August 2009
This is a CT scan in an 80-year-old man with invasive bladder cancer (treated by chemotherapy alone) and a previous right nephroureterectomy for an ureteric tumour. He has been experiencing haematuria despite a recent normal check cystoscopy. What does the CT show? What other investigations should be performed? What treatment is... Read more
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July 2009
This is the abdominal CT scan of a 59-year-old woman who underwent endoscopic resection of multifocal, right-sided bladder tumours followed by single-dose, intra-vesical Mitomycin C. She was re-admitted 12 hours later with increasing lower abdominal pain, frequency, dysuria and poor urine output. What does the CT show? How has this condition arisen? What... Read more
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June 2009
This is the scrotal ultrasound scan of a 21-year-old man who developed a painful, swollen left testis 7 days after an episode of bilateral parotitis. What does the scan show and what is the most likely diagnosis? How might the diagnosis be confirmed? What is the treatment? What is the long-term... Read more
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May 2009
This is an abdominal CT scan of an 82-year-old woman with a 6-month history of left flank pain and recurrent urinary infections who was pyrexial on admission. There was a palpable, slightly tender mass in the left hypochondrium. What does the scan show? What is the initial management? What further measures are... Read more
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April 2009
This is a CT scan of the abdomen in a 65-year-old man on dialysis for chronic renal failure who presented with sudden right flank pain radiating to the right groin. What abnormalities are seen on the CT? What other investigations might be appropriate? How should the patient be... Read more
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March 2009
This is the CT scan of a 27-year-old rugby player who presented with frank haematuria and right flank pain two days after a match in which he recalled a hard fall when making a tackle. His circulation was stable and he had only slight tenderness in the right upper... Read more
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July 2008
The is a pelvic CT of a 66-year-old man with urinary sepsis whilst undergoing chemotherapy for bowel cancer. He had a low anterior resection and is know to have a pre-sacral collection discharging into the rectum. His chemotherapy has been put "on hold" pending treatment of this abnormality. What... Read more
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May 2008
This is a scrotal ultrasound scan in a 12-year-old boy who presented with a painful right testis. The testis was enlarged, reddened and acutely tender to touch but the spermatic cord was normal. There were no urinary symptoms but there was a past history of bilateral dartos pouch... Read more
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April 2008
This is a CT scan of a 52 year old man who presented in an intoxicated state with a self-inflicted laceration to his lower limb. He developed right loin pain whilst in the Accident & Emergency Department. What does the CT scan show? What risk factors may be relevant in this patient? What... Read more
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March 2008
This is a pelvic MRI scan in a 32-year-old man with perineal discomfort, pyrexia and bluish discoloration of the scrotal skin. What does the MRI show? What is the most likely diagnosis? What treatment should be given? Case presented by Mr Tev... Read more
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February 2008
This is an endoscopic view of the urethra of a 25-year-old man who presented with urethral bleeding. What abnormalities are shown? What is the cause of these abnormalities? How should they be managed? Case presented by Mr Nigel... Read more
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January 2008
This is the penis of a middle-aged man who presented with an unrelated problem. What is the abnormality shown? With what other abnormalities can it be associated? How is it managed? Case presented by Mr Nigel... Read more