CHAIRI MALFORMATION III
High cervical/low occipital encephaloceles are present .
The encephaloceles contain varying amounts of brain
÷cerebellum & occipital lobes
÷ ventricles
÷medulla & Pons
÷aberrant deep draining veins and ectopic venous sinuses within the encephaloceles
Chondroblastoma in the proximal epiphysis of the tibia. The
tumour has thinned the overlying cortex and extends across the growth
plate into the upper metaphysis.
Psoriasis. Sausage digit .soft tissue swelling. Periostitis. Increase bone density.
The distal interphalangeal joints are involved in this
condition. Bone density is often preserved. Erosions proceed along the
bases of the distal phalanges and there is splaying of bone locally. Despite
the erosive change, the joints may be increased in width or, alternatively,
fused. These changes are totally unlike those seen in rheumatoid arthritis
both in appearance and distribution. There is also a neurotrophic change at
the distal and middle phalanges, with longitudinal and concentric bone
resorption, producing a 'licked candy stick' appearance.
A tension pneumothorax
There is a large, right-sided, tension pneumothorax that is displacing the heart and mediastinal structures to the left. Tension pneumothoraces can result from penetrating injuries or can arise spontaneously. They are serious because air exchange is compromised in both the lung with the pneumothorax and the opposite lung which is being compressed. They are treated by decompressing the tension and re-expanding the lung
Sacrococcygeal teratoma is the most common solid tumor of the fetus and neonate, with a reported incidence of one in 35000 to 40000 live births. It is a neoplasm composed of tissues from all three germ layers, arising from totipotent somatic cells that originate from the primitive knot (Hensen's node) or caudal cell mass.
A ruptured gastric ulcer
There is a huge amount of free air in the peritoneal cavity that is allowing you to see the entire diaphragm very clearly, since it is now outlined by air on both sides. Normally, the diaphragm is not seen as a line on radiographs because the soft tissues in the peritoneal cavity provide no contrasting density to outline its undersurface. Free intraperitoneal air is almost always from a ruptured viscus which itself contained air. In this case, the patient had a perforated duodenal ulcer which was treated surgically