Postgrad Med J 1999;75:557-559
( September )
Self-assessment questions
The uncommon denominator
D O'Driscoll, M Duddy
Department of
Radiology, University Hospital Birmingham NHS Trust, Selly Oak
Hospital, Birmingham, West Midlands, UK
Correspondence to: D O'Driscoll, Cambridge & Huntingdon Breast Screening Centre, The Rosie Hospital, Robinson Way,
Cambridge CB2 2SW, UK
Accepted 14 January
1999
| The first 150 words of the full text of this article appear below. |
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Introduction |
A 70-year-old man presented with anorexia, altered
bowel habit and weight loss. He had a history of heart failure and
rheumatoid arthritis. Clinical examination showed rheumatoid deformity
and pedal oedema. Laboratory investigations demonstrated microcytic anaemia, eosinophilia and hypoalbuminaemia. Barium enema and
contrast-enhanced abdominal computed tomography (CT) were performed
(figures 1 and 2,
respectively).
| Figure Removed (Available Only in the Full Text) |
| Figure Removed (Available Only in the Full Text) |
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Questions |
| 1 |
What are the radiological signs on figures 1 and 2 ?
|
| 2 |
What is the differential diagnosis for each ?
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| 3 |
Are there any common denominators ?
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Answers |
QUESTION 1
The barium enema (figure 1) shows loss of the normal haustral
pattern and the mucosa appears granular. There is widening of the
presacral space (A). The bladder, opacified by prior CT enhancement, is
narrowed and elongated (B). On the CT scan (figure 2), the intra-abdominal fat is of similar attenuation to the water density of a
simple right renal cyst. The mesenteric and pararenal fat has a misty
appearance with thickening of Gerota's fascia.
QUESTION 2
The differential diagnosis for the CT appearances is summarised in
box 1.1 The differential diagnosis . . . [Full text of this article]
