ANSWER TO PREVIOUS FELLOW'S CHALLENGE

Linda Wagner-Weiner

 

The diagnoses of the patients whose radiographs were shown in the March/April 2004 PROJ issue are given below.  As no patient history accompanied the radiographs in the challenge, other plausible and acceptable diagnoses are given in some cases where there may be more than one interpretation of the xray.

 

 

1.

Legg-Calve-Perthes / avascular necrosis of left hip

2.

Fusion of spinous processes of C2-C3 (child with JIA)

3.

Severe osteoporosis with verterbral compression (patient diagnosed with SLE in 1960's; this radiograph was taken >10 years after diagnosis)

4.

Protrusio acetabuli (teenage girl with long-standing RF+ arthritis)

5.

Fusion of carpal bones (teenage boy with systemic onset arthritis)

6.

Takayasu's arteritis

7.

Slipped capital femoral epiphysis, left hip

8.

Calcinosis (patient with dermatomyositis for >10 years)

9.

Avascular necrosis of bilateral knees at medial condyles (patient with SLE)

10.

Frostbite (occurred at age 5 years; patient evaluated as teenager with complaints of pain and abnormal appearance of fingers)

11.

Osteosarcoma

12.

Fusion of spinous processes of C2-C4 and C5-C7 (9 year old boy with systemic onset arthritis since age 18 months)

13.

Cervical cord impingement at C4-C5 level (this is the MRI of patient in radiograph # 12; note that impingement is at the one cervical level which is   not  fused and where motion is able to take place)

14.

Sequela of right hip septic arthritis

15.

Chronic recurrent multifocal osteomyelitis, left clavicle

16.

Arthritis, right wrist (child with oligoarthritis)

17.

Periosteal reaction of bilateral fibulas, R>L  (patient with sarcoidosis and recurrent lower leg pain)

 

 

 

 

The winner of this fellow's challenge (with 12 correct answers!) is:

Jonathan Akikusa, M.D.

Toronto Sick Children's Hospital

Toronto, Canada