Teaching Cases

Radiology Case Library

Scroll through real imaging cases. Learn the patterns that matter on call. Cases sourced from Radiopaedia.org under Creative Commons license.

CT Head CT Abd/Pelvis Chest X-Ray
Case 01
CT Head Essential

Left MCA Stroke — Dense MCA Sign

📋 Clinical History

Middle-aged patient presenting with sudden onset right-sided weakness and aphasia. NIHSS 18. Last known well 2 hours prior. Non-contrast CT head obtained as part of acute stroke protocol.

💡
Teaching Pearl
The dense MCA sign represents acute clot within the MCA and may be the only CT finding in the first 1–2 hours of a large vessel occlusion — before infarct becomes visible. Sensitivity is ~30–50% but specificity is high. Always compare both MCAs on the same window. Early ischemic changes (sulcal effacement, loss of insular ribbon, gray-white dedifferentiation) are subtle — don't dismiss a "normal" CT in a patient with a convincing stroke exam.
Case courtesy of Radiopaedia.org contributors. View original case. Used under Creative Commons license.
Case 02
CT Abd/Pelvis Essential

Acute Appendicitis

📋 Clinical History

Young adult presenting with 24 hours of right lower quadrant pain, low-grade fever, anorexia, and nausea. Pain initially periumbilical then migrated to the RLQ. WBC 13.8. CT abdomen and pelvis with IV contrast obtained.

💡
Teaching Pearl
The CT criteria for appendicitis: appendix >6 mm diameter + wall thickening + periappendiceal fat stranding. An appendicolith alone is not diagnostic but increases suspicion significantly. A normal-caliber appendix that fills with contrast essentially excludes appendicitis. Always trace the appendix to its tip — a perforated tip with contained abscess can be subtle and is a surgical emergency. Free air = perforation = urgent surgical consult.
Case courtesy of Radiopaedia.org contributors. View original case. Used under Creative Commons license.
Case 03
Chest X-Ray Essential

Pulmonary Edema

📋 Clinical History

Elderly patient with known heart failure presenting with progressive dyspnea, orthopnea, and bilateral leg swelling over 3 days. O2 sat 88% on room air. Crackles bilaterally on auscultation. Chest X-ray obtained on presentation.

💡
Teaching Pearl
The classic CXR findings of pulmonary edema follow a progression: first vascular cephalization, then Kerley B lines (interstitial edema), then perihilar airspace opacities, then pleural effusions. On call, you won't always see all four — recognize any combination as edema until proven otherwise. The bat-wing pattern is classic but late. Cardiomegaly favors cardiogenic edema over non-cardiogenic (ARDS). Always correlate with the clinical picture — a normal heart size doesn't rule out flash pulmonary edema.
Case courtesy of Radiopaedia.org contributors. View original case. Used under Creative Commons license.

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