Thursday, June 30, 2011

Identify this MRI

Can anyone tell me what's wrong with this MRI of the thorax, labeled for your convenience:



Answer will be posted tomorrow.

(Replies are screened)

EDIT: Yes, it's human.

17 comments:

  1. That doesn't even look human to me. Hah.

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  2. Do we get any history of what symptoms this pt is presenting with?

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  3. Looks like subcutaneous air.

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  4. looks like a leg to me...like the distal end of a femur....

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  5. There are several anomalies there. Most striking are that the heart is "behind" the lungs - it is usually just posterior to the sternum &, tangent upon the level of the cut, the only interposing structures b/t heart & sternum would be the lingula {L lung}. Second, there is a large structure c/w muscle density occupying the volume where you'd expect the hear to reside - sort of crescentric/m-shaped - anterior to the lungs from just anterior to the mid-axillary line bilaterally & extending into the anterior mediastinum. Third, the posterior muscles-masses immediately adjacent to both sides of the spinal column are particularly robust, almost surrounding a very dorsal-lying aorta. Lastly, the thorax is very misshapen. I/m no radiologist, but are you sure this is a human? The configuration of this MRI, to me, is suggestive of a quadrupedal animal, not a bipedal one...(per Dr. David Kelley)

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  6. I believe this person has thoracokneeosis

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  7. Call me crazy, but is the heart on the right side?

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  8. You mean, besides the fact that it's a KNEE? :) You can pretty easily see the femoral condyles there, and your "heart" is a cruciate ligament.

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  9. something is horribly wrong in the back - massively overdeveloped muscles? and a small pneumomediastinum in the front.

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  10. hard to tell from the resolution, not quite sure what level this slice is from.

    my guess is anterior mediastinal mass?

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  11. I can't be sure, but I believe this to be a penis.

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  12. Not gonna lie, I spent some more time on this one after realizing my last answer was probably wrong. So much is off with this image. The a/p ratio is way off, the "sternum" is way too wide, the heart isn't quite in the right place, the "erector spinae" are way too big, and the guy has no vertebral column.

    So I call shennanigans.

    Here's what I think. I think your "Sternum" is a patella, your "lungs" are the meniscii, and your "aorta" is the popliteal artery. I'm no orthopedic surgeon... but my money says that's a knee.

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  13. I believe that is a stunning case of genu pectus.

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  14. What's wrong with this thorax is that it's a knee!

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  15. I agree with Jacob. Read the UpToDate article on thoracokneeosis and you'll see that treatment involves a trans-urethral frontal lobotomy.

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