Sternal variations and anomalies have been identified in the past during autopsy or cadaveric studies. Recently, an increasing number of minor sternal variations have been reported with the advent of multidetector computed tomography (CT). Although there are many sternal variations that occur with varying appearance and prevalence, most of them are not recognized or are underreported during routine imaging of thorax. Identification of sternal variations is important to differentiate from pathological conditions and to prevent fatal complications prior to sternal interventions like marrow aspiration or acupuncture. This article aims to describe the minor and asymptomatic sternal variations by multidetector CT and their clinical significance.
We report a case of an anomalous course of the right coronary artery (RCA) through the right atrium, which was evaluated using dual-source CT angiography. There have been a few cases described previously in literature, but most of them were found either during surgery or at autopsy. Although this variant is clinically benign, it has significant consequences during interventional procedures or bypass surgery.
Synovial chondromatosis and parameniscal cysts are well documented pathologies around the knee joint. We present an unusual presentation of synovial chondromatosis masquerading as a parameniscal cyst of the knee. The patient was an 82-year old gentleman seen in our knee clinic with painful swelling over medial aspect of the right knee, no history of injury and with symptoms of a locked knee. Clinico-radiological features were suggestive of a binary pathology of a meniscal tear and multi-locular cyst of the knee. An arthroscopic assisted open excision of the cystic lesion allowed clinical recovery with histological confirmation of benign synovial chondromatosis.
We highlight the challenges in our case with the overlap of diagnostic features of both synovial and meniscal pathology with surgical management of this patient.
We report a rare case of nasopharyngeal neuroglial heterotopia in a 16-year-old girl who presented with sore throat and feeling of a lump in her throat. Neuroglial heterotopia is a mass composed of misplaced neural tissue during embryonic development which has lost its intracranial connection. A careful review of literature in PUBMED shows most of the previously reported cases of nasopharyngeal glial heterotopia presented during neonatal or infancy period with symptoms of respiratory distress or airway obstruction. Our case caused a diagnostic dilemma due to late presentation and atypical radiological findings. Imaging, especially MRI, is vital for evaluating such nasopharyngeal masses in children for pre-surgical planning and more importantly to rule out any intracranial communication. Treatment is surgical resection by endoscopic or external approach, with a rare possibility of recurrence.
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