Mohammad, M.D.

A 35-year-old man presents with intermittent painful inflamed, swollen joints, that worsen during sleep. What does the hand X-ray show?

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 Multiple well defined punched out erosive lesions with sclerotic changes in a juxta-articular pattern are visualized via X-ray. Over-hanging edges, sometimes known as rate-bite erosions, are seen at these locations. 

Surrounding soft tissues may demonstrate pathogomonic tophi which appear as opacities adjacent to the joint spaces on radiograph. Joint effusions can be seen. The joint space is intact in earlier stages of disease, but, in late-stage disease, there is joint space narrowing.

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What is your diagnosis from this hand X-ray?

Image IQ Quiz: Patient Presents with Swollen Joints

A young patient presents with ongoing chronic seizures.

 Subcortical and cortical “tubers” can be seen on MRI with T2 hyperintensity and T1 hyperintensity. A minority of lesions show enhancement, and there are frequently calcifications also seen later in life. If there is enhancement, there is typically intense enhancement. White matter nodular ill-defined, band-like and cystic lesions can be seen.

In a young patient with chronic seizures, what is the diagnosis?

Image IQ Quiz: Young Patient Presents with Chronic Seizures

 On X-ray, key finding includes bowel obstruction as evidenced in diffusely dilated small and large bowel. Further imaging can be performed with fluoroscopy with contrast enema. 

Surgical treatment is the recommended intervention and includes removal of the affected segment of the colon.

A 2-day-old baby fails to pass meconium - what is your diagnosis?

Mohammad, M.D.

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Image IQ Quiz: Patient Presents with Swollen Joints

Image IQ Quiz: Young Patient Presents with Chronic Seizures

Image IQ: Neonatal Patient Fails to Pass Meconium