Diagnosis?

**Roguish Lawyer** · 01-28-2004, 14:08

Good luck!

CPTAUSRET · 01-28-2004, 14:32

Nancy is in DC at the moment, or I would have her look at it:

Terry

Sacamuelas · 01-28-2004, 15:32

more info needed. History, symptoms, recent events that led to you taking high res. images, other images at different depths?

NousDefionsDoc · 01-28-2004, 15:36

GET HIM Jawbreaker!

**Roguish Lawyer** · 01-28-2004, 15:59

Quote:

Originally posted by Sacamuelas
more info needed. History, symptoms, recent events that led to you taking high res. images, other images at different depths?

Do I look like a doctor to you? LOL

OK, stand by. I guess I have to do this right.

**Roguish Lawyer** · 01-28-2004, 16:06

This is the only image available.

Patient is 32 yo female. Fatigue, headaches, nausea and vomiting, low-grade fever, severe muscle aches and joint pain, muscle weakness, purplish skin rashes on face and body.

Best I can do for now.

Sacamuelas · 01-28-2004, 17:05

Does patient experience pain when bending her head forward (touch chin to chest type move)?

It is not like I view a lot of images of the cranium (Doc T does I'm sure). How long have the symptoms been there? Has she received any treatment? Where on the body is the rash? Do the rashes blanche when she presses on them?

To me, the fever/rash symptoms tend to rule out tumor/aneurysm/stroke. At least they do to me, and I do not see any areas on the image that show those three problems. But again, I am not used to viewing those images.

My guess is meningitis/encephalitis. That is a wild guess though.

I know, you may not know the answers to the questions. I am just trying to work this out with you .

DOC T/surgcric/NDD ..... any HELP??

Surgicalcric · 01-28-2004, 17:17

Quote:

Originally posted by Sacamuelas
...DOC T/surgcric/NDD ..... any HELP??

None here. Need a more indepth history of symptoms? I am definately not an authority by any means on CT's. I was usually peering over Doc T's shoulder listening to her talk to the Rad Tech. She is the one to ask.

Doc T?

James D

**Eagle5US** · 01-28-2004, 20:03

Quote:

Originally posted by Roguish Lawyer
This is the only image available.

Patient is 32 yo female. Fatigue, headaches, nausea and vomiting, low-grade fever, severe muscle aches and joint pain, muscle weakness, purplish skin rashes on face and body.

Best I can do for now.

You GOTTA throw us a better bone here...this sounds like half the civilians that work in my office

The Eagle

**Roguish Lawyer** · 01-28-2004, 20:17

Well, to be fair, I know what this patient has, but I don't know whether it is apparent from the image. There are two conditions to be diagnosed, not one. I also mixed up the symptoms of the two conditions to make this harder.

Re: the first condition -- patient has ugly purple blotches that appear on face, arms and other parts of body periodically, particularly when under great stress. They go away eventually. Extreme muscle pain and weakness associated with these flare-ups.

The second unrelated condition was diagnosed from imaging taken to determine whether the first condition is affecting the brain; the imaging was not done because there were symptoms of the second condition.

**Roguish Lawyer** · 01-28-2004, 20:44

Quote:

Originally posted by Sacamuelas
Does patient experience pain when bending her head forward (touch chin to chest type move)?

Pain is not caused by that particular movement, but that movement can result in pain from time to time.

Quote:

Originally posted by Sacamuelas
To me, the fever/rash symptoms tend to rule out tumor/aneurysm/stroke.

See above.

Quote:

Originally posted by Sacamuelas
My guess is meningitis/encephalitis. That is a wild guess though

No.

**Roguish Lawyer** · 01-29-2004, 04:56

The first condition is systemic lupus erythematosus.

I am told that the second condition is visible on the image, which was taken to see if the patient's brain was affected by the lupus. I think I know where it is on the image, too.

Hint: the patient is having surgery to address the second condition.

Sacamuelas · 01-29-2004, 09:24

WTF? You post a MRI of the cranium for a diagnosis, but you list a bunch of symptoms/history that have no relation to what you want diagnosed. Why throw a knuckleball? It is difficult on its own with only one image given.

Obviously, I am stumped. I do see a few things on the MRI that caught my attention at first glance. The blue arrow is the only item I see that doesn't "jive" with normal anatomy. Any calcification, density, or hemorrhage there would show up with that appearance (white contrasted area).

I will wait for Doc T to enlighten us, if you have given her enough info to figure this out. Had to get the old neuro-anatomy book out of storage for this one. Anyway, I'm done on this thread counselor.

**Roguish Lawyer** · 01-29-2004, 12:20

Something tells me my next visit to the dentist is going to be particularly painful. I'm sure you guys talk. We do. LOL

**Eagle5US** · 01-29-2004, 12:53

But I really think this one was a bit beyond what we would consider a plausable thread for all our levels.
The SLE Dx was there in my noodle, but I couldn't relate it to the photo. I'll probably never see this type of image where I will be the knuckle trying to be the sole interpreter, though it was a sig challenge for us all. Knowing my own limitations is one of the few things I pat myself on the back for when it comes to medicine.
How about we cap this one as a learning experience, let DocT give her expertise and then you post up your concurrance or the answer?
The we'll ask FCC to close the thread.

Sounds like we lost the learning curve here. Nice try, but a bit over the top...

The Eagle