The Radiology Partners (RP) Interventional Radiology National Subspecialty Division (NSD) presents our newest Rad to Rad Learning case. 

Peer Learning Opportunity

High-risk features should be identified and described to direct management (surgical, endovascular, or hybrid).

Report true / false lumen extension into coronaries, arch vessels, and visceral arteries.

Shared to improve patient safety and healthcare delivery in the provision of radiology services. The circumstances and facts are changed, altered, or deidentified to preserve confidentiality. Privileges have not been waived.

Practical Insights

High Risk Features:

• • Hemothorax / hemopericardium.
  • End organ infarction.
  • Aortic diameter >40mm, false lumen diameter >22mm.
  • Entry tear on the lesser curvature of the aorta.
  • Refractory pain and/or hypertension.

Takeaway: Accurate characterization of dissections improves survival.

The  Interventional Radiology National Subspecialty Division (NSD) is part of RP’s Clinical Value Team, which works to elevate patient care and enhance value through innovation, collaboration and education. To advance this goal, our radiologists and advanced practice providers are committed to sharing peer learning as valuable reminders and insights about what we encounter in our day-to-day practice. Check back here and on X, LinkedIn and Instagram to see these common cases and our findings.

Visit the Clinical Resources page for more cases and to see what we’ve developed to enhance best practice recommendations, elevate image quality and patient care and update current standards throughout RP’s network of practices, all to deliver excellent radiology services to patients, referring clinicians and client partners.

Radiology Partners, through its owned and affiliated practices, is a leading physician-led and physician-owned technology-enabled radiology practice in the U.S. For the latest news from RP, follow us on X, LinkedIn, Instagram, YouTube and the blog.

The Radiology Partners (RP) Neuroradiology National Subspecialty Division (NSD)  presents our newest Rad to Rad Learning case. 

Peer Learning Opportunity

 High risk of intraoperative hemorrhage with over 10% mortality rate if surgical removal is attempted.

Typical findings are well-defined, homogeneous, markedly T2 hyperintense, avidly enhancing cavernous sinus lesion.

Shared to improve patient safety and healthcare delivery in the provision of radiology services. The circumstances and facts are changed, altered, or deidentified to preserve confidentiality. Privileges have not been waived.

Practical Insights

• • Marked T2 hyperintensity, vascular encasement, progressive “filling-in”, vascular blush, or the absence of hyperostosis, vascular narrowing, or connection to the pituitary gland differentiates it from meningioma, adenoma, schwannoma, or metastasis.

Takeaway: : Pre-treatment diagnosis is critical since lesion is radiosensitive, but surgically challenging.

The  Neuroradiology National Subspecialty Division (NSD) ) is part of RP’s Clinical Value Team, which works to elevate patient care and enhance value through innovation, collaboration and education. To advance this goal, our radiologists and advanced practice providers are committed to sharing peer learning as valuable reminders and insights about what we encounter in our day-to-day practice. Check back here and on X, LinkedIn and Instagram to see these common cases and our findings.

Visit the Clinical Resources page for more cases and to see what we’ve developed to enhance best practice recommendations, elevate image quality and patient care and update current standards throughout RP’s network of practices, all to deliver excellent radiology services to patients, referring clinicians and client partners.

Radiology Partners, through its owned and affiliated practices, is a leading physician-led and physician-owned technology-enabled radiology practice in the U.S. For the latest news from RP, follow us on X, LinkedIn, Instagram, YouTube and the blog.

The Radiology Partners (RP) Cardiothoracic Imaging National Subspecialty Division (NSD) presents our newest Rad to Rad Learning case. 

Peer Learning Opportunity

This patient has a normally functioning pacemaker, but where is the tip of this pacer lead?

Artifacts present in standard axial views can make it difficult to localalize the tips of pacer leads. Oblique MPRs should be used to clarify positioning.

Shared to improve patient safety and healthcare delivery in the provision of radiology services. The circumstances and facts are changed, altered, or deidentified to preserve confidentiality. Privileges have not been waived.

Practical Insights

• • Even though pacer lead complications are rare, pacemakers are common devices.

  • Devices may be functional even with perforation, but may result in complications on attempted lead placement.

Takeaway: Lead perforation may not be clinically evident, but can be detected by imaging.

The  Cardiothoracic Imaging National Subspecialty Division (NSD) is part of RP’s Clinical Value Team, which works to elevate patient care and enhance value through innovation, collaboration and education. To advance this goal, our radiologists and advanced practice providers are committed to sharing peer learning as valuable reminders and insights about what we encounter in our day-to-day practice. Check back here and on X, LinkedIn and Instagram to see these common cases and our findings.

Visit the Clinical Resources page for more cases and to see what we’ve developed to enhance best practice recommendations, elevate image quality and patient care and update current standards throughout RP’s network of practices, all to deliver excellent radiology services to patients, referring clinicians and client partners.

Radiology Partners, through its owned and affiliated practices, is a leading physician-led and physician-owned technology-enabled radiology practice in the U.S. For the latest news from RP, follow us on X, LinkedIn, Instagram, YouTube and the blog.

The Radiology Partners (RP) NMMI Radiology National Subspecialty Division (NSD) presents our newest Rad to Rad Learning case. 

Peer Learning Opportunity

Diagnosis of prosthetic loosening (septic or aseptic) can be achieved with three-phase bone scan using proper technique and specific scintigraphic findings.

63/yo F with right knee pain, bilateral TKAs in 2010

Flow Phase: Asymmetric tracer uptake on the right.

Shared to improve patient safety and healthcare delivery in the provision of radiology services. The circumstances and facts are changed, altered, or deidentified to preserve confidentiality. Privileges have not been waived.

Practical Insights

• • Time since surgery is important history. Patients can have reactive uptake on all three phases up to 1-2 years since surgery.

  • Cemented prostheses usually revert to baseline uptake after one year. Non-cemented prostheses can take up to two years.

  • Laterality and site of pain are also essential history that increase the diagnostic yield.

Takeaway: Abnormal uptake in all three phases likely indicates septic loosening.

The  The NMMI Radiology National Subspecialty Division (NSD) is part of RP’s Clinical Value Team, which works to elevate patient care and enhance value through innovation, collaboration and education. To advance this goal, our radiologists and advanced practice providers are committed to sharing peer learning as valuable reminders and insights about what we encounter in our day-to-day practice. Check back here and on X, LinkedIn and Instagram to see these common cases and our findings.

Visit the Clinical Resources page for more cases and to see what we’ve developed to enhance best practice recommendations, elevate image quality and patient care and update current standards throughout RP’s network of practices, all to deliver excellent radiology services to patients, referring clinicians and client partners.

Radiology Partners, through its owned and affiliated practices, is a leading physician-led and physician-owned technology-enabled radiology practice in the U.S. For the latest news from RP, follow us on X, LinkedIn, Instagram, YouTube and the blog.

The Radiology Partners (RP) Neuroradiology National Subspecialty Division (NSD) presents our newest Rad to Rad Learning case. 

Peer Learning Opportunity

The possibility of intracranial extension of sinus infection results in high morbidity.  

Pott’s Puffy Tumor 

Subperiosteal abscess related to extension of acute frontal sinusitis through the calvarium.

Shared to improve patient safety and healthcare delivery in the provision of radiology services. The circumstances and facts are changed, altered, or deidentified to preserve confidentiality. Privileges have not been waived.

Practical Insights

• • Factors that increase the risk of developing Pott’s include trauma, intranasal cocaine use, methamphetamine use, and craniotomy.

  • Commonly associated intracranial extension needs to be evaluated with an MRI.

  • The overlying calvarium can remain intact.

  • DWI sequence is key for abscess evaluation.

  • More common in adolescents.

Takeaway: Prompt identification is required to avoid significant neurologic complications. 

The  Neuroradiology National Subspecialty Division (NSD) is part of RP’s Clinical Value Team, which works to elevate patient care and enhance value through innovation, collaboration and education. To advance this goal, our radiologists and advanced practice providers are committed to sharing peer learning as valuable reminders and insights about what we encounter in our day-to-day practice. Check back here and on X, LinkedIn and Instagram to see these common cases and our findings.

Visit the Clinical Resources page for more cases and to see what we’ve developed to enhance best practice recommendations, elevate image quality and patient care and update current standards throughout RP’s network of practices, all to deliver excellent radiology services to patients, referring clinicians and client partners.

Radiology Partners, through its owned and affiliated practices, is a leading physician-led and physician-owned technology-enabled radiology practice in the U.S. For the latest news from RP, follow us on X, LinkedIn, Instagram, YouTube and the blog.

The Radiology Partners (RP) Neuroradiology National Subspecialty Division (NSD) presents our newest Rad to Rad Learning case. 

Peer Learning Opportunity

Progressive increase in intracranial pressure over time is life threatening.

Tension Pneumocephalus 

Note the progressive compression of the frontal lobes by air with widening of interhemispheric spaces. 

Shared to improve patient safety and healthcare delivery in the provision of radiology services. The circumstances and facts are changed, altered, or deidentified to preserve confidentiality. Privileges have not been waived.

Practical Insights

• • Occurs most commonly after SDH evacuation, but can also be seen after skill base or sinonasal surgeries, head trauma, and nitrous oxide anesthesia.

  • Treated with ventriculostomy, craniotomy, and dural defect closure.

Takeaway: Symptomatic enlarging pneumocephalus is a neurosurgical emergency.

The Neuroradiology National Subspecialty Division (NSD) is part of RP’s Clinical Value Team, which works to elevate patient care and enhance value through innovation, collaboration and education. To advance this goal, our radiologists and advanced practice providers are committed to sharing peer learning as valuable reminders and insights about what we encounter in our day-to-day practice. Check back here and on X, LinkedIn and Instagram to see these common cases and our findings.

Visit the Clinical Resources page for more cases and to see what we’ve developed to enhance best practice recommendations, elevate image quality and patient care and update current standards throughout RP’s network of practices, all to deliver excellent radiology services to patients, referring clinicians and client partners.

Radiology Partners, through its owned and affiliated practices, is a leading physician-led and physician-owned technology-enabled radiology practice in the U.S. For the latest news from RP, follow us on X, LinkedIn, Instagram, YouTube and the blog.

The Radiology Partners (RP) Body Imaging Subspecialty Division (NSD) presents our newest Rad to Rad Learning case. 

Peer Learning Opportunity

This condition affects 1-2% of pregnancies. With associated bleeding, 1st trimester pregnancies are at a risk of up to 18%. 

Ectopic Pregnancy: 93-97% of ectopics are tubal. Tubal ring sign has 95% PPV for ectopic. Visible double decidual sign of the intrauterine sac indicates low probability of ectopic. 

Fluid in the endo canal is pseudosac (yellow arrow) vs. Ectopic (purple arrow)

Shared to improve patient safety and healthcare delivery in the provision of radiology services. The circumstances and facts are changed, altered, or deidentified to preserve confidentiality. Privileges have not been waived.

Practical Insights

• • Check for adnexal masses and amount of free fluid in the hepatorenal recess to determine significance.

  • Complex free fluid may represent blood products.

  • Quantitative beta HCG levels are required. Levels >2500 are highly suspicious for occult ectopic.

  • Surgery is recommended for ectopic >3.5cm or if cardiac activity is present.

Takeaway: Always report size of ectopic. If >3.5cm, surgery is recommended. 

The Body Imaging Subspecialty Division (NSD) is part of RP’s Clinical Value Team, which works to elevate patient care and enhance value through innovation, collaboration and education. To advance this goal, our radiologists and advanced practice providers are committed to sharing peer learning as valuable reminders and insights about what we encounter in our day-to-day practice. Check back here and on X, LinkedIn and Instagram to see these common cases and our findings.

Visit the Clinical Resources page for more cases and to see what we’ve developed to enhance best practice recommendations, elevate image quality and patient care and update current standards throughout RP’s network of practices, all to deliver excellent radiology services to patients, referring clinicians and client partners.

Radiology Partners, through its owned and affiliated practices, is a leading physician-led and physician-owned technology-enabled radiology practice in the U.S. For the latest news from RP, follow us on X, LinkedIn, Instagram, YouTube and the blog.

The Radiology Partners (RP) Pediatric Radiology National Subspecialty Division (NSD) presents our newest Rad to Rad Learning case.

Peer Learning Opportunity

This condition is associated with high morbidity but is difficult to see on supine neonates.

Anterior Pneumothorax

Hallmarks: Deep sulcus sign, no lung marking at the edge of right lung, increased sharpness of the cardiomediastinal border, more prominent on expiration.

Shared to improve patient safety and healthcare delivery in the provision of radiology services. The circumstances and facts are changed, altered, or deidentified to preserve confidentiality. Privileges have not been waived.

Practical Insights

• • May be bilateral.

  • Can occur in both term and preterm babies.

  • Compare lung lucency between both sides.

  • Decubitus radiograph can be a helpful tool for confirmation.

Takeaway: Even a suspected pneumothorax is a critical result and should be called.

The Pediatric Radiology National Subspecialty Division (NSD) is part of RP’s Clinical Value Team, which works to elevate patient care and enhance value through innovation, collaboration and education. To advance this goal, our radiologists and advanced practice providers are committed to sharing peer learning as valuable reminders and insights about what we encounter in our day-to-day practice. Check back here and on X, LinkedIn and Instagram to see these common cases and our findings.

Visit the Clinical Resources page for more cases and to see what we’ve developed to enhance best practice recommendations, elevate image quality and patient care and update current standards throughout RP’s network of practices, all to deliver excellent radiology services to patients, referring clinicians and client partners.

Radiology Partners, through its owned and affiliated practices, is a leading physician-led and physician-owned technology-enabled radiology practice in the U.S. For the latest news from RP, follow us on X, LinkedIn, Instagram, YouTube and the blog.

The Radiology Partners (RP) MSK National Subspecialty Division (NSD) presents our newest Rad to Rad Learning case.

Peer Learning Opportunity

This finding represents a compressive neuropathy of the interdigital nerve primarily in the 2nd and 3rd intermetatarsal spaces.

Morton’s Neuroma

Shared to improve patient safety and healthcare delivery in the provision of radiology services. The circumstances and facts are changed, altered, or deidentified to preserve confidentiality. Privileges have not been waived.

Practical Insights

• • Presents with radiating pain, throbbing, numbness, and burning from the webspace into the toes. (Walking on marbles.)

  • Differential diagnosis: fracture, osteonecrosis, bursitis, synovial cyst.

  • Can have concomitant intermetatarsal bursitis.

  • AKA Intermetatarsal perineural fibrosis.

Takeaway: Common cause of forefoot pain – best seen on T1 weighted sequences.

The MSK National Subspecialty Division (NSD) is part of RP’s Clinical Value Team, which works to elevate patient care and enhance value through innovation, collaboration and education. To advance this goal, our radiologists and advanced practice providers are committed to sharing peer learning as valuable reminders and insights about what we encounter in our day-to-day practice. Check back here and on X, LinkedIn and Instagram to see these common cases and our findings.

Visit the Clinical Resources page for more cases and to see what we’ve developed to enhance best practice recommendations, elevate image quality and patient care and update current standards throughout RP’s network of practices, all to deliver excellent radiology services to patients, referring clinicians and client partners.

Radiology Partners, through its owned and affiliated practices, is a leading physician-led and physician-owned technology-enabled radiology practice in the U.S. For the latest news from RP, follow us on X, LinkedIn, Instagram, YouTube and the blog.

The Radiology Partners (RP) Pediatric Radiology National Subspecialty Division (NSD) presents our newest Rad to Rad Learning case.

Peer Learning Opportunity

Slipped Capital Femoral Epiphysis (SCFE) is a common and urgent diagnosis and needs to be communicated with the referring provider.

Slipped Capital Femoral Epiphysis

Note the medial and posterior displacement of the right femoral head and widened physis. Frog lateral views are generally more sensitive.

Shared to improve patient safety and healthcare delivery in the provision of radiology services. The circumstances and facts are changed, altered, or deidentified to preserve confidentiality. Privileges have not been waived.

Practical Insights

• • Commonly missed diagnosis that leads to increased complications.

  • Complications include osteonecrosis, chondrolysis, chronic pain, and growth arrest.

  • Having a high index of suspicion is helpful.

  • For at-risk patients, compare the hips on both views.

Takeaway: Make sure to communicate positive findings to the referring provider.

The Pediatric Radiology National Subspecialty Division (NSD) is part of RP’s Clinical Value Team, which works to elevate patient care and enhance value through innovation, collaboration and education. To advance this goal, our radiologists and advanced practice providers are committed to sharing peer learning as valuable reminders and insights about what we encounter in our day-to-day practice. Check back here and on X, LinkedIn and Instagram to see these common cases and our findings.

Visit the Clinical Resources page for more cases and to see what we’ve developed to enhance best practice recommendations, elevate image quality and patient care and update current standards throughout RP’s network of practices, all to deliver excellent radiology services to patients, referring clinicians and client partners.

Radiology Partners, through its owned and affiliated practices, is a leading physician-led and physician-owned technology-enabled radiology practice in the U.S. For the latest news from RP, follow us on X, LinkedIn, Instagram, YouTube and the blog.