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Rad to Rad Learning: Cerebral Amyloid Angiopathy

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

 

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Early imaging-based diagnosis is critical, as hemorrhagic complications can be mitigated by avoiding certain therapies.

Superficial siderosis, sequalae of bilateral microhemorrhages and large parenchymal hemorrhage.

Axial MRI brain scan showing a circular, dark lesion near the left posterior region, possibly indicating a mass or abnormality—an ideal case for Rad to Rad Learning and collaborative diagnostic review.

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    • Causes up to 1/5 of primary intracranial hemorrhage in patients >60 years.
    • Boston criteria are used for diagnosis without biopsy using presence of multiple asymmetric lobar microhemorrhages, cortical superficial siderosis, and lobar ICH.
    • Other markers are multiple dilated perivascular spaces and white matter T2 hyperintensities (70%).
    • May show sulcal or leptomeningeal enhancement or focal nonhemorrhagic mass (amyloidoma) extending to the ventricular wall in younger patients.

Bell iconTakeaway: Suspect CAA in normotensive patients with multiple types of non-traumatic hemorrhages.

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.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 RP Clinical Services and its managed practices, together with Mosaic Clinical Technologies, Inc., its technology and AI division, is the leading provider of technology-enabled radiology services in the U.S., serving more than 3,400 hospitals and other healthcare facilities with high-quality radiology, technology and artificial intelligence solutions. As a physician-led and physician-owned practice, our mission is to transform radiology by innovating across clinical value, technology, and service, while elevating the role of radiology and radiologists in healthcare. For the latest news from RP, follow us on X, LinkedIn, Instagram, YouTube and the blog.

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Rad to Rad Learning: Osteomyelitis

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

 

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T1 marrow replacement is not necessary to diagnose osteomyelitis in the presence of subjacent ulcers.

T1 signal is darker than muscle (marrow replacement).

T1 signal is darker than muscle (marrow replacement).

T2 edema signal.

T2 edema signal.

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    • Bone marrow edema signal with T1 marrow replacement is consistent with osteomyelitis.  
    • Bone marrow edema signal without T1 marrow replacement with adjacent ulcer, abscess, or sinus tract indicates “high likelihood of osteomyelitis”.

Bell iconTakeaway: Osteo – likely no contrast needed.

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.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 RP Clinical Services and its managed practices, together with Mosaic Clinical Technologies, Inc., its technology and AI division, is the leading provider of technology-enabled radiology services in the U.S., serving more than 3,400 hospitals and other healthcare facilities with high-quality radiology, technology and artificial intelligence solutions. As a physician-led and physician-owned practice, our mission is to transform radiology by innovating across clinical value, technology, and service, while elevating the role of radiology and radiologists in healthcare. For the latest news from RP, follow us on X, LinkedIn, Instagram, YouTube and the blog.

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Rad to Rad Learning: VQ Scan

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

 

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PIOPED criteria relies on the size of segmental perfusion defects to determine the probability of pulmonary embolism.

Use the lung segmental map as a guide for determining defect size. This “single” defect is actually three segmental defects, one large and two medium sized.

Two blurry grayscale images side by side show vague shapes. The right image has an orange curved line drawn over its upper right area, while the left image has no markings, illustrating a typical scenario in Rad to Rad Learning visualizations.

Two grayscale images of a lung scan: the left image shows lung regions outlined in white, while the right highlights the upper-right lung region in blue with an orange border, demonstrating detailed focus on that area as part of Rad to Rad Learning.

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    • Small defect <25% of a lung segment.
    • Medium defect >25& to <75% of a lung segment.
    • Large defect >75% of a lung segment.
    • One visible defect may involve two or more segments.
    • Correlate with chest x-ray within 24 hours.

Bell iconTakeaway: The number and size of segmental defects matters in VQ scans.

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.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 RP Clinical Services and its managed practices, together with Mosaic Clinical Technologies, Inc., its technology and AI division, is the leading provider of technology-enabled radiology services in the U.S., serving more than 3,400 hospitals and other healthcare facilities with high-quality radiology, technology and artificial intelligence solutions. As a physician-led and physician-owned practice, our mission is to transform radiology by innovating across clinical value, technology, and service, while elevating the role of radiology and radiologists in healthcare. For the latest news from RP, follow us on X, LinkedIn, Instagram, YouTube and the blog.

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Rad to Rad Learning: Failed Fundoplication

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

 

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Your next case is this abdominal CT without history or priors. What is the diagnosis? Misdiagnosis may lead to ulceration, necrosis, perforation, and/or bleeding.

Patient has a recent history of fundoplication with gastric wrap around.

CT scans showing a large mass in the upper abdomen, likely originating from the spleen, with clear borders and different densities compared to surrounding tissues. One image is axial, the other coronal—ideal for Rad to Rad Learning and collaborative case discussions.

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    • Fundoplication has a 5 year follow-up failure rate of 4-14&, with 2.8% requiring additional surgery.
    • GERD, pain, and difficulty swallowing are common presenting symptoms.
    • Hx of surgery is key to differentiate from GIST, adenocarcinoma, esophageal varices, gastric wall hematoma or hemorrhage.
    • If there is obstruction, follow up surgery is likely required.

Bell iconTakeaway: History is crucial for narrowing the differential.

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.The Body 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 RP Clinical Services and its managed practices, together with Mosaic Clinical Technologies, Inc., its technology and AI division, is the leading provider of technology-enabled radiology services in the U.S., serving more than 3,400 hospitals and other healthcare facilities with high-quality radiology, technology and artificial intelligence solutions. As a physician-led and physician-owned practice, our mission is to transform radiology by innovating across clinical value, technology, and service, while elevating the role of radiology and radiologists in healthcare. For the latest news from RP, follow us on X, LinkedIn, Instagram, YouTube and the blog.

A dark blue background with various hexagonal shapes and lines clustered on the left side, representing rad to rad learning, gradually fading into open space on the right.

Rad to Rad Learning: Rapid Gastric Emptying

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

 

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Rapid gastric emptying and gastroparesis can both present with similar clinical symptoms. Gastric emptying examinations can definitively distinguish between the two etiologies.

 1 hour: 24% retention (normal: 30-90%)

This graph displays the change in gastric activity over time at hourly intervals.

A graph showing gastric emptying over 120 minutes with raw and linear fit lines, and a dashed line for 50% emptying. The x-axis is time in minutes; the y-axis is counts per minute. Text below states Decay Corrected by Xeleris: Yes..

 

Nuclear medicine scan showing anterior and posterior views with highlighted regions labeled ANT MEDLINE, ANT HR, ANT 3HR, POST MEDLINE, POST HR, and POST 3HR in blue outlines.

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    • Seen frequently in patients post gastric surgery, vagotomy, and early diabetes.
    • Diagnostic criteria: <30% retention at 60 minutes.
    • This diagnostic criteria only applies to the standard solid-phase meal, and a combination of anterior and posterior imaging.
    • This examination can be terminated at the 1 hour time point if <30% retention is seen at 60 minutes.

Bell iconTakeaway: Obtaining a detailed patient history is key to an accurate diagnosis.

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.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 RP Clinical Services and its managed practices, together with Mosaic Clinical Technologies, Inc., its technology and AI division, is the leading provider of technology-enabled radiology services in the U.S., serving more than 3,400 hospitals and other healthcare facilities with high-quality radiology, technology and artificial intelligence solutions. As a physician-led and physician-owned practice, our mission is to transform radiology by innovating across clinical value, technology, and service, while elevating the role of radiology and radiologists in healthcare. For the latest news from RP, follow us on X, LinkedIn, Instagram, YouTube and the blog.

A dark blue background with various hexagonal shapes and lines clustered on the left side, representing rad to rad learning, gradually fading into open space on the right.

Rad to Rad Learning: Gangrenous Cholecystitis

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

 

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Around 2% of patients with acute cholecystitis will develop gangrenous cholecystitis, which has an elevated risk of perforation and a 22% mortality rate.

Ultrasound features include gall bladder distension measuring greater than 4 cm in short axis, wall disruption, mucosal irregularity, intraluminal membranes and pericholecystic fluid.

Side-by-side medical images: left is an ultrasound showing a dark, round mass; right is an MRI with a bright, circular structure near the spine, possibly showing an abdominal aortic aneurysm. This comparative Rad to Rad Learning approach enhances diagnostic understanding by juxtaposing key imaging findings across modalities.

 

Black and white medical scan showing the liver and branching bile ducts, likely an MRI or CT image used for diagnosing liver or biliary conditions—ideal for Rad to Rad Learning, where detailed imaging is essential for case-based education and discussion.

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    • Clinical manifestations include findings of sepsis and severe right upper right quadrant pain.
    • Murphy’s sign may be absent in 2/3 of patients.
    • Risk factors include male sex, diabetes, age >45, and cardiovascular disease.
    • Urgent cholecystectomy is the appropriate management. 

Bell iconTakeaway: The hallmark is mucosal sloughing.

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.The Body 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.

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Rad to Rad Learning: Osteoid Osteoma

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

 

Peer Learning Opportunitymegaphone icon

Common benign bone tumors in young adults and adolescents are painful and can be radiographically occult.

Osteoid Osteoma

Four black and white medical images of a bone, likely CT and MRI scans, show cross-sectional and side views with a round mass near the bone’s edge. Various tissue densities and structures are visible, providing detailed visuals ideal for Rad to Rad Learning.

 

Four medical scans of a limb, ideal for Rad to Rad Learning, show a small circular lesion marked by arrows and a circle, highlighting an abnormal area near a bone, likely for diagnostic purposes.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.

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    • Cortical thickening in a young adult or adolescent should be on your differential.
    • More common in males.
    • Treatment may include ablation.
    • Look for small radiolucent nidus <2cm.
    • Differential diagnosis should include stress fracture and infection.
    • Presents with night pain relieved by NSAIDs.

Bell iconTakeaway: To confirm diagnosis, get a CT!

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.

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Rad to Rad Learning: Epidural Abscess

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

 

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Irreversible neurologic deficit is likely if treatment is delayed.

Typical findings are prominence of epidural soft tissue with peripheral enhancement and adjacent spondylodiscitis.

Three medical images: a CT scan (left), an axial MRI (center), and a sagittal MRI (right) of the lumbar spine, showing different views of spinal anatomy and structures—ideal for Rad to Rad Learning and comparative radiology education.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.

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    • Predisposing factors include intravenous drug abuse, immunocompromised state, DM, chronic renal failure, alcoholism, cx, and other chronic illnesses.
    • The common location of epidural abscess changes from posterior above L1 to anterior below the L1.
    • DWI can help in detection of abscesses.

Bell iconTakeaway: Epidural abscess could be seen without discitis in patients with hematogenous seeding or direct extension from a septic joint.

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.

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Rad to Rad Learning: Increased Renal Uptake on Bone Scan

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

 

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Bone scintigraphy is used in staging and restaging metastatic disease. However, it also provides information regarding renal function in oncology patients.

In the example below, osteoblastic osseous metastases are seen to the pelvic bones and left humerus. Additionally, asymmetric activity is noted to the right kidney in cortical morphology relative to the left kidney.

Four whole-body bone scan images in black and white, showing anterior and posterior views of two individuals. Labeled right and left sides enhance orientation—ideal for Rad to Rad Learning sessions.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.

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    • Asymmetric unilateral or bilateral renal uptake, also known as “Hot Kidney signs”, typically suggests underlying metabolic or systemic etiologies.
    • The most common etiology in oncology patients is nephrotoxicity secondary to chemotherapy or other medication.
    • Other etiologies for this finding include hypercalcemia and cirrhosis.
    • In rare instances, increased renal uptake can be seen with aluminum breakthrough from radiotracer generator production.

Bell iconTakeaway: Bone scan provides similar physiologic information on renal function as a renogram.

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.

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Rad to Rad Learning: Fat Embolism in Sickle Cell Crisis

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

 

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Without typical MRI findings Cerebral Fat Embolism can be clinically misdiagnosed as a conventional large vessel stroke or seizure in SCD.

Numerous confluent white matter microinfarcts (Starfield-pattern) and petechial microhemorrhages.

Four grayscale MRI brain scans, side by side, show cross-sectional views with varying contrasts and visible structures. Ideal for Rad to Rad Learning, the images highlight differences in brain tissue and potential abnormalities.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.

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    • Occurs in <1% of Sickle Cell Disease (SCD)
    • Fat globules released due to bone infarcts secondary to vaso-occlusion rather than fracture.
    • History, distribution of lesions and white matter involvement differentiates from DAI and septic or cardiogenic emboli.
    • 90% of patients recover, but may develop atrophy.

Bell iconTakeaway: History and MR appearance are crucial for diagnosis.

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.