Nanda Venkatanarasimha

Littoral cell angioma (LCA) is a rare primary splenic vascular tumour that arises from the littoral cells that line the red pulp sinuses. It is usually asymptomatic and is discovered incidentally on imaging for other pathologies. Radiologists should be aware of these lesions as they may be mistaken for malignant lesions and lead to unnecessary surgery. We present a case of LCA recurrence within a splenunculus that was discovered incidentally in a 60-year-old patient being investigated for right upper quadrant pain.

Multi-detector computed tomography (MDCT) scanner is available in most hospitals and is increasingly being used as the first line imaging in trauma and suspected cardiovascular emergencies, such as acute coronary syndrome, pulmonary artery thrombo-embolism, abdominal aortic aneurysm and acute haemorrhage (Ryan et al. Clin Radiol 60:599–607, 2005). A significant number of these patients are haemodynamically unstable and can rapidly progress into shock and death. Recognition of computed tomography (CT) signs of imminent cardiovascular decompensation will alert the clinical radiologist to the presence of shock. In this review, the imaging findings of cardiovascular emergencies in both acute traumatic and non-traumatic settings with associated signs of imminent decompensation will be described and illustrated.

Sub-trochanteric femoral fractures as a complication of long standing bisphosphonate therapy are rare. Drug regulatory authorities like MHRA in the UK (Medicines and Healthcare products Regulatory Agency) have recently alerted specialists about this complication. We describe and illustrate the plain radiographic, CT and MRI features and emphasize the role of imaging in the accurate diagnosis of this new type of insufficiency fractures. There is paucity of radiology literature on this topic and hence awareness of the typical imaging features helps to prevent misdiagnosis and delayed treatment. Our patients were on bisphosphonates (alendronate) for more than 3 years duration and presented with anterolateral thigh pain to the emergency department.