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Shingo Omata @shingoomata.bsky.social · 06/03/2025

<What's your diagnosis?> A full-term infant, 5 days old #Rdiag #RadSky #MedSky #NeuroRad #FOAMed

Shingo Omata @shingoomata.bsky.social · 05/03/2025

<What's your diagnosis?> Pt: 35 y/o Female CC: Palpable mass in the right inguinal region History: Mass present for 1 year. Incidentally palpated in the upper thigh, gradually increasing in size. No history of trauma. No tenderness. #Rdiag #RadEd #MedEd #FOAMed

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Shingo Omata @shingoomata.bsky.social · 04/03/2025

<What's your diagnosis?> Pt: 36 y/o Female CC: 7-month history of extraocular muscle limitation and visual disturbance #Rdiag #RadEd #MedEd #NeuroRad #FOAMed

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Shingo Omata @shingoomata.bsky.social · 02/03/2025

<What's your diagnosis?> Pt: 24 y/o male CC: Progressive Lt. parietal skull defect Hx: First noticed at age 6, gradually enlarging, no trauma, no significant medical history Symptoms: Asymptomatic #Rdiag #RadSky #MedSky #FOAMed #FOAMRad

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Shingo Omata @shingoomata.bsky.social · 28/02/2025

<What's your diagnosis?> Pt: 60 y/o Male CC: Pain, weakness in bilateral lower limbs and urinary incontinence. #Rdiag #RadSky #MedSky #FOAMed #FOAMRad

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Shingo Omata @shingoomata.bsky.social · 28/02/2025

<What's your diagnosis?> Pt：9 y/o Female CC：Progressive scoliosis for 6 years Height: -4 SD, Weight: -3 SD Upper/lower body ratio: 0.64 (normal: 1.1) Ophthalmologic Findings：Horizontal gaze palsy #Rdiag #RadEd #MedEd #NeuroRad #FOAMRad

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Shingo Omata @shingoomata.bsky.social · 27/02/2025

<What's your diagnosis?> Pt: 42 y/o Male CC: Hypotonia, joint hyperextensibility, aphonia, micrographia, hyperreflexia, facial dystonia, cognitive decline Hx:Mid-teens: Hand tremor (onset) 35y: Gait disturbance (R foot drag) FHx: Mother affected, deceased #Rdiag #RadSky #MedSky #NeuroRad

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Shingo Omata @shingoomata.bsky.social · 26/02/2025

<Aceruloplasminemia> ✅ Symmetric iron deposition: basal ganglia, thalami, dentate nuclei, red nuclei, cortex. 🩻 Imaging CT: Hyperattenuation MRI: T1 ↑, T2 ↓, T2* ↓↓ 🔑 Key: Deep gray hyperattenuation on CT is distinctive. 🩺 Clue: Early-onset diabetes. #Rdiag #RadSky #MedSky #NeuroRad #FOAMRad

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Shingo Omata @shingoomata.bsky.social · 26/02/2025

<What's your diagnosis?> Pt: 55 y/o Male - Diabetes (insulin-dependent), alcohol abuse - DKA + 5-year cognitive decline (LTC placement) - Pigmentary retinopathy #Rdiag #RadSky #MedSky #NeuroRad #FOAMRad

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Shingo Omata @shingoomata.bsky.social · 25/02/2025

<Meningioma & 3.8 ppm Peak> 💡 Accuracy: ✅ 3.8 ppm peak in top 3 → 96.9% ✅ 3.8 ppm/Cr ≥1.44 → 92.3% ✅ Lip-Lac/Cr ≥2.07 → 80.6% 💡 Alanine presence aids diagnosis #Rdiag #RadSky #MedSky #NeuroRad #FOAMRad PMID: 34211737

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Shingo Omata @shingoomata.bsky.social · 24/02/2025

<Dyke-Davidoff-Masson Syndrome> 🩻 Imaging - Hemiatrophy of the cerebrum w/ calvarial thickening - Hyperpneumatization of sinuses ipsilateral to the hemiatrophy 💡 DDx of cerebral hemiatrophy - Rasmussen encephalitis - Sturge-Weber synd. - basal ganglia germinoma #Rdiag #RadEd #MedEd #FOAMRad

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Shingo Omata @shingoomata.bsky.social · 23/02/2025

<What's your diagnosis?> 20 y/o Male w/ seizures since age 3, dx idiopathic generalized epilepsy at 17. CC: multiple generalized seizures, LOC, & post-ictal confusion. Other: Learning difficulties, left school early, no FHx. #Rdiag #RadSky #MedSky #NeuroRad #FOAMed

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Shingo Omata @shingoomata.bsky.social · 23/02/2025

<What's your diagnosis?> Pt: 18 y/o Female CC: 4-month history of headache and dizziness and a 3-day-history of lethargy and vomiting. Neurological exam: papilledema, impaired tandem gait, and right-sided dysmetria #Rdiag #RadSky #MedSky #NeuroRad #FOAMrad

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Shingo Omata @shingoomata.bsky.social · 22/02/2025

<Papillary renal neoplasm with reverse polarity(PRNRP)> 💡 WHO 5th: Newly Defined Papillary Renal Tumor Subtype CT: Small, round, persistently enhancing lesion ("enhancing dot sign"). MRI: T2↓, mild diffusion restriction, pseudocapsule. 🔸 Some show internal heterogeneity. #Rdiag PMID: 37007143

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Shingo Omata @shingoomata.bsky.social · 22/02/2025

<What's your diagnosis?> Pt: 30 y/o Female, previously healthy . An incidental renal mass was detected, leading to further evaluation. MRI: Predominantly T2↓ w/ mild diffusion restriction. #Rdiag #RadSky #MedSky

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Shingo Omata @shingoomata.bsky.social · 21/02/2025

<What's your diagnosis?> Pt: 9 y/o Male, previously healthy CC: Frontal headache x2 wks, worsened in last 2 days Assoc: N/V, photophobia, b/l eye pain ROS: No trauma #Rdiag #RadSky #MedSky

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Shingo Omata @shingoomata.bsky.social · 20/02/2025

<Sarcoid Myopathy> ✅ “Tiger Man Sign” – patchy muscle involvement in granulomatous myositis. 🩻 MRI: Contrast-enhancing granulomas, T1↑, T2↑. 🩻 PET/CT: Hypermetabolic lymphadenopathy + intramuscular & fascial lesions. 🔬 Non-caseating granulomas #Rdaig #RadSky #MedSky PMID: 30637499

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Shingo Omata @shingoomata.bsky.social · 19/02/2025

<What's your diagnosis?> Pt: 53 y/o Male 🔹new-onset gait ataxia 🔹muscle weakness of the proximal thighs #Rdiag #RadSky #MedSky

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Shingo Omata @shingoomata.bsky.social · 19/02/2025

<Sialodochitis fibrinosa (kussmaul disease)> 🔍 Key Imaging Findings: ✅ MRI: Dilated main parotid ducts 🩻 ✅ No masses or sialolithiasis 🚫 🔹 Clinical Clues: - Mucoid secretions expelled with compression - Recurrent, food-related parotid swelling #Rdiag #RadSky #MedSky PMID: 27759642

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Shingo Omata @shingoomata.bsky.social · 19/02/2025

<What's your diagnosis?> 👩‍⚕️ 46 y/o Female 🔹 Recurrent parotid gland swelling & pain (5 years) 🔹 Triggered by food 🍽️ 🔹 Elevated eosinophils & IgE 🩸📈 #Rdiag #RadSky #MedSky

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Shingo Omata @shingoomata.bsky.social · 18/02/2025

<Pneumoparotid> Retrograde air entry into Stensen’s duct from increased intraoral pressure. Causes: -Dental procedures, positive pressure ventilation -Wind instrument playing, psychological factors -CT puff-cheek technique DDx: Suppurative parotitis (painful, inflammatory) #Rdiag #RadSky #MedSky

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Shingo Omata @shingoomata.bsky.social · 17/02/2025

<What's your diagnosis?> Pt：11 y/o Male CC：Bilateral cheek swelling, recurrent and painless x 8 months, refractory to antibiotics. #Rdiag #RadSky #MedSky

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Shingo Omata @shingoomata.bsky.social · 17/02/2025

<What's this incidental finding?> Pt: 50 y/o Male #Rdiag #RadSky #MedSky

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Shingo Omata @shingoomata.bsky.social · 16/02/2025

<Bisphosphonate-Related Complete Atypical Fracture> 🩻 Features - Focal lateral cortical thickening at the fracture site - Transverse orientation of the fracture - Medial spike - Lack of comminution 💡Note: High risk of contralateral fracture💡 #Rdiag #MSKRad #RadSky #MedSky PMID: 21940585

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Shingo Omata @shingoomata.bsky.social · 15/02/2025

<What's your diagnosis?> 64 y/o Female, post minor trauma. #Rdiag #MSKRad #RadSky #MedSky

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Shingo Omata @shingoomata.bsky.social · 15/02/2025

CIPS (Calcineurin Inhibitor-induced Pain Syndrome) ✅ Acute symmetric pain in transplant pts on CNI ✅ distal → proximal joints ✅ MRI: subchondral/periarticular edema; T1↓, T2↑ ✅ Bone scan: calcaneal uptake↑ ✅ Treatment: Ca channel blockers #Rdiag #MSKRad #RadSky #MedSky PMID: 23615775

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Shingo Omata @shingoomata.bsky.social · 15/02/2025

<What's your diagnosis?> Pt: 41 y/o Male HPI：POD 73 of cadaveric renal transplant: New onset bilateral pain in feet and ankles, ascending to knees. PMH: IgA nephropathy, HTN #Rdiag #RadEd #MedEd #MSKRad

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Shingo Omata @shingoomata.bsky.social · 14/02/2025

<Menkes disease> ✅ X-linked neurodegenerative disorder due to ATP7A mutation ✅ MRI: tortuous brain vessels, atrophy, delayed myelination ✅ Low copper enzyme activity affecting connective tissue, blood vessels, and hair structure #Rdiag #RadSky #MedSky #NeuroRad PMID: 23836947

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Shingo Omata @shingoomata.bsky.social · 14/02/2025

<What's your diagnosis?> 6-month-old twins, born to a consanguineous couple, presented with hypotonia, hypothermia, seizures, and developmental delay. #Rdiag #RadSky #MedSky #NeuroRad

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Shingo Omata @shingoomata.bsky.social · 12/02/2025

<Intradiploic pseudomeningocele> ✅ Post-op CSF accumulation in posterior fossa ✅ Pseudomeningocele = CSF in soft tissue ✅ Can form intradiploic ✅ Due to persistent opening of the dura and arachnoid #Rdiag #RadSky #MedSky #NeuroRad PMID: 28185017

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Shingo Omata @shingoomata.bsky.social · 12/02/2025

<What's your diagnosis?> 4 y/o girl w/ Chiari malformation type I underwent foramen magnum decompression and partial C1 laminectomy. A follow-up MRI was performed. #Rdiag #RadSky #MedSky #NeuroRad

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Shingo Omata @shingoomata.bsky.social · 11/02/2025

<LAMN with Acute Torsion> LAMN: Low-Grade appendiceal mucinous neoplasm ✅ Histologically adenoma but potentially malignant (risk of pseudomyxoma peritonei) ✅ Twisted stalk visible at appendiceal base between cecum and LAMN ✅ Mimics acute appendicitis #Rdiag #RadSky #MedSky PMID: 17579135

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Shingo Omata @shingoomata.bsky.social · 10/02/2025

<What's your diagnosis?> Pt: 59 y/o Male CC: Acute onset of RLQ abdominal pain L/D: WBC 12,300/μL with a slight left shift #Rdiag #RadSky #MedSky

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Shingo Omata @shingoomata.bsky.social · 10/02/2025

<Biotin-thiamine-responsive basal ganglia disease> 💡Tip: Globus pallidi sparing = 🔑 clue! MRI key findings: - B/L BG T2/FLAIR ↑ w/ globus pallidi sparing - Medial thalami & cortical involvement - DWI+ & enhancement in acute phase - Reversible w/ biotin/thiamine Rx #Rdiag #RadSky PMID: 35003475

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Shingo Omata @shingoomata.bsky.social · 09/02/2025

<What's your diagnosis?> 20 yo Male w/ recurrent neuro sx x12y: Initial episode @ 8 yo → dx'd viral encephalitis Recent: 5d GTC sz Sx include: GTC sz, choreoathetosis, dystonia, hypotonia, apraxia, ataxia All negative: LP, infectious/rheum w/u, mito panel, muscle bx #Rdiag #RadSky #MedSky

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Shingo Omata @shingoomata.bsky.social · 09/02/2025

<Pulmonary arterial cement embolization> 💡 A rare complication of vertebroplasty where bone cement forms emboli in pulmonary arteries. Lumber spine Xp: Cement embolization into lumbar veins CT: high-density within the pulmonary arteries #Rdiag #RadEd doi.org/10.5144/0256...

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Shingo Omata @shingoomata.bsky.social · 09/02/2025

<What's your diagnosis?> Pt: 73 y/o Male CC: Slowly progressive dyspnea Past Surgical History: ・Lumbar spine fixation ・Vertebroplasty (performed 7 months ago) #Rdiag #RadSky #MedSky

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Shingo Omata @shingoomata.bsky.social · 08/02/2025

<Starry sky appearance> ✅ Normal finding in a 7-year-old child ✅ May represent: - Residual red marrow - Areas of increased vascularity - Normal developmental stress from weight bearing ✅ Typically resolves by age 15 #Rdiag #RadSky #MedSky #MSKRad PMID: 37536825

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Shingo Omata @shingoomata.bsky.social · 08/02/2025

<How would you write the radiology report?> Pt: 7 y/o Male MRI performed for evaluation of the ankle following a sprain. #Rdiag #RadSky #MedSky #MSKRad

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Shingo Omata @shingoomata.bsky.social · 07/02/2025

<Emphysematous Osteomyelitis> ✅ Intraosseous "pumice stone" air pattern (96%) without cortical destruction + extraosseous gas ✅ Common site: pelvis, vertebrae, femur ✅ soft tissue inflammation with gas (79%), absence of cortical destruction (79%) #Rdiag #RadSky #MedSky PMID：30042030

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Shingo Omata @shingoomata.bsky.social · 06/02/2025

<What's your diagnosis?> 75 y/o male w/ T2DM CC: Suprapubic pain x 5 days PMH: Prostate CA (treated w/ RT + brachytherapy) #Rdiag #RadSky #MedSky

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Shingo Omata @shingoomata.bsky.social · 06/02/2025

<Idiopathic hypertrophic spinal pachymeningitis> ✅ IHSP: Rare inflammatory disease with hypertrophic dura mater inflammation. ✅ MRI: Long T2-hypointense epidural mass with peripheral enhancement. ✅ May show homogeneous enhancement, mimicking epidural lymphoma. #Rdiag #RadSky #MedSky PMID: 25732370

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Shingo Omata @shingoomata.bsky.social · 05/02/2025

<What's your diagnosis?> Pt: 41 y/o Male CC: Bilateral leg numbness and paraparesis for 3 months #Rdiag #RadSky #MedSky

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Shingo Omata @shingoomata.bsky.social · 05/02/2025

<Amyloid goiter w/ diffuse thyrolipomatosis> ✅ Amyloid goiter associates w/ thyroid lipomatosis ✅ 2° amyloidosis presents as goiter w/ fatty infiltration ✅ Thyroid lipomatosis: interstitial infiltration of mature adipose tissue #RadSky #MedSky Vallathai S et al. Int Surg J. 2024 May;11(5):840-842

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Shingo Omata @shingoomata.bsky.social · 04/02/2025

<What's your diagnosis?> Pt: 42 y/o Female CC: Progressive neck mass x 6 yrs, recent compressive symptoms PMH: T2DM PE: Neck: Lobulated, asymmetric diffuse thyroid enlargement No lymphadenopathy Labs: TFTs, CBC, BMP: WNL #Rdiag #RadSky #MedSky

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Shingo Omata @shingoomata.bsky.social · 04/02/2025

<Fibrodysplasia Ossificans Progressiva> ✅ FOP is an autosomal dominant disorder caused by ACVR1 gene mutations ✅ Onset typically occurs between ages 2-5 ✅ Characterized by progressive formation of extra bone in soft tissues #Rdiag #RadSky #MedSky #MSKRad

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Shingo Omata @shingoomata.bsky.social · 04/02/2025

<What's your diagnosis?> Pt: 18 y/o Female CC: Progressive musculoskeletal stiffness HPI: Initial cervical stiffness → thoracolumbar rigidity with firm nodules → right shoulder pain and ROM restriction. Each site preceded by pain. #Rdiag #RadSky #MedSky #MSKRad

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Shingo Omata @shingoomata.bsky.social · 03/02/2025

<Early Rheumatoid Arthritis> (Anti-GalD IgG Ab: 8.6 AU/mL (+)) ✅ Ankle joints: First symptoms in 19% of cases ✅ Intermetatarsal bursitis is a characteristic MRI finding in early RA ✅ Treatment within 1yr prevents disability progression #Rdiag #RadSky #MedSky #MSKRad PMID: 33973415, 33228769

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Shingo Omata @shingoomata.bsky.social · 03/02/2025

<What's your diagnosis?> 60 y/o Female w/ MTP joint pain & swelling Normal X-rays at previous hospital. No improvement with pain medication. L/D: WBC: 7,350/μL, CRP: 0.37 mg/dL, ESR: 126 mm/hr, RF: <11 IU/mL, Anti-CCP antibody: <0.5 U/mL #Rdiag #RadSky #MedSky #MSKRad

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