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

<Normal development in neonatal brain imaging> ✅ The anterior pituitary may show T1↑ like the posterior, mimicking hemorrhage. ✅ The subthalamic nucleus and globus pallidus show T1↑, 💡 A small subdural hematoma: Associated w/ vaginal delivery. www.medicalk.net/jspr_journal...

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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

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

<Lipoma with osseous metaplasia> CT: ✅ Well-defined mass ✅ Irregular linear ossified components ✅ Low-attenuation fatty background ✅ No continuity with adjacent bone MRI: ✅ T1: ↑ (fat) + ↓ (bone) ✅ T2: ↑ (fat) + ↓ (bone) + focal ↑ (soft tissue) ✅ No contrast enhancement → Poor vascularity

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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

<Cavernous Hemangiomas in the Cavernous Sinus> MRI ✅ Strong hyperintensity on T2WI ✅ Homogeneous ✅ Extension from intrasellar to suprasellar ✅ Dumbbell shape 💡 When all 4 findings are present 　⇨ sensitivity 87.5%, specificity 96.3% PMID: 12812943

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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

<Gorham-Stout Disease> ✅ Progressive bone resorption (outer skull resorbed, inner layer preserved) ✅ Vascular shaped contrast enhancement within the single lesion on MRI ✅ Asymptomatic, no signs of inflammation #Rdiag #RadSky #MedSky #NeuroRad #FOAMed PMID: 32117063

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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

<Horizontal Gaze Palsy with Progressive Scoliosis（HGPPS）> ✅ Pinhole pons appearance - pontine hypoplasia, fourth ventricle floor depression ✅ Butterfly medulla - absent cuneate/gracile nuclei, prominent olivary nuclei ✅ Absent pyramidal decussation and transverse pontine fibers on tractography

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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

<Neuroferritinopathy> 💡 Basal ganglia cystic degeneration in advanced stages 🩻 MRI T2∗WI: Earliest finding → Marked ↓ signal (iron deposition) T2WI: ↓ Signal (iron) in early stage, ↑ Edema/Gliosis in middle stage Atrophy: Frontal lobe, cerebellum PMID: 21808735

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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

Thanks!! Please check my answer post out, if you would like.

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

<Rosette-Forming Glioneural tumor> #Rdiag ✅ Young females, fourth ventricle. ✅ Solid or solid-cystic. ✅ Low cellularity, mucinous matrix → T2 ↑. ✅ 65% : "green bell pepper sign" (post-contrast). ✅ Cystic: 53%, Hydrocephalus: 43%, Calcification: 25%. 💡 WHO Grade I, but CSF dissemination isn't rare.

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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

<Spontaneous Arachnoid Cyst Rupture w/ Subdural Hygroma> ✅ Arachnoid cysts may rupture from trauma, surgery, or Valsalva strain. ✅ Complications: Rare subdural hygroma, hematoma, hemorrhage. ✅ MRI findings: Subdural hemorrhage (2.43%), hygroma (0.46%). PMID: 26989525

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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

<Osteoma cutis> ✅ Benign, non-invasive soft tissue calcification (mainly face/scalp) ✅ Primary or secondary (iatrogenic, traumatic, metabolic, inflammatory, neoplastic) ✅ Usually asymptomatic #Rdiag #RadSky #MedSky #MSKRad doi.org/10.53347/rID...

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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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