Manavendra Upadhyaya,MD
@ManavendraUpad1
Radiologist|Self employed|Manavendra Upadhyaya Imaging Center| My income=patients' money, they deserve the best| Cases are own| Aim is knowledge sharing|
Hepatic Hydatid Cyst( WHO 2001 CE 3B- transitional phase) involving Common Bile Duct & right lower lung.@mharisinghani @Mahan_Mathur @WillyRontgen @ItaniMalak @cookyscan1 @CasesCookyJar
Identification Card from my first job as a radiologist. I'll forever cherish.
Hepatic Hydatid Cyst CE4 with ball of wool sign. 33yo F.
Blink an eye & you'll miss pectus excavatum (27 week fetus).
Cystic hygroma with fetal hydrops.15 week fetus.
Easy to be distracted by emphysematous Cholecystitis( gas at fundus wall), don't miss liver metastasis. 65 yo F .
Ileo cecal tuberculosis. In med school pathology we said "lamina proprica" is our friend. In real life radiology we scream " intact mucosa" is our friend. Focus on intact mucosa to rule out malignancy.
Gall bladder carcinoma involving right liver lobe, omentum & descending portion of duodenum. Metastasis to peri portal, Porto caval & aorto caval nodes. Stage IIIb( T3,N1,Mx). Not giving proper Dx with staging in a classic case like this is MALPRACTICE. 64 yo F.
Apple core lesion in cecum with nodes in mesentery and Porto caval space( retroperitoneum).
Behold & enjoy the beauty of " Focal Nodular Hyperplasia". 26 yo F.
Initially read as "ascites" at multiple centers.26 yo F. Classic case of peritoneal carcinomatosis with " blink an eye and you'll miss" primary( bilateral ovarian malignancy).
Necrotic lymph nodes in the greater omentum. ✓Tubercular peritonitis.
Multifocal urothelial carcinoma of Bladder . 74 yo M.
Take home amount per case read is our net worth. " High volume" radiology practice is due to people working at throwaway prices. Our net worth has decreased for a radiologist in 1995.
Private practice radiology > 50%of cases are normal, ~25% are f/u(initially read by competent people), < 25%are diagnostic . The 25% Dx cases are lost after receiving proper Dx (become easy f/u cases). Commission is the king . We are surviving . FUTURE OF RADIOLOGY IS DARK.
Pyogenic hepatic abscesses secondary to cholangitis( focus on common hepatic duct).
Hirschsprung disease( short segment type, involving recto-sigmoid segment).
Gross hydronephrosis is secondary to obstructing calculus at ureteropelvic junction( focus on the shadow). 24 yo M.
Calyceal diverticulum containing calculus, ostium beautifully seen .