There are still limited places available for the Sep 5-6th courses and the Sep 12-13th courses. Early registrants will be exposed to more emailed material and personalised feedback!
Johnny Vlahos
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Emailed cases with feedback on your responses will start in about 1 week for registrants already signed up for the autumn FRCR Grayscale Vlahos courses. This will included complex cases with learning points taken step by step, conventional FRCR viva cases, long cases and rapid reporting material.
There are still limited places available for the Sep 5-6th courses and the Sep 12-13th courses. Early registrants will be exposed to more emailed material and personalised feedback! Johnny Vlahos
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This is somewhat of Aunt Minnie diagnosis. On first inspection the images of the bone isotope study demonstrate extensive non-osseous uptake in the lower limbs below the knee. This resembles skin contamination but it can be seen that the uptake is symmetrical and comparable on anterior and posterior images. There is also no uptake related to the urinary catheter which would be expected in skin urinary contamination. The history states obesity and the images clearly demonstrate that there is a symmetrical excess of soft tissues and that unusually this is more prominent in the lower limbs than in the upper torso. This distribution of peripheral uptake is characteristic of lymphoedema. While bone isotope imaging is not a typical test for evaluation of this entity it is worth recognising the distinct appearances. More usually patients are evaluated by lymphoscintigraphy to evaluate the distribution of nodes and lymphatic channels, this being a replacement to the lost art of lymphography. Pelvic MRI can be used to evalaute both the presence of unusual lymphatic dilatations or of alternative pathology due to compressive pathology on the venous system. More superiorly CT or MR can evaluate venous compression or pathology near the expected location of the cisterna chyli or thoracic duct in the posterior mediastinum.
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