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New series - "When Images Speak: A Case-Based Journey from Scan to Slide"

Radiology is often described as the art of seeing the unseen — but its true power emerges when the grayscale of an image meets the colors of pathology. "When Images Speak: A Case-Based Journey from Scan to Slide" takes you through real clinical stories where diagnostic imaging and histopathology are not separate silos, but two halves of the same truth. Each case begins with the patient’s presentation, unfolds through key radiological findings, and concludes at the histopathology bench — revealing how images translate into microscopic confirmation. This integrated approach not only sharpens diagnostic accuracy but also deepens our understanding of disease processes, bridging the gap between radiologists and pathologists. In this series, you’ll see how a subtle shadow becomes a specimen, how a pattern in pixels transforms into a slide under the microscope, and how each step brings us closer to the patient’s definitive diagnosis. ✍️  Written by Dr. Upasana | Radioglia 🎓 For mor...
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"Cervical Funneling in Preterm Labor – What Every Radiologist Should Know"

🚨 The Call That Changed the Day “Hi, this is Dr. Y from OBGYN. Can you do a quick cervical length scan for a 26-weeker with uterine tightening?”*  It wasn’t unusual to get such calls—but the tone hinted at urgency. The patient, a 32-year-old gravida 2 para 1, had presented with mild lower abdominal pain. Her history? A previous preterm delivery at 28 weeks. Her current pregnancy had been uneventful so far—until today. The OBGYN team suspected cervical insufficiency. And that meant it was time for a "Transvaginal ultrasound". 🔍 On the Monitor: Something More Than a Short Cervix The grayscale image appeared, crisp and clear. The endocervical canal was no longer a smooth, long T-shaped tube. Instead, it opened up at the internal os, tapering like a funnel. This was "cervical funneling"—a subtle but significant sign that the cervix was losing its integrity, and the pregnancy might be at risk.  📚 What Is Cervical Funneling? Cervical funneling refers to the progressive...
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Xanthogranulomatous Oophoritis: A Radiologic Masquerader

  Xanthogranulomatous oophoritis  is a rare, chronic inflammatory condition affecting the ovary, characterized histologically by lipid-laden macrophages (foamy histiocytes), plasma cells, and multinucleated giant cells. It is often confused with ovarian neoplasms due to its imaging appearance and clinical presentation. 📸  Imaging Findings of Xanthogranulomatous Oophoritis 1. Ultrasound (US) Complex adnexal mass : May appear as a multiloculated, cystic-solid mass. Heterogeneous echotexture : Due to mixed inflammatory and necrotic tissue. Septations  or  internal debris : Mimics tubo-ovarian abscess or neoplasm. No specific vascular pattern  on Doppler – may or may not show peripheral flow. 2. CT Scan Enlarged ovary or tubo-ovarian mass : Complex with solid and cystic components. Low-attenuation areas : Correspond to necrosis or pus. Peripheral enhancement : Suggests inflammation. Fat stranding  and  inflammatory changes  in adjacent tissues (...
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Spontaneous Reduction of Obstructed Hernia Under General Anesthesia: A Radiology and Surgery Perspective

 Imagine preparing to operate on an obstructed hernia… and as soon as general anesthesia (GA) is induced, the hernia disappears. No bulge. No obstruction. No need for surgery, right? Wrong. 🔍 What Just Happened? The phenomenon is called  spontaneous reduction , where the hernia slips back into the abdominal cavity due to muscle relaxation under GA. While it may seem like a stroke of luck, this can  dangerously mask underlying bowel ischemia or obstruction . 🩺  Surgical Perspective: The Hidden Danger Muscle relaxation  under GA reduces intra-abdominal pressure, allowing herniated bowel to reduce. This is especially common in  inguinal and femoral hernias . It might  falsely reassure  the team that surgery is no longer needed. But what if the reduced bowel is  non-viable or strangulated ? If you close the case without inspecting the bowel, you risk  missing ischemia , which may lead to  perforation, peritonitis, or death . 🚩 The mo...
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🧠 Voiding Dysfunction in Children: What Every Radiology Resident Should Kno

  🚽 Why It Matters Pediatric voiding dysfunction is one of the most  common but underappreciated referrals  to pediatric radiologists. While most children with urinary incontinence don’t have an underlying anatomic abnormality, imaging can be the  key to unlocking missed diagnoses , guiding treatment, and providing parental reassurance. This blog post explores the  embryology, neural control, clinical presentation , and  radiologic approach  to voiding dysfunction in children — so you, as a radiology resident, know when and what to look for. 🧬 The Embryologic Link: Why Bladder and Bowel Go Hand-in-Hand During 4–6 weeks of gestation, the  cloaca divides  into the bladder (anterior) and rectum (posterior). This shared origin means: Both organs are innervated by  S2–S4 sacral segments Dysfunction in one often affects the other Constipation can worsen urinary incontinence 🔁  Think of it as a two-way street between rectal and bladder ...
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Is It Just “Hydronephrosis”? Why We Needed a New Language in Pediatric Urinary Tract Dilation

  Ever received a fetal scan report saying “mild pyelectasis,” and then the postnatal ultrasound called it “hydronephrosis”? Was it the same thing? Did it need follow-up? Antibiotics? A VCUG? Or was it just going to resolve on its own? If you’ve been asking these questions in your rounds or reports—you’re not alone. Let’s unravel the  why ,  what , and  how  of the updated  UTD Classification System  for pediatric urinary tract dilation, and why it matters for us as residents in radiology and pediatrics alike. 🔍  Why was a new classification system needed? Confusing Terminology : Terms like  hydronephrosis ,  pyelectasis ,  pelviectasis , and  pelvicaliectasis  were being used interchangeably—but not consistently. Disjointed Communication : Antenatal and postnatal reports often didn’t “speak the same language.” Pediatricians, nephrologists, urologists, and radiologists all interpreted the findings differently. Missed or O...
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Image-Guided Percutaneous Biopsy of Gastric Lesions

Hello Believers! Yesterday I performed USG guided percutaneous biopsy on a case of endoscopy negative gastric mass. Here are some take aways. - Gastric lesions are most commonly evaluated via "endoscopy with biopsy". - However, in certain cases — especially when the lesion is "submucosal, extrinsic, or inaccessible endoscopically" — "image-guided percutaneous biopsy" becomes necessary. - These techniques are increasingly used in "interventional radiology" with good diagnostic yield and safety profiles. 1. Indications for Percutaneous Biopsy - Endoscopy failure (due to poor access or inadequate sampling) - Large exophytic gastric masses - Suspicion of GISTs (Gastrointestinal Stromal Tumors)with extragastric growth - Lymphomas or metastases presenting as gastric wall thickening Reference:* Kim JH et al. Radiology*. 2014. CT-guided biopsy for gastrointestinal masses showed high diagnostic accuracy and minimal complications.  2. Imaging Modalities Us...
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