Faculty Bibliography

Sarcoidosis is an idiopathic multisystem disorder characterized by noncaseating granulomas. The article focuses on the typical imaging manifestations of sarcoid and the common differentials that need to be included when appropriate. Mistaking a sarcoid-mimicking disease for sarcoid can result in increased patient morbidity and mortality. The pulmonary system is the most common system involved and is typically the best understood by the radiologist, however a deeper knowledge of the pulmonary findings and features of sarcoid in other organ systems is critical. There is a myriad of sarcoid imaging manifestations that can involve every organ system. Often a confidant diagnosis of sarcoid can be made, however a broad differential may need to be considered- differential diagnoses include primary neoplasm, metastatic disease, infectious, and inflammatory etiologies. Radiologist familiarity with the multimodality multisystem imaging findings of sarcoid can help guide clinical management and optimize patient care.

There are numerous benefits to increasing diversity and inclusion within our radiology departments, and both areas need to be a part of our core mission to garner real change. A diverse and inclusive radiology department not only benefits the radiology department, but also our patients and society as a whole. Our paper provides our thoughts on a practical step-by-step guide on how to increase both diversity and inclusion within the radiology workplace, such that every voice can be heard, and every person can be seen.

Acute aortic syndrome can be a fatal pathology if not diagnosed and managed early. Although acute aortic syndrome is more often a diagnosis of adulthood, it may occasionally afflict the pediatric patients. We herein present a case of a 5-year-old female that was discovered to have multiple acute and congenital aortic abnormalities after presenting to the emergency department with infectious symptoms and lower extremity pain. Acute aortic syndrome may not be a top differential consideration in children with acute chest pain; however, it is important to consider because delayed diagnosis and management can have fatal implications.

The aim of this paper is to describe the varying clinical and imaging manifestations of Osteogenesis Imperfecta (OI) in the fetus, the child, and the adult. OI is a genetic disorder with mutation of Type 1 and non-type 1 collagen genes that results in disruption of multiple collagen based organ systems, most notably bones, often leading to "brittle bones". Additional features such as blue sclera, dentinogenesis imperfecta, joint and ligamentous hyperlaxity, hearing loss and cardiac defects may be present. Currently, there are at least 30 recognized genetic forms of OI. Given the multiple genes involved, variable genetic inheritance, and the wide range in phenotype, diagnosis can be challenging. While OI may sometimes be diagnosed in the fetus, patients with mild forms of OI may be diagnosed in childhood or even in adulthood. Imaging, including ultrasound, radiography, computed tomography, and magnetic resonance imaging, plays an important role in the diagnoses of OI in the fetus, the child, and the adult. Imaging is also crucial in identifying the many multisystem manifestations of OI. In particular, imaging can help differentiate manifestations of OI from injuries sustained in non-accidental trauma. Age, severity and manner of presentation of OI vary broadly depending on the specific genetic mutation involved, mode of inheritance, and age of the patient. Successful diagnosis of OI hinges on a detailed knowledge of the variable presentation and complications that may be encountered with this disease. CONCLUSION: In conclusion, OI comprises a heterogeneous group of genetic disorders responsible for bone fragility and additional connective tissue disorders, which can result in specific clinical and imaging findings in the fetus, the child, and the adult.

As research continues to demonstrate successes in the use of percutaneous trans-vascular techniques in structural heart intervention, both the subspecialty trained and non-subspecialty trained cardiac imager find themselves performing and reporting larger amounts of information regarding cardiovascular findings. It is therefore imperative that the imager gains understanding and appreciation for how these various measurements are obtained, as well as their implication in a patient's care. Cardiac gated computed tomography (CT) has solidified its role and ability at providing high resolution images that can be used to obtain the key measurements used in structural heart intervention planning. This manuscript aims to provide an overview of what measurements are necessary to report when interpreting CT examinations purposed for structural heart intervention. This includes a review on indications and brief discussion on complications related to these procedures.

An ectopic pregnancy carries the potential for disastrous maternal complications. Early first trimester pelvic ultrasound examinations are frequently obtained in cases of pelvic pain and vaginal bleeding to assess for such diagnoses. The "bagel sign" and the "blob sign" described two sonographic appearances of tubal ectopic pregnancy with positive predictive values of > 95%. Current ectopic pregnancy consensus statements differ in the interpretation of these findings; however, radiologists should have familiarity with the appearances of these findings so as to best educate ordering providers on the potential for presence of a tubal ectopic pregnancy and need for very close patient surveillance.

As more people receive coronavirus disease 2019 (COVID-19) vaccinations, the side effects of the vaccines will become more apparent. One reported side effect that has come to light is unilateral axillary lymphadenopathy ipsilateral to the vaccination site. In general, unilateral axillary lymphadenopathy has a broad differential including malignancy, infection, autoimmune disorder, and iatrogenic etiologies. We present a case of a previously healthy 38-year-old woman who received her first dose of Pfizer COVID-19 vaccination 3 days prior to presenting to the emergency department complaining of 2 weeks of abdominal pain and 20-pound unintentional weight loss. Unilateral axillary lymphadenopathy, ipsilateral to the vaccination site, was found on a contrast-enhanced computed tomography examination of the chest, abdomen, and pelvis. Subsequent diagnostic mammograms did not demonstrate evidence of malignancy; however, axillary ultrasound again revealed nonspecific lymphadenopathy. A short-term follow-up axillary ultrasound was recommended, rather than a lymph node biopsy, given the history of recent vaccination. At clinical follow-up, the patient's abdominal pain resolved and no further weight loss was noted. This case report discusses the key components and workup recommendation of unilateral axillary lymphadenopathy in the setting of COVID-19 vaccination.

The clinical manifestations of abdominal and pelvic organ torsion can often be non-specific and can affect a wide range of ages and demographic groups. Radiologists have a key role in not only establishing the diagnosis of organ torsion, but also in the assessment of potential complications. As multiple imaging modalities may be utilized in the evaluation of abdominal and pelvic pain, recognizing the various appearances of organ torsion is important to ensure early diagnosis and thereby reducing patient morbidity and mortality, particularly since abdominal and pelvic organ torsion may not be clinically suspected at the time of initial patient presentation.