Teenager with progressive spasticity

CT of os odontoideum
Sagittal CT without contrast of the cervical spine (left) shows a large well-corticated ossicle posterior and superior to the anterior arch of C1 and superior to the dens, hypertrophy of the anterior arch of C1, and a large atlanto-dens interval due to atlanto-axial dislocation. Sagittal T2 MRI without contrast of the cervical spine (right) shows a narrow spinal canal secondary to the atlanto axial dislocation with spinal cord compression and abnormal bright signal in the spinal cord at C1-C2.

The diagnosis was dystopic os odontoideum.

School ager with crampy abdominal pain and a non-transient small bowel-small bowel intussusception

Surgical image of small bowel - small bowel intussusception due to Non-Hodgkin lymphoma
Laparoscopic surgical image (above) shows the small bowel-small bowel intussusception. Surgical image of the small bowel after reduction of the intussusception (below) shows the serosa is pink-tan and intact with a 1.5 x 0.6 cm puckered, red, firm area that when opened in pathology revealed a 2.6 x 2.0 cm red-pink mass.

The diagnosis was diffuse B-cell lymphoma (Non-Hodgkin lymphoma) causing small bowel-small bowel intussusception.

School ager with abdominal pain and a non-transient small bowel-small bowel intussusception

Gross pathological image of small bowel - small bowel intussusception due to Burkitt lymphoma
Gross pathological images of the resected segment of intussuscepted small bowel shows on its serosal surface (above) a 2.0 x 1.2 cm irregular, tan-white centrally ulcerated and umbilicated firm area. The opened image of small bowel (below) reveals a 3.4 x 2.9 x 1.2 cm irregular, tan-white, smooth, firm mass which was sectioned to reveal smooth, tan-white, glistening, homogenous cut surfaces.

The diagnosis was Burkitt lymphoma causing small bowel-small bowel intussusception.

Newborn with a myelomeningocele

MRI of Chiari II malformation and myelomeningocele
Sagittal T1 MRI without contrast of the brain (left) shows a small posterior fossa with downward cerebellar tonsil herniation and a small fourth ventricle. There is kinking of the spinal cord at the cervico-medullary junction. Sagittal (above right) and axial (below right) T2 MRI without contrast of the spine shows a low-lying conus medullaris with the spinal cord nerve roots terminating in a posteriorly located cerebrospinal fluid filled sac which is not covered by skin at the level of the L5-S1 vertebral bodies.

The diagnosis was Chiari II malformation with a myelomeningocele.