Dr Vikas Shah
@thexraydoctor.org
☢️ abdominal, emergency & post-mortem radiologist; managing editor of Radiopaedia
⚽️ sports, 💻 tech and 🗺️ travel
#RadSky #MedSky
⚽️ sports, 💻 tech and 🗺️ travel
#RadSky #MedSky
Happy new year #WQuers. Almost had a disastrous start to 2026 but managed to hold on to my streak!
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January 1, 2026 at 10:26 AM
Happy new year #WQuers. Almost had a disastrous start to 2026 but managed to hold on to my streak!
Wordle 1,657 6/6*
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Wordle 1,657 6/6*
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Reposted by Dr Vikas Shah
🎉 Dec 2025 COTM. Vote COTY: bit.ly/RadiopaediaC...
☢️ CT & 🧲 MRI: Large mixed-density abdominal mass with vessels tracking to left inguinal region. Absent normal left spermatic cord. Enlarged para-aortic nodes.
✅ Seminoma in undescended testis
📒 Magdi Mahsoub, radiopaedia.org/cases/207190
☢️ CT & 🧲 MRI: Large mixed-density abdominal mass with vessels tracking to left inguinal region. Absent normal left spermatic cord. Enlarged para-aortic nodes.
✅ Seminoma in undescended testis
📒 Magdi Mahsoub, radiopaedia.org/cases/207190
December 31, 2025 at 12:20 PM
🎉 Dec 2025 COTM. Vote COTY: bit.ly/RadiopaediaC...
☢️ CT & 🧲 MRI: Large mixed-density abdominal mass with vessels tracking to left inguinal region. Absent normal left spermatic cord. Enlarged para-aortic nodes.
✅ Seminoma in undescended testis
📒 Magdi Mahsoub, radiopaedia.org/cases/207190
☢️ CT & 🧲 MRI: Large mixed-density abdominal mass with vessels tracking to left inguinal region. Absent normal left spermatic cord. Enlarged para-aortic nodes.
✅ Seminoma in undescended testis
📒 Magdi Mahsoub, radiopaedia.org/cases/207190
🔍 Autoimmune pancreatitis mimicking malignancy
🧲 Diffusely enlarged smooth pancreas with biliary dilatation, no PD dilatation. Mesenteric & pelvic soft tissue masses.
☢️ FDG uptake in pancreas, nodes & soft tissue. Whipple histology confirmed IgG4-related AIP
📚 radiopaedia.org/cases/199309
🧲 Diffusely enlarged smooth pancreas with biliary dilatation, no PD dilatation. Mesenteric & pelvic soft tissue masses.
☢️ FDG uptake in pancreas, nodes & soft tissue. Whipple histology confirmed IgG4-related AIP
📚 radiopaedia.org/cases/199309
December 26, 2025 at 12:57 PM
🔍 Autoimmune pancreatitis mimicking malignancy
🧲 Diffusely enlarged smooth pancreas with biliary dilatation, no PD dilatation. Mesenteric & pelvic soft tissue masses.
☢️ FDG uptake in pancreas, nodes & soft tissue. Whipple histology confirmed IgG4-related AIP
📚 radiopaedia.org/cases/199309
🧲 Diffusely enlarged smooth pancreas with biliary dilatation, no PD dilatation. Mesenteric & pelvic soft tissue masses.
☢️ FDG uptake in pancreas, nodes & soft tissue. Whipple histology confirmed IgG4-related AIP
📚 radiopaedia.org/cases/199309
🎄 Festive imaging requests at Christmas.
🚀 Brussels sprouts contain raffinose. Colonic bacteria ferment it -> gas + smell. So an abdo x-ray/CT after sprouts may look extra gassy.
🩻 Like radiology, disliked early on, great when done right.
✨ Merry Christmas!
🚀 Brussels sprouts contain raffinose. Colonic bacteria ferment it -> gas + smell. So an abdo x-ray/CT after sprouts may look extra gassy.
🩻 Like radiology, disliked early on, great when done right.
✨ Merry Christmas!
December 25, 2025 at 12:44 PM
🎄 Festive imaging requests at Christmas.
🚀 Brussels sprouts contain raffinose. Colonic bacteria ferment it -> gas + smell. So an abdo x-ray/CT after sprouts may look extra gassy.
🩻 Like radiology, disliked early on, great when done right.
✨ Merry Christmas!
🚀 Brussels sprouts contain raffinose. Colonic bacteria ferment it -> gas + smell. So an abdo x-ray/CT after sprouts may look extra gassy.
🩻 Like radiology, disliked early on, great when done right.
✨ Merry Christmas!
Reposted by Dr Vikas Shah
🎄 Holiday wishes from Frank & the Radiopaedia team.
A breast ultrasound scar forms a Christmas tree, 25 years after cancer surgery. A reminder of the shared work of radiologists, clinicians, & technologists, & the long-term impact of what we do together.
Wishing you a safe & happy holiday season.
A breast ultrasound scar forms a Christmas tree, 25 years after cancer surgery. A reminder of the shared work of radiologists, clinicians, & technologists, & the long-term impact of what we do together.
Wishing you a safe & happy holiday season.
December 25, 2025 at 9:53 AM
🎄 Holiday wishes from Frank & the Radiopaedia team.
A breast ultrasound scar forms a Christmas tree, 25 years after cancer surgery. A reminder of the shared work of radiologists, clinicians, & technologists, & the long-term impact of what we do together.
Wishing you a safe & happy holiday season.
A breast ultrasound scar forms a Christmas tree, 25 years after cancer surgery. A reminder of the shared work of radiologists, clinicians, & technologists, & the long-term impact of what we do together.
Wishing you a safe & happy holiday season.
13-year-old me at the @rigb.org Christmas Lectures.
Those early experiences helped spark a lifelong love of science.
Grateful for institutions that inspire curiosity, opportunity, and future scientists.
Those early experiences helped spark a lifelong love of science.
Grateful for institutions that inspire curiosity, opportunity, and future scientists.
December 21, 2025 at 4:46 PM
13-year-old me at the @rigb.org Christmas Lectures.
Those early experiences helped spark a lifelong love of science.
Grateful for institutions that inspire curiosity, opportunity, and future scientists.
Those early experiences helped spark a lifelong love of science.
Grateful for institutions that inspire curiosity, opportunity, and future scientists.
🚀 Multimodality imaging of mature cystic ovarian teratoma (dermoid)
🔊 US: mixed echo mass w/ layering hyperechoic content
☢️ CT: mixed density with fat, complex fluid, central rounded focus
🧲 MRI: fat & fluid layering with interface nodule (Poke ball)
📚 radiopaedia.org/cases/171196
🔊 US: mixed echo mass w/ layering hyperechoic content
☢️ CT: mixed density with fat, complex fluid, central rounded focus
🧲 MRI: fat & fluid layering with interface nodule (Poke ball)
📚 radiopaedia.org/cases/171196
December 20, 2025 at 1:13 PM
🚀 Multimodality imaging of mature cystic ovarian teratoma (dermoid)
🔊 US: mixed echo mass w/ layering hyperechoic content
☢️ CT: mixed density with fat, complex fluid, central rounded focus
🧲 MRI: fat & fluid layering with interface nodule (Poke ball)
📚 radiopaedia.org/cases/171196
🔊 US: mixed echo mass w/ layering hyperechoic content
☢️ CT: mixed density with fat, complex fluid, central rounded focus
🧲 MRI: fat & fluid layering with interface nodule (Poke ball)
📚 radiopaedia.org/cases/171196
Reposted by Dr Vikas Shah
🎉 Feb 2025 COTM. Vote for COTY and win a free 12-month Radium Supporter Status: bit.ly/RadiopaediaC...
☢️ CT shows an obstructing left main bronchus lesion with complete left lung collapse.
🔬 Inflammatory myofibroblastic tumour.
📒 Case courtesy of Christin Wei Tong Lim radiopaedia.org/cases/192175
☢️ CT shows an obstructing left main bronchus lesion with complete left lung collapse.
🔬 Inflammatory myofibroblastic tumour.
📒 Case courtesy of Christin Wei Tong Lim radiopaedia.org/cases/192175
December 20, 2025 at 12:29 PM
🎉 Feb 2025 COTM. Vote for COTY and win a free 12-month Radium Supporter Status: bit.ly/RadiopaediaC...
☢️ CT shows an obstructing left main bronchus lesion with complete left lung collapse.
🔬 Inflammatory myofibroblastic tumour.
📒 Case courtesy of Christin Wei Tong Lim radiopaedia.org/cases/192175
☢️ CT shows an obstructing left main bronchus lesion with complete left lung collapse.
🔬 Inflammatory myofibroblastic tumour.
📒 Case courtesy of Christin Wei Tong Lim radiopaedia.org/cases/192175
Reposted by Dr Vikas Shah
🎉 January 2025 COTM. Vote for COTY and win 12 month Radium Supporter Status: bit.ly/RadiopaediaC...
🧲 MRI shows an aggressive pelvic mass involving bladder and uterus.
🔬 CT guided biopsy confirmed pelvic actinomycosis, a key inflammatory mimicker.
📒 Laura Machado, radiopaedia.org/cases/188615
🧲 MRI shows an aggressive pelvic mass involving bladder and uterus.
🔬 CT guided biopsy confirmed pelvic actinomycosis, a key inflammatory mimicker.
📒 Laura Machado, radiopaedia.org/cases/188615
December 19, 2025 at 10:55 AM
🎉 January 2025 COTM. Vote for COTY and win 12 month Radium Supporter Status: bit.ly/RadiopaediaC...
🧲 MRI shows an aggressive pelvic mass involving bladder and uterus.
🔬 CT guided biopsy confirmed pelvic actinomycosis, a key inflammatory mimicker.
📒 Laura Machado, radiopaedia.org/cases/188615
🧲 MRI shows an aggressive pelvic mass involving bladder and uterus.
🔬 CT guided biopsy confirmed pelvic actinomycosis, a key inflammatory mimicker.
📒 Laura Machado, radiopaedia.org/cases/188615
🩻 3D CT showing an inferior vena cava filter.
⚙️ Infrarenal IVC device to prevent pulmonary embolism from lower limb DVT when anticoagulation is not possible.
📐 Residual calcium flecks remain, but major vessels, kidneys, liver and heart are seen.
⚙️ Infrarenal IVC device to prevent pulmonary embolism from lower limb DVT when anticoagulation is not possible.
📐 Residual calcium flecks remain, but major vessels, kidneys, liver and heart are seen.
December 19, 2025 at 2:32 PM
🩻 3D CT showing an inferior vena cava filter.
⚙️ Infrarenal IVC device to prevent pulmonary embolism from lower limb DVT when anticoagulation is not possible.
📐 Residual calcium flecks remain, but major vessels, kidneys, liver and heart are seen.
⚙️ Infrarenal IVC device to prevent pulmonary embolism from lower limb DVT when anticoagulation is not possible.
📐 Residual calcium flecks remain, but major vessels, kidneys, liver and heart are seen.
🚀 Gallbladder volvulus
🔑 CT: distended thick-walled GB, poor enhancement, horizontal lie, medially pointing fundus, beak at neck, twisted vessels
🔪 Surgery: torted cystic duct/artery → cholecystectomy
📚 View on @radiopaedia.org : radiopaedia.org/cases/183929
🔑 CT: distended thick-walled GB, poor enhancement, horizontal lie, medially pointing fundus, beak at neck, twisted vessels
🔪 Surgery: torted cystic duct/artery → cholecystectomy
📚 View on @radiopaedia.org : radiopaedia.org/cases/183929
December 18, 2025 at 5:16 PM
🚀 Gallbladder volvulus
🔑 CT: distended thick-walled GB, poor enhancement, horizontal lie, medially pointing fundus, beak at neck, twisted vessels
🔪 Surgery: torted cystic duct/artery → cholecystectomy
📚 View on @radiopaedia.org : radiopaedia.org/cases/183929
🔑 CT: distended thick-walled GB, poor enhancement, horizontal lie, medially pointing fundus, beak at neck, twisted vessels
🔪 Surgery: torted cystic duct/artery → cholecystectomy
📚 View on @radiopaedia.org : radiopaedia.org/cases/183929
☢️ FDG PET-CT: abnormal tracer activity of aorta & subclavian arteries > indicates arterial wall inflammation
🧬 CT: low density smooth circumferential aortic wall thickening
📚 Non-infectious aortitis has many causes, including giant cell arteritis, Takayasu arteritis and rheumatologic diseases
🧬 CT: low density smooth circumferential aortic wall thickening
📚 Non-infectious aortitis has many causes, including giant cell arteritis, Takayasu arteritis and rheumatologic diseases
December 17, 2025 at 2:05 PM
☢️ FDG PET-CT: abnormal tracer activity of aorta & subclavian arteries > indicates arterial wall inflammation
🧬 CT: low density smooth circumferential aortic wall thickening
📚 Non-infectious aortitis has many causes, including giant cell arteritis, Takayasu arteritis and rheumatologic diseases
🧬 CT: low density smooth circumferential aortic wall thickening
📚 Non-infectious aortitis has many causes, including giant cell arteritis, Takayasu arteritis and rheumatologic diseases
🚀 Multimodality imaging of MEN 1
1️⃣ Pancreatic NET (gastrinoma) → Zollinger Ellison, DJ perforation
2️⃣ Parathyroid adenoma → ↑ calcium, renal stones
3️⃣ Pituitary adenoma → ↑ prolactin
🔥 Exam tip: autosomal dominant
📚 radiopaedia.org/cases/206567
1️⃣ Pancreatic NET (gastrinoma) → Zollinger Ellison, DJ perforation
2️⃣ Parathyroid adenoma → ↑ calcium, renal stones
3️⃣ Pituitary adenoma → ↑ prolactin
🔥 Exam tip: autosomal dominant
📚 radiopaedia.org/cases/206567
December 15, 2025 at 3:20 PM
🚀 Multimodality imaging of MEN 1
1️⃣ Pancreatic NET (gastrinoma) → Zollinger Ellison, DJ perforation
2️⃣ Parathyroid adenoma → ↑ calcium, renal stones
3️⃣ Pituitary adenoma → ↑ prolactin
🔥 Exam tip: autosomal dominant
📚 radiopaedia.org/cases/206567
1️⃣ Pancreatic NET (gastrinoma) → Zollinger Ellison, DJ perforation
2️⃣ Parathyroid adenoma → ↑ calcium, renal stones
3️⃣ Pituitary adenoma → ↑ prolactin
🔥 Exam tip: autosomal dominant
📚 radiopaedia.org/cases/206567
Plenty of consultants like me will be working to provide FULL emergency care, and support our current resident and future consultant colleagues in their strike action.
Strikes will GO AHEAD from 17-22 December, after resident doctors in England voted overwhelmingly to reject the latest offer from Wes Streeting.
December 15, 2025 at 2:24 PM
Plenty of consultants like me will be working to provide FULL emergency care, and support our current resident and future consultant colleagues in their strike action.
🚀 Gossypiboma: retained surgical swab. Low-density mass w/ curvilinear strands and spongiform gas
📍 Exam tip: abscesses show non-dependent air or air-fluid levels, not diffuse bubbles
🔥 Reporting tip: main mimic is haemostatic material. Check the op note
📚 radiopaedia.org/cases/100302
📍 Exam tip: abscesses show non-dependent air or air-fluid levels, not diffuse bubbles
🔥 Reporting tip: main mimic is haemostatic material. Check the op note
📚 radiopaedia.org/cases/100302
December 14, 2025 at 4:52 PM
🚀 Gossypiboma: retained surgical swab. Low-density mass w/ curvilinear strands and spongiform gas
📍 Exam tip: abscesses show non-dependent air or air-fluid levels, not diffuse bubbles
🔥 Reporting tip: main mimic is haemostatic material. Check the op note
📚 radiopaedia.org/cases/100302
📍 Exam tip: abscesses show non-dependent air or air-fluid levels, not diffuse bubbles
🔥 Reporting tip: main mimic is haemostatic material. Check the op note
📚 radiopaedia.org/cases/100302
Which one will you vote for as @radiopaedia.org’s case of the year 2025?
View all cases and vote at bit.ly/RadiopaediaC...
View all cases and vote at bit.ly/RadiopaediaC...
🏆 Case of the Year voting is open
Vote for your favourite Case of the Month from 2025
🎁 Author wins a 12-month All-Access Pass
🙌 Voters can win 12-month Radium Supporter status
Winners announced Jan 2026
Vote 👉 bit.ly/RadiopaediaC...
Vote for your favourite Case of the Month from 2025
🎁 Author wins a 12-month All-Access Pass
🙌 Voters can win 12-month Radium Supporter status
Winners announced Jan 2026
Vote 👉 bit.ly/RadiopaediaC...
December 14, 2025 at 12:37 PM
Which one will you vote for as @radiopaedia.org’s case of the year 2025?
View all cases and vote at bit.ly/RadiopaediaC...
View all cases and vote at bit.ly/RadiopaediaC...
🚀 Perforated small-bowel diverticulitis: prior barium extensive diverticulosis; new CT shows gas, fluid & fat stranding in the mesentery
📍 Exam tip: false diverticula don’t contain all bowel layers
🔥 Reporting tip: mesenteric-focused inflammation → run the small bowel
radiopaedia.org/cases/206579
📍 Exam tip: false diverticula don’t contain all bowel layers
🔥 Reporting tip: mesenteric-focused inflammation → run the small bowel
radiopaedia.org/cases/206579
December 11, 2025 at 5:23 PM
🚀 Perforated small-bowel diverticulitis: prior barium extensive diverticulosis; new CT shows gas, fluid & fat stranding in the mesentery
📍 Exam tip: false diverticula don’t contain all bowel layers
🔥 Reporting tip: mesenteric-focused inflammation → run the small bowel
radiopaedia.org/cases/206579
📍 Exam tip: false diverticula don’t contain all bowel layers
🔥 Reporting tip: mesenteric-focused inflammation → run the small bowel
radiopaedia.org/cases/206579
🚀 Meckel diverticulitis
🔑 Blind-ending tubular structure arising from the mid small bowel
📍 Remnant of omphalomesenteric duct
2️⃣ Rule of 2s useful to learn facts
🔥 Inflammation: fat stranding +/- fluid & gas in small bowel mesentery, wall thickening
Scroll: radiopaedia.org/cases/206545
🔑 Blind-ending tubular structure arising from the mid small bowel
📍 Remnant of omphalomesenteric duct
2️⃣ Rule of 2s useful to learn facts
🔥 Inflammation: fat stranding +/- fluid & gas in small bowel mesentery, wall thickening
Scroll: radiopaedia.org/cases/206545
December 10, 2025 at 5:21 PM
🚀 Meckel diverticulitis
🔑 Blind-ending tubular structure arising from the mid small bowel
📍 Remnant of omphalomesenteric duct
2️⃣ Rule of 2s useful to learn facts
🔥 Inflammation: fat stranding +/- fluid & gas in small bowel mesentery, wall thickening
Scroll: radiopaedia.org/cases/206545
🔑 Blind-ending tubular structure arising from the mid small bowel
📍 Remnant of omphalomesenteric duct
2️⃣ Rule of 2s useful to learn facts
🔥 Inflammation: fat stranding +/- fluid & gas in small bowel mesentery, wall thickening
Scroll: radiopaedia.org/cases/206545
Radiology has changed. I’m just here trying not to get buried.
December 7, 2025 at 5:16 PM
Radiology has changed. I’m just here trying not to get buried.
Reposted by Dr Vikas Shah
“And then they made him a fake trophy because he kept whining and moaning and wouldn’t STFU.”
December 6, 2025 at 4:06 AM
“And then they made him a fake trophy because he kept whining and moaning and wouldn’t STFU.”
CT scout image shows a distended & gas-filled loop of bowel occupying left mid-abdomen, with a central crease (coffee bean sign), with a normally positioned caecal pole. Yes, that is a key in a pocket. Sigmoid volvulus, coronal image shows whirling pattern of the vessels near the point of twisting.
December 6, 2025 at 4:12 PM
CT scout image shows a distended & gas-filled loop of bowel occupying left mid-abdomen, with a central crease (coffee bean sign), with a normally positioned caecal pole. Yes, that is a key in a pocket. Sigmoid volvulus, coronal image shows whirling pattern of the vessels near the point of twisting.
I just asked my kids “hey which numbers will you be opening in your advent calendars this weekend?”
Continuing to earn cool dad points.
IYKYK.
@gammacounter.bsky.social
Continuing to earn cool dad points.
IYKYK.
@gammacounter.bsky.social
December 6, 2025 at 11:39 AM
I just asked my kids “hey which numbers will you be opening in your advent calendars this weekend?”
Continuing to earn cool dad points.
IYKYK.
@gammacounter.bsky.social
Continuing to earn cool dad points.
IYKYK.
@gammacounter.bsky.social
🤔 What is the key 🔑 finding on this scout image of a CT abdomen and pelvis? What do you think the CT images will show? Put your answer in the comments!
December 5, 2025 at 3:42 PM
🤔 What is the key 🔑 finding on this scout image of a CT abdomen and pelvis? What do you think the CT images will show? Put your answer in the comments!
Coronal CT displayed in bone window: Paget disease with coarse trabecular thickening of left ilium and femur, and decreased angle between femoral neck and shaft, also known as coxa vara. This is called the Shepherd crook deformity as it resembles the stick carried by shepherds...sort of.
December 4, 2025 at 4:50 PM
Coronal CT displayed in bone window: Paget disease with coarse trabecular thickening of left ilium and femur, and decreased angle between femoral neck and shaft, also known as coxa vara. This is called the Shepherd crook deformity as it resembles the stick carried by shepherds...sort of.
Liver haemangiomas (or strictly speaking 'venous malformations') show "centripetal peripheral nodular discontinuous enhancement" on MRI with gadolinium - this means they fill in from outside to inside, and tend to retain contrast on delayed images.
November 30, 2025 at 12:16 PM
Liver haemangiomas (or strictly speaking 'venous malformations') show "centripetal peripheral nodular discontinuous enhancement" on MRI with gadolinium - this means they fill in from outside to inside, and tend to retain contrast on delayed images.