Shingo Omata
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shingoomata.bsky.social
Shingo Omata
@shingoomata.bsky.social
Diagnostic Radiologist in 🇯🇵 | #MSKRad | #GeneralRad |
Sharing insights in Radiology | #RadSky | #MedSky | #Rdiag |
Posting Morning Daily Quiz & Evening Explanation


A full-term infant, 5 days old

#Rdiag #RadSky #MedSky #NeuroRad #FOAMed
March 6, 2025 at 1:11 PM


Pt: 35 y/o Female
CC: Palpable mass in the right inguinal region

History:
Mass present for 1 year.
Incidentally palpated in the upper thigh, gradually increasing in size.
No history of trauma.
No tenderness.

#Rdiag #RadEd #MedEd #FOAMed
March 5, 2025 at 9:33 AM


Pt: 36 y/o Female

CC: 7-month history of extraocular muscle limitation and visual disturbance

#Rdiag #RadEd #MedEd #NeuroRad #FOAMed
March 4, 2025 at 8:25 AM


Pt: 24 y/o male
CC: Progressive Lt. parietal skull defect

Hx: First noticed at age 6, gradually enlarging, no trauma, no significant medical history

Symptoms: Asymptomatic

#Rdiag #RadSky #MedSky #FOAMed #FOAMRad
March 2, 2025 at 9:17 AM


Pt: 60 y/o Male

CC: Pain, weakness in bilateral lower limbs and urinary incontinence.

#Rdiag #RadSky #MedSky #FOAMed #FOAMRad
February 28, 2025 at 11:20 PM


Pt:9 y/o Female
CC:Progressive scoliosis for 6 years

Height: -4 SD, Weight: -3 SD
Upper/lower body ratio: 0.64 (normal: 1.1)
Ophthalmologic Findings:Horizontal gaze palsy

#Rdiag #RadEd #MedEd #NeuroRad #FOAMRad
February 28, 2025 at 8:31 AM


Pt: 42 y/o Male

CC: Hypotonia, joint hyperextensibility, aphonia, micrographia, hyperreflexia, facial dystonia, cognitive decline

Hx:Mid-teens: Hand tremor (onset)
35y: Gait disturbance (R foot drag)

FHx: Mother affected, deceased

#Rdiag #RadSky #MedSky #NeuroRad
February 27, 2025 at 11:18 AM


✅ Symmetric iron deposition: basal ganglia, thalami, dentate nuclei, red nuclei, cortex.

🩻 Imaging
CT: Hyperattenuation
MRI: T1 ↑, T2 ↓, T2* ↓↓

🔑 Key: Deep gray hyperattenuation on CT is distinctive.
🩺 Clue: Early-onset diabetes.

#Rdiag #RadSky #MedSky #NeuroRad #FOAMRad


Pt: 55 y/o Male

- Diabetes (insulin-dependent), alcohol abuse
- DKA + 5-year cognitive decline (LTC placement)
- Pigmentary retinopathy

#Rdiag #RadSky #MedSky #NeuroRad #FOAMRad
February 26, 2025 at 12:35 PM


Pt: 55 y/o Male

- Diabetes (insulin-dependent), alcohol abuse
- DKA + 5-year cognitive decline (LTC placement)
- Pigmentary retinopathy

#Rdiag #RadSky #MedSky #NeuroRad #FOAMRad
February 26, 2025 at 12:34 PM


💡 Accuracy:
✅ 3.8 ppm peak in top 3 → 96.9%
✅ 3.8 ppm/Cr ≥1.44 → 92.3%
✅ Lip-Lac/Cr ≥2.07 → 80.6%

💡 Alanine presence aids diagnosis

#Rdiag #RadSky #MedSky #NeuroRad #FOAMRad
PMID: 34211737
February 25, 2025 at 9:16 AM
February 25, 2025 at 9:15 AM


🩻 Imaging
- Hemiatrophy of the cerebrum w/ calvarial thickening
- Hyperpneumatization of sinuses ipsilateral to the hemiatrophy

💡 DDx of cerebral hemiatrophy
- Rasmussen encephalitis
- Sturge-Weber synd.
- basal ganglia germinoma

#Rdiag #RadEd #MedEd #FOAMRad


20 y/o Male w/ seizures since age 3, dx idiopathic generalized epilepsy at 17.

CC: multiple generalized seizures, LOC, & post-ictal confusion.

Other: Learning difficulties, left school early, no FHx.

#Rdiag #RadSky #MedSky #NeuroRad #FOAMed
February 24, 2025 at 7:52 AM


20 y/o Male w/ seizures since age 3, dx idiopathic generalized epilepsy at 17.

CC: multiple generalized seizures, LOC, & post-ictal confusion.

Other: Learning difficulties, left school early, no FHx.

#Rdiag #RadSky #MedSky #NeuroRad #FOAMed
February 23, 2025 at 11:25 PM


Pt: 18 y/o Female

CC: 4-month history of headache and dizziness and a 3-day-history of lethargy and vomiting.

Neurological exam: papilledema, impaired tandem gait, and right-sided dysmetria

#Rdiag #RadSky #MedSky #NeuroRad #FOAMrad
February 23, 2025 at 8:43 AM


💡 WHO 5th: Newly Defined Papillary Renal Tumor Subtype

CT: Small, round, persistently enhancing lesion ("enhancing dot sign").
MRI: T2↓, mild diffusion restriction, pseudocapsule.
🔸 Some show internal heterogeneity.

#Rdiag
PMID: 37007143


Pt: 30 y/o Female, previously healthy .

An incidental renal mass was detected, leading to further evaluation.

MRI: Predominantly T2↓ w/ mild diffusion restriction.

#Rdiag #RadSky #MedSky
February 22, 2025 at 9:42 AM


Pt: 30 y/o Female, previously healthy .

An incidental renal mass was detected, leading to further evaluation.

MRI: Predominantly T2↓ w/ mild diffusion restriction.

#Rdiag #RadSky #MedSky
February 22, 2025 at 12:04 AM


Pt: 9 y/o Male, previously healthy

CC: Frontal headache x2 wks, worsened in last 2 days
Assoc: N/V, photophobia, b/l eye pain
ROS: No trauma

#Rdiag #RadSky #MedSky
February 21, 2025 at 2:10 PM


✅ “Tiger Man Sign”
– patchy muscle involvement in granulomatous myositis.

🩻 MRI: Contrast-enhancing granulomas, T1↑, T2↑.
🩻 PET/CT: Hypermetabolic lymphadenopathy + intramuscular & fascial lesions.
🔬 Non-caseating granulomas

#Rdaig #RadSky #MedSky
PMID: 30637499


Pt: 53 y/o Male

🔹new-onset gait ataxia
🔹muscle weakness of the proximal thighs

#Rdiag #RadSky #MedSky
February 20, 2025 at 7:32 AM


Pt: 53 y/o Male

🔹new-onset gait ataxia
🔹muscle weakness of the proximal thighs

#Rdiag #RadSky #MedSky
February 19, 2025 at 10:00 PM


🔍 Key Imaging Findings:
✅ MRI: Dilated main parotid ducts 🩻
✅ No masses or sialolithiasis 🚫

🔹 Clinical Clues:
- Mucoid secretions expelled with compression
- Recurrent, food-related parotid swelling

#Rdiag #RadSky #MedSky
PMID: 27759642


👩‍⚕️ 46 y/o Female

🔹 Recurrent parotid gland swelling & pain (5 years)
🔹 Triggered by food 🍽️
🔹 Elevated eosinophils & IgE 🩸📈

#Rdiag #RadSky #MedSky
February 19, 2025 at 10:26 AM


👩‍⚕️ 46 y/o Female

🔹 Recurrent parotid gland swelling & pain (5 years)
🔹 Triggered by food 🍽️
🔹 Elevated eosinophils & IgE 🩸📈

#Rdiag #RadSky #MedSky
February 19, 2025 at 1:56 AM


Retrograde air entry into Stensen’s duct from increased intraoral pressure.

Causes:
-Dental procedures, positive pressure ventilation
-Wind instrument playing, psychological factors
-CT puff-cheek technique

DDx: Suppurative parotitis (painful, inflammatory)

#Rdiag #RadSky #MedSky


Pt:11 y/o Male
CC:Bilateral cheek swelling, recurrent and painless x 8 months, refractory to antibiotics.

#Rdiag #RadSky #MedSky
February 18, 2025 at 8:34 AM


Pt:11 y/o Male
CC:Bilateral cheek swelling, recurrent and painless x 8 months, refractory to antibiotics.

#Rdiag #RadSky #MedSky
February 17, 2025 at 10:47 PM


Pt: 50 y/o Male

#Rdiag #RadSky #MedSky
February 17, 2025 at 8:07 AM


🩻 Features
- Focal lateral cortical thickening at the fracture site
- Transverse orientation of the fracture
- Medial spike
- Lack of comminution

💡Note: High risk of contralateral fracture💡

#Rdiag #MSKRad #RadSky #MedSky
PMID: 21940585


64 y/o Female, post minor trauma.

#Rdiag #MSKRad #RadSky #MedSky
February 16, 2025 at 7:03 AM