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
Medical student interested in radiology? The Midlands National Radiology Conference is a great place to start. Talks from the RCR President, AI and IR sessions, workshops, and student competitions. I’ll be speaking on post-mortem CT.
🎟️ linktr.ee/leicesterradiologysociety
🎟️ linktr.ee/leicesterradiologysociety
January 14, 2026 at 12:12 PM
Medical student interested in radiology? The Midlands National Radiology Conference is a great place to start. Talks from the RCR President, AI and IR sessions, workshops, and student competitions. I’ll be speaking on post-mortem CT.
🎟️ linktr.ee/leicesterradiologysociety
🎟️ linktr.ee/leicesterradiologysociety
🔍 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!
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
🩻 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
🚀 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
🚀 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.
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.
🤔 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.
"Rorschach" radiology. When an image makes you think of something completely unrelated. This abdominal xray shows small bowel obstruction with Gastrografin, but my brain keeps turning those coiled loops into a cinnamon swirl.
November 29, 2025 at 12:56 PM
"Rorschach" radiology. When an image makes you think of something completely unrelated. This abdominal xray shows small bowel obstruction with Gastrografin, but my brain keeps turning those coiled loops into a cinnamon swirl.
🧩 CT colonogram with oral contrast in the colon. The bright tubular structure inside the inguinal hernia is the appendix, filled with contrast. An Amyand hernia. A finding that feels a little like spotting something from the Upside Down.
#radiology #FOAMed #strangerthings
#radiology #FOAMed #strangerthings
November 26, 2025 at 7:15 PM
🧩 CT colonogram with oral contrast in the colon. The bright tubular structure inside the inguinal hernia is the appendix, filled with contrast. An Amyand hernia. A finding that feels a little like spotting something from the Upside Down.
#radiology #FOAMed #strangerthings
#radiology #FOAMed #strangerthings
At work, I introduced DWI & volume body MRI, cine enterography, MRI proctography, oral contrast for GI leaks, & iodinated contrast for CT colonography - all now routine.
Fused T2/DWI in rectal MRI never took off.
With TNT and the need to detect a complete response, time for a come back?
Fused T2/DWI in rectal MRI never took off.
With TNT and the need to detect a complete response, time for a come back?
November 24, 2025 at 4:12 PM
At work, I introduced DWI & volume body MRI, cine enterography, MRI proctography, oral contrast for GI leaks, & iodinated contrast for CT colonography - all now routine.
Fused T2/DWI in rectal MRI never took off.
With TNT and the need to detect a complete response, time for a come back?
Fused T2/DWI in rectal MRI never took off.
With TNT and the need to detect a complete response, time for a come back?
My answer each time: "even better news: it's twins"
(clip of UK MP Emily Thornbury on a news show]
(clip of UK MP Emily Thornbury on a news show]
November 23, 2025 at 1:15 PM
My answer each time: "even better news: it's twins"
(clip of UK MP Emily Thornbury on a news show]
(clip of UK MP Emily Thornbury on a news show]
✅ MEDULLARY NEPHROCALCINOSIS DUE TO TYPE 1 RENAL TUBULAR ACIDOSIS
🖼️ AXR: bilateral kidney-contour calcification
🌀 US: hyperechoic medullary foci with shadowing and no hydronephrosis.
🧊 CT/3D/cinematic rendering: dense medullary calcification.
#radiology #FOAMed
🖼️ AXR: bilateral kidney-contour calcification
🌀 US: hyperechoic medullary foci with shadowing and no hydronephrosis.
🧊 CT/3D/cinematic rendering: dense medullary calcification.
#radiology #FOAMed
November 22, 2025 at 10:35 AM
✅ MEDULLARY NEPHROCALCINOSIS DUE TO TYPE 1 RENAL TUBULAR ACIDOSIS
🖼️ AXR: bilateral kidney-contour calcification
🌀 US: hyperechoic medullary foci with shadowing and no hydronephrosis.
🧊 CT/3D/cinematic rendering: dense medullary calcification.
#radiology #FOAMed
🖼️ AXR: bilateral kidney-contour calcification
🌀 US: hyperechoic medullary foci with shadowing and no hydronephrosis.
🧊 CT/3D/cinematic rendering: dense medullary calcification.
#radiology #FOAMed
November 21, 2025 at 2:08 PM
The start of this week was spent in Hull, speaking to radiology consultants and residents about post-mortem CT. No conferences for a little while now. Time to focus on building the exciting things lined up for 2026.
November 20, 2025 at 6:41 AM
The start of this week was spent in Hull, speaking to radiology consultants and residents about post-mortem CT. No conferences for a little while now. Time to focus on building the exciting things lined up for 2026.
Here’s the answer 👇
Hyperinflated lungs with flat diaphragms suggest emphysema.Triangular opacity over the cardiac shadow plus increased left upper zone lucency gives the sail sign of left lower lobe collapse with left upper lobe hyperexpansion.
#radiology #FOAMed
Hyperinflated lungs with flat diaphragms suggest emphysema.Triangular opacity over the cardiac shadow plus increased left upper zone lucency gives the sail sign of left lower lobe collapse with left upper lobe hyperexpansion.
#radiology #FOAMed
November 17, 2025 at 5:57 PM
Here’s the answer 👇
Hyperinflated lungs with flat diaphragms suggest emphysema.Triangular opacity over the cardiac shadow plus increased left upper zone lucency gives the sail sign of left lower lobe collapse with left upper lobe hyperexpansion.
#radiology #FOAMed
Hyperinflated lungs with flat diaphragms suggest emphysema.Triangular opacity over the cardiac shadow plus increased left upper zone lucency gives the sail sign of left lower lobe collapse with left upper lobe hyperexpansion.
#radiology #FOAMed