Pelvis/Hip

I had a patient yesterday that had a left hip MRI exam and the indication for the exam was piriformis syndrome. He was presenting extreme hip pain that radiated down into his toes. He already had lumbar MRI, so they ruled out any cord or disc issues. So, not knowing what piriformis syndrome was, I called the Rad and he stated that sometimes that muscle can impinge the sciatic nerve, and cause the extreme pain that my patient had. So I did quite a bit of high-resolution (512x284) pelvis/hip sequences and some area-specific scans to get a good view of the piriformis and sciatic nerve. Anyway, it was just something out of the ordinary that we usually don't scan for, so I thought it was cool.

Polycystic Kidneys

Last week at work, during spring break, I scanned an inpatient for his kidneys. He was having some lower abdominal pain and some flank pain. As I began scanning him, i quickly realized why he was having pain. He had so many cysts on each of his kidneys. Probably 10-15 on each one. I've seen 1 or 2 cysts on a single kidney, but never that many on both. I just thought it was a cool case, especially since we had just studied pelvic pathologies.

MRI with anesthesia

The hospital I work at is in a north suburb of Indianapolis and we are the north side peds center of our hospital corporation, therefore we do alot of pediatric patients under general anesthesia. Most of our GA cases go off without a hitch, even long, multiple-study exams. The other day our GA was a little stressful as our GA machine was acting up and the patient was inhaling too much carbon dioxide back into their system. The Md tried several different setups and maneuvers with the equipment to lower the inhaled CO2. Finally he thought it was okay and I put the head coil on and moved the patient into the scanner. As the first sequence began to run, the patent's stats began to drop and we all had to rush in the room, pull him out of the coil, and the Md pulled the LMA out and ended up intubating him. Then he had to use the respirator/automated breathing option on the GA machine. It was a somewhat scary experience, but a learning experience, nonetheless.

MRI Brain Scan

I had an interesting case the other day at work. A patient came into the ER with severe headaches, lightheadedness, confusion, and very weak. He was in his late 60's and had known lung cancer, which was being treated with chemo and radiation. The ER physician ordered a brain MRI w/wo contrast to rule out any anatomical abnormalities, stroke, and/or metistatic disease.
As I began to scan him, I notices several questionable areas on the T2's and FLAIRs. After I injected the contrast and ran my post axial T1 fat-sat, there was one large enhancing mass in his cerebellum as well as numerous ring-enhancing lesions; too many to even count. It ended up being METS from his lung cancer. I've only been in MRI for two years, but I've never seen so many lesions at once before. It was definitely a case you would see in a textbook.