Image DDX



Case of the Week 370

What's the most likely diagnosis?

  • 42 year-old with crampy right lower quadrant pain

Small Bowel Study-Close-up Right Lower Quadrant

  1. Carcinoma of the ileum
  2. Lymphogranuloma venereum
  3. Crohn's Disease
  4. Retroperitoneal fibrosis
  5. Ulcerative colitis

Additional Image - Small Bowel Study-Same finding, different patient


Additional Image


Small Bowel Study-Same finding, different patient




3. Crohn's Disease - String Sign



More (Click Discussion Tab)

String Sign - Crohn's Disease

General Considerations

  • Finding seen on contrast studies using primarily barium
  • Originally described in the terminal ileum in Crohn’s disease and that is its most common usage
  • Initially, it is caused by severe spasm secondary to irritability of the loop producing the appearance of a frayed cotton string
  • At first, edema and spasm narrow the loop but the narrowing is at least partially distensible
  • Eventually the wall of the ileum may become fibrotic and the lumen fixed in diameter

    More ...


    This Week

    42 year-old with crampy right lower quadrant abdominal pain
    Presented as a series of cards, this podcast asks more of the most common causes of pediatric imaging findings and diseases making it ideal for a quick review. Can be used as either an audio only or audio/video podcast.; Complements Video Flashcard Podcasts 15,21,25,38,42
    and 46
    View this complete Video Podcast (Video Podcast 16-Fractures and Dislocations of the Wrist) in full-screen size on your computer without the need to download from iTunes
    Key points on recognizing the most common fractures and dislocations
    Basic CT imaging of the brain focusing on the findings of cerebrovascular accidents
    The top diagnostic imaging diagnoses that all medical students should recognize according to the Alliance of Medical Student Educators in Radiology
    Recognizing normal and  key abnormal intestinal gas patterns, free air and abdominal calcifications
    Some of the fundamentals of interpreting chest images
    is an award-winning educational website aimed primarily at medical students and radiology residents-in-training, containing  lectures, handouts, images, Cases of the Week, archives of cases, quizzes, flashcards of differential diagnoses and “most commons” lists, primarily in the areas of chest, GI, GU cardiac, bone and neuroradiology.