Cardiac
GI
Bone
GU
Neuro
Peds
Faculty
Student
Quizzes
Image DDX
Museum
Mobile
  Misc
Videocasts
Signs
Twitter

 

 

Learning
Radiology:
Recognizing
the Basics
Available
on the Kindle
and IPad

LearningRadiology Imaging Signs
on Twitter

  

Follow us on

Case of the Week 534



What is the most likely diagnosis?

  • 71 year-old with dysphagia



Frontal Radiograph of the Chest

  1. Overdistension of ETT Balloon
  2. Aspiration Pneumonia
  3. Tracheomegaly
  4. Pneumomediastinum
  5. Achalasia

Additional Image-Esophagram

 

Additional Images

 


Esophagram


Answer:

 

5. Achalasia

 

More (Click Discussion Tab)

 

 

Achalasia

General Considerations

  • Usually idiopathic in origin
    • Degeneration of neurons within the myenteric plexus of the esophageal smooth muscle
  • Neuronal destruction is typically inflammatory in nature
    • Histologically: lymphocytic infiltrate surrounding the plexus
    • Predominantly involves the nitric-oxide producing inhibitory neurons
      • Cause smooth muscle relaxation by inhibiting the acetylcholine producing excitatory neurons
  • Loss of inhibitory input results in unopposed contractile stimulation and aperistalsis
    • Acetylcholine producing neurons (which stimulate smooth muscle contraction) are relatively spared in this degenerative process

MORE . . .

 


.

This Week
71 year-old with dysphagia
 
 
Some of the fundamentals of interpreting chest images
 
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
 
Recognizing the parameters that define a good chest x-ray; avoiding common pitfalls
 
How to recognize the most common arthritides




LearningRadiology
Named Magazine's
"25 Most Influential"

See Article on LearningRadiology
in August, 2010
RSNA News

LearningRadiology.com
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.