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Training Collections
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Black Friday Save 30%On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Black Friday Save 30%Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
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Black Friday Save 40%Unlock access to our full Course Library and all self-paced Fellowships.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
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Dr. Resnick's MSK Conference
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Musculoskeletal Imaging
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Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
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Lesson
Orbital Imaging Protocols
4 topics, 10 min.
Lesson
Orbit Anatomy
10 topics, 19 min.
Lesson
Case Review - Ocular Pathology
17 topics, 1 hr. 11 min.
Anterior Globe Rupture with Laterally Dislocated Cataract
4 m.Foreign Body in Globe
4 m.Wood Foreign Body and Ocular Hypotony
2 m.Hemmorhage in Both Chambers, Open Globe
3 m.Staphyloma
4 m.Persistent Hyperplastic Primary Vitreous (PHPV)
5 m.Retinal Detachment
3 m.Retinoblastoma on CT
4 m.Retinoblastoma on MRI
9 m.Bilateral Retinoblastoma
7 m.Ocular Pathology - Review
11 m.Endophthalmitis
3 m.PHPV Review, Coloboma, and Staphyloma
5 m.Phthisis Bulbi, Macrophthalmia, and Microphthalmia
4 m.Ocular Calcification
4 m.Retinoblastoma - Review
5 m.Choroidal Melanoma
3 m.Lesson
Case Review - Intraconal Pathology
15 topics, 1 hr. 8 min.
Intraconal, Conal and Extraconal Anatomy
1 m.Intraconal Hemangioma
5 m.Venous Vascular Malformation
3 m.Optic Nerve Glioma, NF1
4 m.Optic pathway glioma (pilocytic astrocytoma)
4 m.Optic Neuritis, Multiple Sclerosis
6 m.Optic Neuritis, Multiple Sclerosis (2)
7 m.Neuromyelitis Optica Spectrum Disorder
5 m.Neuromyelitis Optica With Spinal Cord Involvement
3 m.Optic Nerve Sheath Meningioma
5 m.Bilateral Optic Neuritis, Leukemia
6 m.Intraconal Pathology - Review
11 m.Optic Neuritis - Review
5 m.Optic Nerve Glioma - Review
4 m.Optic Nerve Sheath Meningioma - Review
6 m.Lesson
Case Review - Conal Lesions
5 topics, 16 min.
Lesson
Case Review - Extraconal Injuries and Abnormalities
18 topics, 55 min.
Extraconal Pathology - Introduction
1 m.Periorbital Cellulitis & Abscess
4 m.Type 3 Orbital Infection
3 m.Solitary Fibrous Tumor
4 m.Langerhans Cell Histiocytosis
2 m.Juvenile Ossifying Fibroma
2 m.Perineural Spread of Squamous Cell Carcinoma
5 m.Proptosis from Extraosseous Extension of Prostate Metastasis
3 m.Orbital Floor Fracture
5 m.Orbital Floor Fracture with Muscle/Fat Herniation
4 m.Orbital Floor Fracture: Status Post Repair
2 m.Bilateral Orbital Fracture Repair
2 m.Periorbital Cellulitis - Review
5 m.Orbital Pseudotumor - Review
3 m.Orbital Wall Abnormalities - Review
3 m.Orbital Fracture - Review
7 m.Giant Cell Reparative Granuloma
3 m.Granulomatous Sinusitis with IgG4-related Ophthalmic Disease
4 m.Lesson
Case Review - Orbital Appendage Pathology
6 topics, 19 min.
0:01
This was a one-year-old who presented with
0:03
pain along the right lateral orbit.
0:07
The serial imaging here shows a lesion which is
0:12
involving the lateral orbital wall and superior orbital
0:16
wall. It is a bony lesion in a one-year-old.
0:20
Our differential diagnosis for bone lesions in the
0:25
infant and young toddler age includes Langerhans
0:31
cell histiocytosis. Alternatively,
0:35
one might suggest a possible diagnosis of neuroblastoma
0:39
with a primary tumor in the abdomen and secondary
0:42
involvement of the bones of the face and/or
0:45
the skull all comers throughout the world.
0:48
One also might consider involvement of tuberculosis
0:52
affecting the skull and the facial bones.
0:55
In this case,
0:56
the patient shows heterogeneous signal intensity on the
1:02
FLAIR imaging as well as T2-weighted scans
1:06
as well as the post-contrast scans.
1:09
We also note that there appears to be some extraosseous
1:13
involvement with soft tissue enhancement that is
1:16
occurring along the temporalis muscle at the edge of the skull.
1:22
What would be helpful is to have the CT scan in this
1:25
case to identify whether or not this was a punched-out
1:28
lesion that one would expect with Langerhans cell
1:31
histiocytosis. Indeed, that was the case.
1:35
However, we get the sense of that on the axial post-contrast imaging
1:40
and scan where we are losing the edge of the lesion at the bony margin.
1:49
In this age group,
1:50
the best diagnosis is Langerhans cell histiocytosis.
Langerhans Cell Histiocytosis
HIDEInteractive Transcript
0:01
This was a one-year-old who presented with
0:03
pain along the right lateral orbit.
0:07
The serial imaging here shows a lesion which is
0:12
involving the lateral orbital wall and superior orbital
0:16
wall. It is a bony lesion in a one-year-old.
0:20
Our differential diagnosis for bone lesions in the
0:25
infant and young toddler age includes Langerhans
0:31
cell histiocytosis. Alternatively,
0:35
one might suggest a possible diagnosis of neuroblastoma
0:39
with a primary tumor in the abdomen and secondary
0:42
involvement of the bones of the face and/or
0:45
the skull all comers throughout the world.
0:48
One also might consider involvement of tuberculosis
0:52
affecting the skull and the facial bones.
0:55
In this case,
0:56
the patient shows heterogeneous signal intensity on the
1:02
FLAIR imaging as well as T2-weighted scans
1:06
as well as the post-contrast scans.
1:09
We also note that there appears to be some extraosseous
1:13
involvement with soft tissue enhancement that is
1:16
occurring along the temporalis muscle at the edge of the skull.
1:22
What would be helpful is to have the CT scan in this
1:25
case to identify whether or not this was a punched-out
1:28
lesion that one would expect with Langerhans cell
1:31
histiocytosis. Indeed, that was the case.
1:35
However, we get the sense of that on the axial post-contrast imaging
1:40
and scan where we are losing the edge of the lesion at the bony margin.
1:49
In this age group,
1:50
the best diagnosis is Langerhans cell histiocytosis.
Report
Description
Faculty
David M Yousem, MD, MBA
Professor of Radiology, Vice Chairman and Associate Dean
Johns Hopkins University
Tags
Pediatrics
Orbit
Neuroradiology
Neuro
Neoplastic
Musculoskeletal (MSK)
MRI
Head and Neck
Bone & Soft Tissues
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