This 40 year old man presented with short history of bloody diarrhoea. He was initially systemically well. Stool cultures were negative. A flexible sigmoidoscopy showed an acute
colitis with biopsies confirming acute inflammation consist with ulcerative colitis. Despite being given parenteral steroids and mesalazine his symptoms failed to improve. Over 3 days he developed increasing abdominal
distension. He became systemically unwell with features of peritonism. This plain abdominal x-ray was taken. It shows a dilated colon with evidence of mucosal oedema. The appearances are those of toxic
dilatation. The patient proceeded to a subtotal colectomy and made an uncomplicated recovery
This 43 year old lady had undergone breast augmentation with silicone implants 5 years previously. She presented to the breast clinic with pain in here right breast and concerned that breast had
changed shape. Examination failed to identify an discrete palpable lump. The clinical concern was that the implant had leaked. With access to magnetic resonance imaging this was felt to be the most appropriate imaging
modality. This scan shows a sub-glandular implant in-situ. The capsule around the implant appears intact. There was no radiological evidence of either an intracapsular or extracapsular leak. If a leak were present this
often causes the shell of the implant to collapse resulting in the 'linguine' sign. The sensitivity of MRI with a dedicated breast coli for implant rupture has been shown to be greater than 95%. The sensitivity of ultrasound is
This 75 year old man presented abdominal pain and a change in bowel habit. He had not experienced any rectal bleeding. Rectal examination was normal A flexible sigmoidoscopy was incomplete
due to poor bowel preparation. A barium enema was requested. This shows a typical apple-core stricture of a colonic carcinoma.
This 56 year old lady attended for her second screening mammogram. A radiologically suspicious lesion was identified. When recalled the lesion was impalpable and an ultrasound-guided FNA
proved inconclusive. She proceeded to a wire-localisation breast biopsy. This x-ray shows the specimen radiograph taken after this operation confirming that the lesion had been adequately localised. Histology confirmed that it was
a carcinoma. She proceeded to a subsequent wide local excision and axillary gland clearance.