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Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
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.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
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For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
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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