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Varicella-Zoster Virus Myelitis: MRI Diagnosis, CT Imaging, Emergency Radiology Pearls & Rare Spinal Cord Findings

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  Varicella-Zoster Virus Myelitis: MRI Diagnosis, CT Imaging Findings, Differential Diagnosis, and Emergency Radiology Interpretation Introduction A 74-year-old woman arrives at the emergency department with an unusual complaint. Over the past two weeks, she has experienced progressively worsening numbness in both lower extremities. She has metastatic breast cancer but has remained neurologically stable until recently. During the physical examination, clinicians notice something that immediately changes the diagnostic direction—a painful, linear vesicular rash extending from the right buttock to the foot. Could this be spinal metastasis? Acute spinal cord infarction? Multiple sclerosis? Or something much rarer? The answer lies in one of the most fascinating yet easily overlooked neurological complications of Varicella-Zoster Virus (VZV) — Varicella-Zoster Virus Myelitis . Although herpes zoster ("shingles") is common worldwide, spinal cord involvement occurs in only a tiny fr...

The Hidden Radiologic Clue of Diabetes Mellitus: Why Calcified Vas Deferens Matters More Than You Think

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  A Tiny Pelvic Calcification That Changed the Diagnosis Imagine a 63-year-old man visiting the emergency department because of suspected renal stones. He has a long history of poorly controlled diabetes mellitus complicated by advanced diabetic nephropathy and secondary hyperparathyroidism. His physicians request a routine abdominal radiograph and non-contrast CT scan to evaluate possible urinary tract calculi. No hydronephrosis is identified. No radiopaque renal stone is detected. Instead, the radiologist notices something unexpected. Two delicate, symmetrical tubular calcifications extend through the pelvis. These calcifications are not ureteral stones. They are not vascular calcifications. They are not surgical clips. They represent bilateral calcification of the vas deferens , an uncommon but highly characteristic imaging finding that should immediately prompt consideration of long-standing diabetes mellitus. The uploaded case describes exactly this scenario, in which pelvic r...