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When a Chest X-Ray Reveals a “Split” Vertebra: Imaging Diagnosis of Butterfly Vertebra and Hemivertebra in Adults

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  A Radiology-Centered Clinical Guide to Congenital Vertebral Malformations, CT Diagnosis, MRI Indications, Differential Diagnosis, and the Emerging Role of AI Author: Hwunjae Lee, PhD, MD Director & Editor, ScholarGen Inc. Medical Imaging Scientist | Medical AI Researcher | Healthcare Technology Innovator A Vertebra That Looks Broken—But Isn’t A 22-year-old woman presented with seven days of persistent sore throat and cough. Her clinical problem appeared straightforward: evaluate a respiratory complaint. The chest radiograph, however, revealed something unexpected. The lungs did not provide the most important imaging clue. Instead, one of the lower thoracic vertebral bodies appeared unusually divided, almost as if the vertebra had been split into two parts. There was no history of significant trauma. She did not report back pain. Was this an old compression fracture? Could it represent a destructive bone lesion? Was there an underlying infection? Or was the unusual appearance...
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Type 1 Autoimmune Pancreatitis: When a “Sausage-Shaped Pancreas” Mimics Pancreatic Cancer

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A 60-Year-Old Man With Persistent Postprandial Upper Abdominal Pain A 60-year-old man presented with approximately one month of persistent upper abdominal pain, particularly after meals. At first glance, postprandial abdominal pain may suggest common gastrointestinal disorders such as gastritis, gallstone disease, or functional dyspepsia. However, the clinical picture becomes considerably more important when persistent abdominal pain is accompanied by abnormal hepatobiliary enzymes and pancreatic enlargement on contrast-enhanced CT. In this case, the pancreas was diffusely enlarged and had a characteristic rounded, thickened “sausage-like” appearance . A low-attenuation capsule-like rim surrounded the pancreas. Endoscopic retrograde cholangiopancreatography (ERCP) demonstrated distal bile duct narrowing, while serum IgG4 was elevated. Histologic examination demonstrated lymphoplasmacytic infiltration, fibrosis, and chronic inflammation without evidence of malignancy. Following glucoco...
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Quadricuspid Pulmonary Valve on CT: A Rare Incidental Finding in a 43-Year-Old Woman With Sudden Epigastric Pain

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A radiologist’s approach to quadricuspid pulmonary valve: CT diagnosis, four-cusp morphology, differential diagnosis, pulmonary regurgitation, pulmonary artery aneurysm, multimodality imaging, management, and prognosis. By Hwunjae Lee, MD, PhD Introduction A 43-year-old woman presented with sudden epigastric pain radiating to the back . That clinical description immediately raises an important diagnostic concern. Sudden severe upper abdominal or epigastric pain extending toward the back can represent acute aortic syndrome (AAS) , including aortic dissection, intramural hematoma, penetrating atherosclerotic ulcer, or aortic rupture. In an emergency setting, these potentially fatal conditions must be excluded rapidly. CT angiography was therefore performed. The aorta was unremarkable for an acute aortic catastrophe. There was no convincing aortic dissection, penetrating atherosclerotic ulcer, intramural hematoma, rupture, or pericardial effusion. However, the examination contained an une...
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