Answer image to my last post. Coronal pelvic MRI in someone | Figure 1

thexraydoctor

Coronal pelvic MRI in someone with rectal cancer

Yellow arrow = levator muscle. Orange arrow = intermediate signal tissue in rectum - tumour. Green arrow = intermediate signal tissue extending along a vessel - highly suspicious for EMVI (extramural venous invasion). This is a strong predictor of liver metastases.

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Sagittal (image 1) and axial (image 2) T2-weighted MRI of the lumbar spine show diffusely abnormal marrow signal and a soft tissue mass in the retroperitoneum up-lifting the abdominal aorta (arrow).
What is the most likely diagnosis in this patient?](https://app.figure1.com/case-detail/097d1c18-876c-457d-932b-74ab0e3f6193)



Axial (Image 1) and coronal (Images 2 and 3) T2-weighted MRI show a large pelvic soft tissue mass (arrow), which displaces the bladder and causes obstruction leading to hydronephrosis and hydroureter (dashed arrow). Rhabdomyosarcoma is the most common soft tissue malignancy in the pediatric pelvis. The tumor most commonly originates from the bladder, uterus, vagina, or prostate.](https://app.figure1.com/case-detail/2b9bb49d-2e6f-4d85-ba02-e7c4eba6e2ae)



Axial T2W MRI through the atlantooccipital articulations shows an abnormal volume of joint fluid (yellow arrows), similar to the preceding C1-C2 image. Subtle intermediate signal synovial proliferation can be seen on both images, suggesting synovitis and raising suspicion for juvenile idiopathic arthritis, which was ultimately confirmed through additional clinical and laboratory findings in this patient. Infection and trauma are also frequent causes of synovitis in children. (A unrelated mild Chiari I is also noted on this image, denoted by green arrows.) #FridayQuizDay](https://app.figure1.com/case-detail/593c6438-c3d9-4448-b4a0-65d51b3d94ef)



Axial T1-weighted MRI shows hyperintense signal (arrow) within the left mesial temporal lobe. Material bright on T1-weighted images include fat, protein, hemorrhage, and melanin. In this patient with neurocutaneous melanosis, the increased T1 signal represents melanin. Neurocutaneous melanosis is a type of phakomatosis characterized by congenital nevi and meningeal or parenchymal melanosis. Patients are at risk for malignant degeneration to central nervous system melanoma.](https://app.figure1.com/case-detail/643071c6-0fb1-4289-a524-d9468ea787f9)