Radiology Quiz March 2026

In collaboration with Dr. Adrien-Maxence Hespel from the University of Tennessee, we present the following radiology quiz. The goal of this case is to practice identifying radiographic findings and formulating a radiographic diagnosis based on a brief patient description. The final section provides additional information about the treatment.

History

5 year old male castrated cat. Has been treated forβ€―elevatedβ€―renal values.

X-ray images

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Description of the RX images

The cardiac silhouette is moderately to severelyβ€―enlargedβ€―occupying greater than 2/3 theβ€―heightβ€―of theβ€―thoracic cavityβ€―and almost the entireβ€―widthβ€―of theβ€―thoracic cavityβ€―on the ventrodorsal radiograph. Theβ€―rightβ€―cranialβ€―lobarβ€―pulmonary veinβ€―is mildlyβ€―enlargedβ€―compared to the correspondingβ€―artery. Theβ€―pulmonary arteriesβ€―areβ€―enlargedβ€―and mildlyβ€―tortuous. There is a mild,β€―diffuseβ€―unstructuredβ€―interstitialβ€―to bronchointerstitial pulmonary pattern.

There is aβ€―smallβ€―volumeβ€―ofβ€―fluidβ€―in theβ€―pleural spaceβ€―of both hemithoraces which widens the pleural fissures. Theβ€―cranialβ€―mediastinumβ€―isβ€―widenedβ€―on the ventrodorsal radiograph and there is aβ€―focal,β€―rounded,β€―soft tissueβ€―opaqueβ€―convexityβ€―immediatelyβ€―dorsalβ€―to theβ€―secondβ€―sternebra. There is aβ€―smallβ€―volumeβ€―of incidental gas within theβ€―intrathoracicβ€―esophagus.

Severeβ€―cardiomegaly in conjunction with theβ€―enlargedβ€―rightβ€―cranialβ€―lobar vein,β€―pleural effusionβ€―andβ€―diffuseβ€―unstructuredβ€―interstitialβ€―pulmonary pattern is most concerning forβ€―congestive heart failureβ€―from underlyingβ€―cardiomyopathyβ€―and/orβ€―fluidβ€―overload.β€―Echocardiographyβ€―is recommended for further evaluation. The mild tortuosity of theβ€―pulmonary arteriesβ€―may beβ€―aβ€―patientβ€―variant or represent a component of cardiovascular disease (vs.β€―pulmonary hypertension). – Theβ€―soft tissueβ€―convexityβ€―immediatelyβ€―dorsalβ€―to theβ€―secondβ€―sternebra may represent anβ€―enlargedβ€―sternalβ€―lymph nodeβ€―or loculatedβ€―pleural effusion.

Under-conditionned

The case was initially seen by Dr Monto.

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