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Berlin Case Viewer

Mit der App BerlinCaseViewer medizinische Bildgebung lernen. Auf deinem iPhone, deinem iPad oder deinem Mac. Oder mit unserer universellen Web-App.

Lern medical imaging of all kinds on your iPhone, iPad, or Mac.

14/09/2026

🖐️ The Fat Finger

An 89-year-old woman presents with slowly progressive swelling of the third finger. No acute illness, no high-grade fever — just an indolent process that has clearly been developing for some time.

What is causing this unusual dactylitis?

👉 Want to explore the full scrollable case with MRI, MCQ, and teaching text? Comment “summer” and we’ll send you the clickable link. Find it here: https://bcv.app/sumr26

🌍 Case contributed by Ritika Chamadia from India. Thank you for sharing this fascinating case with our community!

–– Do not read the below if you want to quiz yourself ––

✅ Diagnosis: Tuberculous dactylitis

Tuberculosis involving the short tubular bones of the hand may cause destructive osteomyelitis with soft-tissue involvement and tenosynovitis. The classic expansile appearance is known as spina ventosa — a term most often associated with childhood disease, making this presentation in an 89-year-old woman particularly striking.

Keep learning — one case at a time.

11/09/2026

☀️ Summer of Cases – Case 20

A 22-year-old man with persistent low back pain and an MRI initially interpreted as unilateral sacroiliitis seemed to fit the picture of early axial spondyloarthritis. But the clinical and imaging findings did not fully align. A closer look at the MRI—and one additional imaging modality—changed the diagnosis completely.

This excellent case comes from Moscow, Russia, and was kindly provided by Dr. Valeria Korol. What makes it particularly valuable is the detailed patient history and carefully reasoned diagnostic journey, showing step by step why the initial diagnosis had to be reconsidered.

👉 Want to explore the full scrollable case including the complete clinical story, MRI and CT findings, MCQs, teaching points, and color-overlay illustrations highlighting the key imaging abnormalities?
Find it here: https://bcv.app/sumr26

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🔍 The reveal: the apparent “sacroiliitis” was actually reactive bone marrow edema caused by an osteoid osteoma of the sacrum.

A crucial diagnostic lesson: bone marrow edema is not synonymous with sacroiliitis—and location matters.

09/09/2026

🇲🇽 Case 19 of the BCV Summer of Cases 2026 comes from Mexico!

A painless enlargement of the thumb since childhood, slowly progressive over many years. More recently, nocturnal paresthesias developed in the thumb, index, and middle fingers, together with early thenar weakness and a palpable fusiform swelling in the distal forearm.

MRI was requested before surgical exploration to characterize the presumed soft-tissue mass.

This excellent case was contributed by Dr. Miguel Herrera Pérez from Mexico — many thanks for sharing it with the BCV community! 🙌

👉 Want to explore the full scrollable case including the MRI images, MCQ, imaging findings, and teaching text?
Find it here: https://bcv.app/sumr26

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🔎 The diagnosis: Lipomatosis of nerve

MRI demonstrates fusiform enlargement of the median nerve with preserved fascicles embedded in mature fat, creating the classic “coaxial cable” appearance on axial images and “spaghetti” appearance longitudinally. In addition, there is fibroadipose overgrowth of the thumb within the territory of the affected nerve.

This pattern is considered diagnostic on imaging alone. The key clinical point is crucial: the apparent “mass” is the enlarged nerve itself. Biopsy or interfascicular dissection should be avoided, as they may result in permanent motor or sensory deficit.

💡 Teaching Pearl:
Fat between and around preserved nerve fascicles + coaxial cable/spaghetti appearance = lipomatosis of nerve. Associated nerve-territory overgrowth makes the diagnosis even more characteristic.

08/09/2026

Bone tumors can be challenging — not because every lesion is rare, but because the key is knowing how to approach them systematically.

On November 17 & 24, 2026, the next BCV Master Series will focus on Bone Tumors and Tumor-like Lesions with Iris Eshed, Gideon Flusser, and Kay G. Hermann.

Expect focused expert lectures, interactive case discussions, pattern recognition, mimics, pitfalls, and plenty of real imaging.

The launch offer is now live for the first 20 tickets.

👉 https://www.berlincaseviewer.com/tumors26/

07/09/2026

🏉 From the rugby pitch to the MRI scanner — and back again faster than you might expect.

A 31-year-old professional South African 🇿🇦 rugby player sustained an ankle injury during a tackle. The mechanism was unusual, the MRI findings impressive, and the clinical course even more surprising.

What would you look for first after an injury like this?

👉 Want to explore the full scrollable case, including the MRI, MCQ, and teaching summary?
Find it here: https://bcv.app/sumr26

Thank you, Dr. Colin Turner, for this submission to the BCV Summer of Cases 2026 and the insight into the rugby play, which is big in South Africa.

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🏉 THE REVEAL

This was not the typical ankle injury pattern seen after a rugby tackle.

MRI demonstrated a complete tear of both the superficial and deep deltoid ligament complex, accompanied by multifocal bone bruising, extensive soft-tissue edema, and a split tear of the tibialis anterior tendon.

What makes the pattern particularly unusual:
The lateral ligament complex and syndesmosis were intact.

And then comes the real rugby twist:

Just 12 days after the injury, the player was back on the field — playing an international match for his country.

A striking reminder that in elite sport, MRI severity and functional recovery do not always run in parallel.

💡 Teaching pearl:
Treat the athlete, not the MRI. Imaging defines the structural injury, but return-to-play depends on stability, pain, strength, function, and sport-specific performance.

05/09/2026

Fifteen Days After the Tackle ⚽️

A 22-year-old man injured his knee while playing football. What initially seemed like a routine sports injury took an unexpected course over the following two weeks, with increasing pain, swelling, and severe limitation of motion.

The MRI tells quite a story. What do you think is going on?

Want to explore the full scrollable case?
Find it here: https://bcv.app/sumr26

Many thanks to Maria Lua Sampaio de Lira Gulde for contributing this fascinating case to our BCV Summer of Cases! 🙏

–– ⚠️ Do not read the below if you want to quiz yourself ––

This was far more than a post-traumatic knee injury. The patient had septic arthritis with associated distal femoral osteomyelitis and a large infected posterior subperiosteal collection, accompanied by extensive surrounding soft-tissue inflammation and possible pyomyositis.

An important reminder that a convincing history of trauma can become an anchoring trap when the subsequent clinical course and imaging findings no longer fit a purely traumatic process.

25/08/2026

Trying a slightly different format today 🎤😄

A little faster, a little more direct — and straight into the imaging.

This time: rheumatoid arthritis of the hand. 
Joint-space narrowing, marginal erosions, and the key pattern to recognize at the MCP joints.

If this kind of short, focused imaging explanation is useful, let me know in the comments. More of these?

25/08/2026

Case 16 of our Summer of Cases ☀️

A 73-year-old woman presents with weight loss, atypical facial pain, and new-onset strabismus. Chest imaging reveals a spiculated cavitary pulmonary mass with additional nodules — initially highly suspicious for malignancy.

But then the sinonasal findings come into play.

What connects the lung, ENT region, and strabismus?

This case comes from rheumatologist Dagmara Piotrowska — thank you for sharing such a fascinating diagnostic journey with us.

Want to explore the full scrollable case?
Find it here: https://bcv.app/sumr26

24/08/2026

28 cases. One summer. Radiology from around the world. 🌍☀️
Summer of Cases 2026 — and we’re only halfway through.

20/08/2026

Case 15 of our starts with a very everyday complaint: stairs are becoming harder.

A 66-year-old woman presents with slowly progressive lower-limb weakness, recurrent falls, and increasing difficulty rising from a chair and climbing stairs. Muscle MRI reveals a highly characteristic distribution: distal-predominant quadriceps involvement with prominent atrophy, relative sparing of the re**us femoris, and bilateral fatty atrophy of the medial gastrocnemius.

Want to explore the full scrollable case and quiz question?
Find it here: https://bcv.app/sumr26

–– Do not read the below if you want to quiz yourself ––

The diagnosis is inclusion body myositis — a condition in which pattern recognition on MRI can add real diagnostic value beyond simply showing “myositis.” In this case, imaging also helped identify the vastus medialis as a suitable target for biopsy.

A particularly nice reminder that muscle MRI is not only about detecting edema. Distribution, atrophy, fatty replacement, and selective muscle involvement matter.

Case by Dr. Miguel Vega, Medellín, Colombia.

Special thanks to Prof. Torsten Diekhoff, Berlin, Germany, for his careful additional review of the case.

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