The Common Vein

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Where did the story start?



03382pi.8s hat red ribbon gondola Venice Italy gondolier hat impressionist Davidoff art Davidoff photography copyright 2009 all rights reserved



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Where did the story start?



03382pi.8s hat red ribbon gondola Venice Italy gondolier hat impressionist Davidoff art Davidoff photography copyright 2009 all rights reserved



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Where did the story start?

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Where did the story start?

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Duplicated Kidneys?



Are we seeing double? Do we see a duplex kidney? This is the portal venous phase of a superior mesenteric artery angiogram. There is a narrowing of the portal vein and post stenotic dilatation in this patient with carcinoma of the pancreas causing encasement of the vein Courtesy Ashley Davidoff MD. 13438 code portal vein pancreas encasement post stenotic dilatation carcinoma radiologists and detectives



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Duplicated Kidneys?



Are we seeing double? Do we see a duplex kidney? This is the portal venous phase of a superior mesenteric artery angiogram. There is a narrowing of the portal vein and post stenotic dilatation in this patient with carcinoma of the pancreas causing encasement of the vein Courtesy Ashley Davidoff MD. 13438 code portal vein pancreas encasement post stenotic dilatation carcinoma radiologists and detectives



)

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Duplicated Kidneys?

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Duplicated SMA?



Double exposure – for Radiologists and Detectives 13437



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Duplicated SMA?



Double exposure – for Radiologists and Detectives 13437



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Duplicated SMA?

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Duplicated SMA?

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Why Are the Veins Distended Yet the Arms Are HIgher than the Heart?



A sculpture of the crucifixion on the banks of the Salzach river which runs through Salzburg, Austria. A sharp edged wound, presumablly representing a penetrating wound, enters the right chest. Note, that despite the elevation of the arms above the right atrium (RA) there is persistent distension of the veins. How do you put this together as a clinical scenario? Cardiac tamponade is the best explanation. Courtesy Ashley Davidoff MD. 00162 code accessory interesting detectives and radiologists pericardium pericardial tamponade Davidoff photography



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Why Are the Veins Distended Yet the Arms Are HIgher than the Heart?



A sculpture of the crucifixion on the banks of the Salzach river which runs through Salzburg, Austria. A sharp edged wound, presumablly representing a penetrating wound, enters the right chest. Note, that despite the elevation of the arms above the right atrium (RA) there is persistent distension of the veins. How do you put this together as a clinical scenario? Cardiac tamponade is the best explanation. Courtesy Ashley Davidoff MD. 00162 code accessory interesting detectives and radiologists pericardium pericardial tamponade Davidoff photography



)

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Last Switch – There Should Be No Doubt



Now the image is in the appropriate projection – What do you think of it now? – Can you see a chin? The image is of course a posterior view of the right shoulder. Courtesy Ashley Davidoff MD. 13433 code For Radiologists and Detectives



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Last Switch – There Should Be No Doubt



Now the image is in the appropriate projection – What do you think of it now? – Can you see a chin? The image is of course a posterior view of the right shoulder. Courtesy Ashley Davidoff MD. 13433 code For Radiologists and Detectives



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Last Switch – There Should Be No Doubt

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Last Switch – There Should Be No Doubt

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Switch the Orientation
What is it Now?



The image has been turned around – What do you think this image repesents? The image will be turned around in the series – one more time – See what you think? 13432 Courtesy Ashley Davidoff MD. code For Radiologists and Detectives



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Switch the Orientation
What is it Now?



The image has been turned around – What do you think this image repesents? The image will be turned around in the series – one more time – See what you think? 13432 Courtesy Ashley Davidoff MD. code For Radiologists and Detectives



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Switch the Orientation
What is it Now?

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Switch the Orientation
What is it Now?

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What is it?



This is part of the game of perception. What do you think this picture represents? The next image turns the image around – see what you think. 13430 Courtesy Ashley Davidoff MD. code For Radiologists and Detectives radiologists and detectives



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What is it?



This is part of the game of perception. What do you think this picture represents? The next image turns the image around – see what you think. 13430 Courtesy Ashley Davidoff MD. code For Radiologists and Detectives radiologists and detectives



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What is it?

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What is Going On?



13579 leaf shadow result false positive perception art photo interesting accessory radiologists and detectives Davidoff art



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What is Going On?



13579 leaf shadow result false positive perception art photo interesting accessory radiologists and detectives Davidoff art



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What is Going On?

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Where in the US are We?



Courtesy Ashley Davidoff MD. 13429 radiologists and detectives



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Correct Orientation
See the Debris Floating on the Water



Courtesy Ashley Davidoff MD. 13428 radiologists and detectives



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Which is the Reflection and Which is Real?



Are we downside up or upside down? Can you tell which is the real image and which the reception? Courtesy Ashley Davidoff MD. 13427 code accessory interesting for radiologists and detectives



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Polly Which Face?



Polly is back again – is this his left face or his right. What features distinguished the left from the right? Did you see the little black spot on hithe upper beak of his right face – This is his right face which we switched on you to help build powers of observation.Courtesy Ashley Davidoff MD. 13426 radiologists and detectives



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Polly Which Face?



Polly is back again – is this his left face or his right. What features distinguished the left from the right? Did you see the little black spot on hithe upper beak of his right face – This is his right face which we switched on you to help build powers of observation.Courtesy Ashley Davidoff MD. 13426 radiologists and detectives



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Polly Left Face



Polly turns his face to to the other side, and shows the left face. Make your observations because the next image could be the left or the right side. Courtesy Ashley Davidoff MD 13425 radiologists and detectives



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Polly Right Face



Polly looks this way and shows the right side of his face. Take as much in as you can because we are going to show you the other side and the last in the series will test your powers of observation. Courtesy Ashley Davidoff MD 13424 radiologists and detectives



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Polly Right Face



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Multiple Views to Get to the Truth



Its the bird of paradise of course – aka strelitsia The orthogonal view as in radiology is key. yet those who have the knowledge of flowers would recognise the strelitsia by a single petal. This is part of the art of looking and seeing. Courtesy Ashley Davidoff MD. 13423 radiologists and detectives Davidoff photography



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Multiple Views to Get to the Truth



Its the bird of paradise of course – aka strelitsia The orthogonal view as in radiology is key. yet those who have the knowledge of flowers would recognise the strelitsia by a single petal. This is part of the art of looking and seeing. Courtesy Ashley Davidoff MD. 13423 radiologists and detectives Davidoff photography



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What Type of Flower?



This is a picture of a very well known flower – which from this view may be difficult to recognise. A second view will give the game away. Courtesy Ashley Davidoff MD. 13422 radiologists and detectives Davidoff photography



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What Type of Flower?



This is a picture of a very well known flower – which from this view may be difficult to recognise. A second view will give the game away. Courtesy Ashley Davidoff MD. 13422 radiologists and detectives Davidoff photography



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This fence surrounds a farm in Pennsylvania and there are odd looking hair balls at fixed intervals along the fence and then at a lower lvel these hair balss collect in a more linear fashion. Can you work this one out? Courtesy Ashley Davidoff MD. 02162p code accessory interesting radiologists and detectives



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06065p.8s Peru window stone mountains Machu Picchu Davidoff photography copyright 2009 all rights reserved radiologists and detectives



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