Length of distal esophageal segment tertiary contractions tram track sign and filling defects in distal esophageal segment are useful esophagographic features distinguishing primary from secondary achalasia. The video will describe bronchiectasis as seen on chest x ray.
Mri with gadolinium enhancement shows leptomeningeal angioma.
Tram track appearance on skull x ray. Tram track sign was found in 55 patients with primary achalasia. Pathology tram track appearance refers to parallel thickening and splitting of the glomerular capillary basement membrane due to subendothelial deposition of immune complexes mesangial matrix and neutrophilic debris between the glomerular basement membrane and the vascular endothelium causing a double contour by light microscopy a classic finding in type i less in type ii. Skull x ray film may show classic tram line or tram track calcifications.
Mild form shows tram track appearance. Tram track sign annotated in a 65 year old male with diagnosed bronchiectasis secondary to dilated bronchi within both lower lobes. A computed tomography ct scan subsequently revealed extensive gyriform calciﬁcation in the right parieto occipital region with ipsilateral cerebral cortical atrophy.
Filling defects in the distal esophageal segment were noted in 94 patients with secondary achalasia. A lateral x ray of the skull showed the typical gyriform calciﬁcation tram track calciﬁcation and enlargement of the paranasal sinuses figure 1. Hair on end appearance on skull x rays is seen in 1 rickets.
Spect demonstrates decreased cortical perfusion. Tram track sign may be used in chest radiography or ct to denote the thickened non tapering parallel walls of cylindrical bronchiectasis. Please see disclaimer on my website.
Ct scan may show brain atrophy calcification and ipsilateral choroid plexus enlargement. When found in the lungs tram tracks are radiologic signs that are usually accompanied by pulmonary edema in cases of congestive heart failure and bronchiectasis tram tracks are caused by bronchial wall thickening and can be detected on a lateral chest x ray. What was seen on the chest x ray it is nothing but the tram line appearance unable to spot it here comes the modified image.
Case discussion the tram tack sign seen on this chest x ray denoted thickened non tapered walls of the cylindrical bronchiectasis. Now compare the previous x ray with the one above here are few examples of tram line shadows. The term tram tracks is also used to describe the basement membrane duplication found on light microscopy.
It should not be confused with other tram track signs elsewhere in the body.