Traumatic adrenal hemorrhage
Fell 2 meters off a ladder. Now mid back pain and right upper quadrant pain
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Ovoid hyperdense mass (arrow) in the right adrenal gland associated with stranding in the perirenal fat and a subtle subcapsular collection overlying the upper pole of the right kidney. Note the T9 vertebral body fracture with anterior disc widening indicative of a severe hyperextension injury.
The adrenal mass was thought by a colleague to represent a cortical adenoma but it is hyperdense (not hypodense as usually seen in adenomas) and associated with adjacent fat stranding indicative of hemorrhage. The patient has sustained a significant impact force given the thoracic vertebral fracture.