Advanced Image Interpretation part 2 case 4

This is the fourth case in this second exercise on advanced image interpretation. Read through and ask the questions as you go. At the end you will be asked to think about the differential diagnosis and management. Now all four have been published, you will be able to complete some questions relating to each and then submit some information in order to achieve your interactive point for this exercise. You may benefit from having a pen and paper to hand in order to make notes as you go.