Question 2246
{"accessible":false,"alternatives":[{"id":11124,"text":"Erdheim-Chester disease"},{"id":11125,"text":"IgG4 disease"},{"id":11126,"text":"metastases"},{"id":11127,"text":"Rosai-Dorfman disease"},{"id":11128,"text":"tuberculosis"},{"id":11129,"text":"viral meningitis"}],"archived":false,"correctAlternativeId":11129,"explanation":"\u003cp\u003eIsolated viral meningitis results in minimal if any imaging features and when changes are visible it most often presents as leptomeningeal enhancement (not pachymeningeal). In many instances, leptomeningeal inflammation is associated with parenchymal involvement (meningoencephalitis) in which case parenchymal high T2 signal and swelling will be most obvious.\u0026nbsp;\u003c/p\u003e\u003cp\u003eThe other alternatives can cause bulky hypertrophic pachymeningeal thickening.\u0026nbsp;\u003c/p\u003e","id":2246,"imageUrl":null,"imageAttribution":null,"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/2246","nextQuestionPath":null,"relatedArticles":[{"id":1297,"title":"Erdheim-Chester disease","link":"/articles/erdheim-chester-disease?lang=us"},{"id":42128,"title":"Dural metastases","link":"/articles/dural-metastases?lang=us"},{"id":8669,"title":"Tuberculous meningitis","link":"/articles/tuberculous-meningitis?lang=us"},{"id":12299,"title":"Rosai-Dorfman disease","link":"/articles/rosai-dorfman-disease?lang=us"},{"id":57868,"title":"IgG4-related hypertrophic pachymeningitis","link":"/articles/igg4-related-hypertrophic-pachymeningitis-1?lang=us"}],"alsoUsedIn":[{"id":1167,"kind":"Course","title":"Adult Neuroradiology Review Course - page 1167","link":"https://radiopaedia.org/courses/adult-neuroradiology-review-course/pages/1167"},{"id":1167,"kind":"Course","title":"Adult Neuroradiology Review Course - page 1167","link":"https://radiopaedia.org/courses/adult-brain-mri-review-course-2015-online-video/pages/1167"}],"stem":"\u003cp\u003eWhich of the following entities is\u0026nbsp;\u003cstrong\u003eLEAST \u003c/strong\u003elikely to present as a lobulated pachymeningeal mass?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/2246"}],"attemptsPercentages":[{"alternativeId":"11124","percentage":14},{"alternativeId":"11127","percentage":7},{"alternativeId":"11125","percentage":4},{"alternativeId":"11129","percentage":59},{"alternativeId":"11128","percentage":6},{"alternativeId":"11126","percentage":10}],"promptToLogin":false,"questionManager":false,"articleId":"viral-meningitis"}