Crack the Core + High Yield Flashcards by Tonia Forjoe

When I say:
Subglottic haemangioma
Cutaneous Haemangioma

PHACES Syndrome
(Posterior fossa malformation, Haemangioma, Arterial malformation, Coarctation/cardiac, Ear anomalies, Subglottic haemangioma)

How well did you know this?

Not at all

Perfectly

When I say:
Ropy appearance
Post term delivery

Meconium aspiration

How well did you know this?

Not at all

Perfectly

When I say:
Fluid in the fissures
Hx of C-Section
Maternal sedation

Transient tachypnoea of newborn

How well did you know this?

Not at all

Perfectly

When I say:
Grannular opacities + Premature

Respiratory distress syndrome

How well did you know this?

Not at all

Perfectly

When I say:
Granular opacities + Term + high lung volume

Non GBS Pneumonia

How well did you know this?

Not at all

Perfectly

When I say:
Granular opacities + Term + Low lung volume

GBS Pneumonia

How well did you know this?

Not at all

Perfectly

When I say:
Band like opacities

Chronic lung disease (BPD)

How well did you know this?

Not at all

Perfectly

When I say:
Linear lucencies

Pulmonary interstitial emphysema

How well did you know this?

Not at all

Perfectly

When I say:
Pulmonary hypoplasia

Diaphragmatic hernia

How well did you know this?

Not at all

Perfectly

When I say:
Lung cysts and nodules

LCH or Papillomatosis

How well did you know this?

Not at all

Perfectly

When I say:
Lower lobe bronchiectasis

Primary ciliary dyskinesia

How well did you know this?

Not at all

Perfectly

When I say:
Upper lobe bronchiectasis

Cystic fibrosis

How well did you know this?

Not at all

Perfectly

When I say:
Posterior mediastinal mass <2

Neuroblastoma

How well did you know this?

Not at all

Perfectly

When I say:
No air in stomach

Oesophageal atresia

How well did you know this?

Not at all

Perfectly

When I say:
Excessive air in the stomach

H type TOF

How well did you know this?

Not at all

Perfectly

When I say:
Anterior oesophageal impression
Tracheal stenosis

Pulmonary sling

How well did you know this?

Not at all

Perfectly

When I say:
Single bubble

Gastric atresia

How well did you know this?

Not at all

Perfectly

When I say:
Double bubble
Downs syndrome

Duodenal atresia

How well did you know this?

Not at all

Perfectly

When I say:
Single bubble with distal gas
Bilous vomiting in an infant
Corkscrew duodenum

Mid gut volvulus

How well did you know this?

Not at all

Perfectly

When I say:
Non bilious vomiting
Paradoxial aciduria

Hypertrophic pyloric stenosis

How well did you know this?

Not at all

Perfectly

When I say:
Reversed SMA and SMV (SMV to left of SMA)

Malrotation

How well did you know this?

Not at all

Perfectly

When I say:
Absent gallbladder
Triangle cord sign

Biliary atresia

How well did you know this?

Not at all

Perfectly

When I say:
Asplenia

Cyanotic heart disease

How well did you know this?

Not at all

Perfectly

When I say:
Infarcted spleen
Gallstones

Sickle cell disease

How well did you know this?

Not at all

Perfectly

When I say: Short microcolon

Colonic atresia

When I say: Long microcolon

Meconium ileum or distal ileal atresia

When I say: Saw tooth colon

Hirschsprung disease

When I say: Calcified mass in mid abdomen of a newborn

Meconium peritonitis

When I say: Meconium ileus equivalent

Distal intestinal obstruction syndrome

When I say: Abrupt caliber change of aorta below coeliac axis

Hepatic haemangioendothelioma

When I say: Cystic mass in liver of a newborn

Mesenchymal Hamartoma

When I say: Elevated AFP with mass in liver of a newborn

Hepatoblastoma

When I say: CBD measures >10 mm in child

Choledochal cyst

When I say: Lipomatous pseudohypertrophy of the pancreas

Cystic fibrosis

When I say: Unilateral renal agenesis

Unicornuate uterus

When I say: Neonatal renal vein thrombosis

Maternal diabetes

When I say: Neonatal renal artery thrombosis

Misplaced UAC

When I say: Hydronephrosis on fetal MRI

Posterior urethral valve

When I say: Urachus

Bladder adenocarcinoma

When I say: Nephroblastomatosis with necrosis

Wilms

When I say: Solid renal tumour of infancy

Mesoblastic nephroma

When I say: Solid renal tumour of childhood

Wilms

When I say: Most common RCC subtype in kids Prior exposure to cytotoxic chemotherapy

Translocation subtype

When I say: Midline pelvic mass in a female

Hydrometrocolpos

When I say: Right sided varicocele

Abdominal pathology

When I say: Blue dot sign

Torsion of the testicular appendage

When I say: Hand or foot pain/swelling in an infant

Sickle cell with hand foot syndrome

When I say: Extratesticular scrotal mass

Embryonal rhabdomyosarcoma

When I say: Narrowing of interpedicular distance

Achondroplasia

When I say: Platyspondyly (Flat vertebral bodies)

Thanatophoric

When I say: Mystery liver abscess in a child

Chronic granulomatous disease

When I say: Anterior mediastinal mass with calcification in a child

Treated lymphoma or thymic lesion

When I say: 3 weeks to 3 months 4 mm single wall dimension 14 mm pyrloric canal length

Hypertrophic pyloric stenosis

Which side is gastrochisis always found?

Right side

When I say: Most common tumour of foetus or infant

Sacrococcygeal teratoma

When I say: Cervical kyphosis Lateral thoracic meningocele Bilateral optic nerve gliomas

NF1

When I say: Bilateral vestibular schwannoma

NF2

When I say: Retinal hamartoma

Tuberous sclerosis

When I say: Retinal angioma Multiple haemangioblastoma

VHL (Von Hippel Lindau)

When I say: Brain tumour with restricted diffusion Crosses the midline

Lymphoma

When I say: Cyst and nodule in child

Pilocytic astrocytoma

When I say: Cyst and nodule in adult

Haemangioblastoma

When I say: Swiss cheese tumour in ventricle

Central neurocytoma

When I say: CN 3 palsy

Posterior communicating artery aneurysm

When I say: CN 6 palsy

Increased ICP

When I say: Ventricles out of size to atrophy

Normal pressure hydrocephalus

When I say: Haemorrhagic putamen

Methanol

When I say: Decreased FDG uptake in lateral occipital cortex

Lewy body dementia

When I say: TORCH with periventricular calcifications

CMV

When I say: TORCH with hydrocephalus

Toxoplasmosis

When I say: TORCH with haemorrhagic transformation

HSV

When I say: Neonatal infection with frontal lobe atrophy

HIV

When I say: Rapidly progressing dementia Rapidly progressing atrophy

CJD

When I say: Expanding cortex

Oligodendroglioma

When I say: Tumour acquired after trauma (LP)

Epidermoid

When I say: Palate separated from maxilla/floating palate

Le fort 1

When I say: Face separated from cranium

Le fort 3

When I say: Maxilla separated from the face/pyramidal

Le fort 2

When I say: Airless expanded sinus

Mucocele

When I say: Developmental venous anomaly

Cavernoma

When I say: Single vascular lesion in the pons

Capillary telangiectasia

When I say: Elevated NAA peak

Canavans

When I say: Tigroid appearance

Metachromic leukodystrophy

When I say: Endolymphatic sac tumour

VHL

When I say: T1 bright in petrous apex

Cholesterol granuloma

When I say: Restricted diffusion in petrous apex

Cholesteatoma

When I say: Lateral rectus palsy + Otomastoiditis

Grandenigo syndrome

When I say: Cochlear and semicircular canal enhancement

Labrynthitis

When I say: Conductive hearing loss in an adult

Otosclerosis

When I say: Noise induced vertigo

Superior semicircular canal dehiscence

When I say: Widening of the maxillary ostium

Antrochonal polyp

When I say: Inverted papilloma

Squamous cell cancer

When I say: Adenoid cystic

Perineural spread

When I say: Left sided vocal cord palsy

AP window mass

When I say: Bilateral coloboma

CHARGE syndrome

When I say: Retinal detachement + Small eye

PHPV

When I say: Bilateral small eye

Retinopathy of prematurity

Calcification of globe of a child

Retinoblastoma

When I say: Fluid/Fluid levels in the orbit

Lymphangioma

When I say: Orbital lesion worse with valsalva

Orbital varix

When I say: Pulsatile exophthalmos

NF1 and CC fistula

When I say: Sphenoid wing dysplasia

NF1

When I say: Scimitar sacrum

Currarino triad

When I say: Bilateral symmetrical increased T2 signal in dorsal columns

B12 or HIV

When I say: Owl eye appearance of spinal cord

Spinal cord infarct

When I say: Enhancement of nerve roots of cauda equina

Gullain Barre

When I say: Subligamentous spread of infection

When I say: Most common primary brain tumour in adults

Astrocytoma

When I say: Brain tumour that commonly calcifies

Oligodendroglioma

When I say: Restricted diffusion in ventricle

Choroid plexus xanthogranuloma

When I say: Pituitary T1 big and bright

Pituitary apoplexy

When I say: Pituitary T2 bright

Rathke Cleft cyst

When I say: Pituitary calcified

Craniopharyngioma

When I say: CP angle Invades the IAC

Schwannoma

When I say: CP angle invades both IAC

Schwannoma with NF2

When I say: CP angle mass Restricts on diffusion

Epidermoid

When I say: Child Mass arising from vermis

Medulloblastoma

When I say: Child Toothpaste tumour out of 4th ventricle

Ependymoma

When I say: Hippocampal atrophy first

Alzheimers dementia

When I say: Beaked tectum

Chiari 2 malformation

When I say: Beaked anterior L1 vertebrae

Hurlers

When I say: Sometimes beaked pons

Multi-system atrophy

When I say: Most common TORCH infection

CMV

When I say: Abscess that does not restrict diffusion

Toxoplasmosis

When I say: H&N tumour with positive octreotide scan

Enthesioneuroblastoma

When I say: Most common intra-ocular tumour in adult

Melanoma

When I say: Enhancement of nerve roots >6 weeks post surgery

Arachnoiditis

When I say: Anterior sacral meningocele Anorectal malformation Saccrococcgyeal osseous defect

Currarino triad

When I say: Spares the basal ganglia

Herpes

When I say: Most common malignant lacrimal gland tumour

Adenoid cystic adenocarcinoma

When I say: Obliteration of raiders triangle (Retrotracheal space)

Aberrant right subclavian artery

When I say: Flat waist sign

Left lower lobe collapse

When I say: Dental procedure gone bad, now with jaw osteomyelitis, pneumonia

Actinomycoses

When I say: Halo sign

Fungal pneumonia - Invasive aspergillosis

When I say: Reverse halo or atoll sign

COP

When I say: Finger in glove Asthma

ABPA

When I say: Septic emboli + Jugular vein thrombosis Fusobacterium Necrophorum

Lemierre

When I say: Paraneoplastic syndrome with SIADH

Squamous cell lung cancer

When I say: Paraneoplastic syndrome with PTH

Squamous cell cancer

When I say: Small cell lung cancer + Proximal weakness

Lambert Eaton

When I say: Cavity fills with air, post pneumonectomy

Bronchopleural fistula

When I say: Malignant bronchial tumour

Carcinoid

When I say: Malignant tracheal tumour

Adenoid cystic

When I say: AIDS patient with lung nodules, pleural effusion and lymphadenopathy

Lymphoma

When I say: Gallium negative

Kaposi sarcoma

When I say: Thallium negative

PCP

When I say: Macroscopic fat and popcorn calcifications

Hamartoma

When I say: Bizarre shaped cysts

LCH

When I say: Lung cysts in a TS patient

LAM

When I say: Honeycombing

UIP

When I say: Ground glass with sub pleural sparing

NSIP

When I say: UIP Lungs + Parietal pleural thickening

Asbestosis

When I say: Cavitation in setting of silicosis

When I say: Air trapping seen 6 months post lung transplant

Chronic rejection/Bronchiolitis Obliterans syndrome

When I say: Crazy paving

PAP or COVID

When I say: Perivascular cysts

LIP

When I say: UIP + Air trapping

Chronic hypersensitivity pneumonitis

When I say: Dilated oesophagus + ILD

Scleroderma + NSIP

When I say: Pulmonary HTN with normal wedge pressure

Pulmonary veno-occlusive disease

When I say: Persistent fluid collection after pleural drain/tube placement

Extrapleural haematoma

When I say: Displaced extrapleural fat

Extrapleural haematoma

When I say: Massive air leak in setting of trauma

Bronchial or tracheal injury

When I say: Hot on PET - around the periphery

Pulmonary infarct

When I say: Multilobar collapse

Sarcoid

When I say: Spontaneous coronary artery dissection

Fibromuscular dysplasia

When I say: Supravalvular aortic stenosis

Williams syndrome

When I say: Bicuspid aortic valve with coarctation

Turners syndrome

When I say: Isolated right upper lobe oedema

Mitral regurgitation

When I say: Peripheral pulmonary stenosis

Alagille syndrome

When I say: Box shaped heart

Ebsteins anomaly

When I say: Hand/Thumb defects + ASD

Holt Oram

When I say: Ostium primum ASD (ECD)

Downs syndrome

When I say: Right sided PAPVR

Sinus venosus ASD

When I say: Calcification in left atrium wall

Rheumatic heart disease

When I say: Difficult to suppress myocardium Blood pool suppression on delayed enhancement

Amyloid

When I say: Septal bounce Ventricular interdependence

Constrictive pericarditis

When I say: Focal thickening of the septum not HOCM

Sarcoid

When I say: Ballooning of the left ventricular apex

Takotsubo

When I say: Fat in the wall of a dilated right ventricle

ARVC (Arrythmogenic right ventricular cardiomyopathy)

When I say: Kid with dilated heart and mid wall enhancement

Muscular dystrophy

When I say: Cardiac rhabdomyoma

Tuberous sclerosis

When I say: Bilateral ventricular thrombus

Eosinophillic cardiomyopathy

When I say: Diffuse LV Subendocardial enhancement not restricted to a vascular distribution

Cardiac amyloid

When I say: Multiple cardiac myxomas

Carneys complex

When I say: Prominent ventricular trabeculation

Non-compaction

When I say: Vessel in fissure of ligamentum venosum

Replaced left hepatic artery

When I say: Vessel coursing on pelvic rim

Corona mortis

When I say: Ascending aorta calcifications

Syphillis and Takayasu

When I say: Tulip bulb aorta

Marfans

When I say: Marfans variant Tortous vessels

Loeys Dietz

When I say: Tortuosity of ulnar artery causing a corkscrew appearance

Hypothenar Hammer

When I say: Renal artery stenosis with HTN in a child

NF1

When I say: Nasty looking saccular aneurysm without intimal calcifications

Mycotic aneurysm

When I say: Tree bark intimal calcifications

Syphillitic aneurysm

When I say: Painful aneurysm in smoker, sparing the posterior wall

Inflammatory aneurysm

When I say: Turkish man with pulmonary artery anuerysm

Behcets

When I say: GI Bleed with early opacification of a dilated draining vein

Colonic angiodysplasia

When I say: Spider webb appearance of hepatic veins on angiogram

Budd Chiari

When I say: Non-de-compressible varicocele Right sided varicocele

CT AP for abdominal malignancy

When I say: Swollen left leg

May Thurner syndrome

When I say: Great saphenous vein on the wrong side of the calf - lateral side

Marginal vein of servelle (Klippel feil syndrome)

When I say: Asian Vasculitis involves the aorta

Takayasu

When I say: Child with vertigo and aortitis

Cogan syndrome

When I say: Nasal perforation + Cavitary lung lesions

Wegeners

When I say: Diffuse pulmonary haemorrhage

Microscopic polyangitis

When I say: Smoker + Hand angiogram

Beurgers

When I say: Unilateral tardus parvus in the carotid

Stenosis of the innominate

When I say: Bilateral tardus parvus in the carotids

Aortic stenosis

When I say: Bilateral reversal of flow in carotids

Aortic regurgitation

When I say: Lack of diastolic flow on carotid US

Brain death

When I say: IVC >28 mm

Mega Cava

When I say: Hairpin turn during bronchial angiography

Anterior medullary artery

When I say: Pulmonary AVM

HHT

When I say: AIDS + Bilateral GGO + Thin walled cysts + Pneumothorax

PCP

When I say: Most common vascular ring

Double aortic arch

When I say: Most common congenital heart disease

VSD

When I say: Most common neoplasm to involve the cardiac valves

Fibroelastoma

When I say: Most common primary cardiac tumour in children

Rhabdomyoma

When I say: 2nd most common primary cardiac tumour in children

Fibroma

When I say: Most common cause of cardiac mets

Lung cancer Lymphoma

When I say: Claudication Absent/Decreased femoral pulses Impotence

Leriche syndrome

When I say: Most common associated defect with aortic coarctation

Bicuspid aorta

When I say: Medial deviation of the popliteal artery by the medial head of gastronemius

Popliteal entrapment

When I say: Most common vasculitis in a child

HSP

When I say: Tardus parvus

Stenosis proximal to that vessel

When I say: Mystery liver abscess in a kid

Chronic granulomatous disease

When I say: Oesophageal concentric rings

Eosinophilic oesophagitis

When I say: Shaggy or plaque like oesophagus

Candidiasis

When I say: Shaggy or plaque like oesophagus Asymptomatic old lady

Glycogen Acanthosis

When I say: Reticular mucosal pattern High stricture with associated hiatal hernia

Barretts

When I say: Abrupt shoulders Oesophageal lesion

Cancer

When I say: Killian dehiscence

Zenker diverticulum

When I say: Transient fine transverse folds across the oesophagus

Feline oesophagus

When I say: Birds beak Oesophageal lesion

Achalasia

When I say: Solitary oesophageal ulcer

CMV/AIDS

When I say: Ulcers at level of arch or distal oesophagus

Medication induced

When I say: Breast cancer Bowel hamartomas

Cowdens

When I say: Brain tumours Bowel polyps

Turcots

When I say: Desmoid tumours Bowel polyps

Gardners

When I say: Enlarged left supraclavicular node

Virchow node (GI Cancer)

When I say: Crosses the pylorus

Gastric lymphoma

When I say: Isolated gastric varices

Splenic vein thrombus

When I say: Multiple gastric ulcers

Chronic aspirin use

When I say: Multiple duodenal/jejunal ulcers

Zollinger Ellison

When I say: Pancreatitis post bilroth 2

Afferent loop syndrome

When I say: Weight gain years post Roux-en-Y

Gastro-Gastro fistula

When I say: Clover leaf sign in duodenum

Healed peptic ulcer

When I say: Sand like nodules in jejunum

Whipples

When I say: Sand like nodules in jejunum + CD4 <100

MAI

When I say: Ribbon like bowel

GvHost

When I say: Ribbon like jejunum Moulage pattern (Loss of jejunal folds) Fold reversal of jejunum/ileum Cavitary lymph nodes

Long standing coeliac

When I say: Hidebound or stack of coins Megaduodenum

Scleroderma

When I say: Duodenal obstruction recent weight loss

SMA syndrome

When I say: Cone shaped caecum

Amebiasis

When I say: Lead pipe

Ulcerative colitis

When I say: String sign

Crohns

When I say: Massive circumferential thickening without obstruction

Lymphoma

When I say: Multiple small bowel target signs

Melanoma

When I say: Scalloped appearance of the liver

Pseudomyxoma peritonei

When I say: HCC without cirrhosis

Hep B or Fibrolamellar HCC

When I say: Capsular retraction

Cholangiocarcinoma

When I say: Periportal hypoechoic infiltration + AIDS

Kaposi's

When I say: Sparing of caudate lobe

Budd Chiari

When I say: Large T2 bright nodes + Budd chiari

Hyperplastic nodules

When I say: Liver Low signal in phase Low High out of phase

Haemochromatosis

When I say: Multifocal intrahepatic and extra hepatic biliary stricture

PSC

When I say: Multifocal intrahpeatic and extra hepatic biliary strictures Papillary stenosis

AIDS Cholangiopathy

When I say: Bile ducts full of stones

Recurrent pyogenic cholangitis

When I say: Gallbladder comet tail artifact

Adenomyomatosis

When I say: Lipomatous pseudo hypertrophy of the pancreas

Cystic fibrosis

When I say: Sausage shaped pancreas

Autoimmune pancreatitis

When I say: RP Fibrosis Sclerosing cholangitis Fibrosing mediastinitis Inflammatory pseudotumour

IgG4

When I say: Wide duodenal sweep

Pancreatic cancer

When I say: Grandmother pancreatic cyst

Serous cystadenoma

When I say: Mother pancreatic cyst

Mucinous

When I say: Daughter pancreatic cyst

Solid pseudo papillary (SPEN)

When I say: Bladder stones

Neurogenic bladder

When I say: Urethra cancer

Squamous cell cancer

When I say: Urethra cancer - prostatic portion

Transitional cell cancer

When I say: Urethra cancer - in a diverticulum

Adenocarcinoma

When I say: Long term suprapubic catheter

Squamous bladder Ca

When I say: E.coli infection

Malakoplakia

When I say: Vas deferens calcifications

Diabetes

When I say: Calcifications in a fatty renal mass

RCC

When I say: Protrude into the renal pelvis

Multilocular cystic nephroma

When I say: No functional renal tissue

Multicystic dysplastic kidney

When I say: Xanthogranulomatous pyelonpehritis

Staghorn calculus

When I say: Papillary necrosis

Diabetes

When I say: Shrunken calcified kidney

TB (Putty kidney)

When I say: Big bright kidney with decreased renal function

HIV

When I say: Hx of lithotripsy

Page kidney

When I say: Cortical rim sign

Subacute renal infarct

When I say: Hx of renal biopsy

AVF

When I say: Reversed renal diastolic flow

Renal vein thrombosis

When I say: Sickle cell trait Renal mass

Medullary RCC

When I say: Young adult, renal mass Severe HTN

Juxtaglomerular cell tumour

When I say: Squamous bladder ca Entire bladder calcified

Schistosomiasis

When I say: Urachus

Adenocarcinoma of the bladder

When I say: Long stricture in the urethra

Gonococcal

When I say: Short stricture in the urethra

Straddle injury

When I say: T shaped uterus

DES related or Vaginal clear cell cancer

When I say: Marked enlargement of the uterus Thickening of the junctional zone

Adenomyosis

When I say: Wolffian duct remnant

Gartner duct cyst

When I say: Theca lutein cysts

Moles and multiple gestations

When I say: Theca lutein cysts and pleural effusions

Hyperstimulation syndrome

When I say: Low level internal echoes in ovary

Endometrioma

When I say: T2 shortening

Endometrioma - Shading sign

When I say: Fishnet appearance

Haemorrhagic cyst

When I say: Ovarian fibroma + Pleural effusion

Meigs syndrome

When I say: Show storm uterus

Complete mole - 1st trimester

When I say: Serum HcG levels that rise in 8-10 weeks post evacuation of molar pregnancy

Choriocaricinoma

When I say: Midline cystic structure near back of bladder of a man

Prostatic utricle

When I say: Lateral cystic structure near back of bladder of a man

Seminal vesicle cyst

When I say: Isolated orchitis

Mumps

When I say: 20-30 yr old male with enlarged retroperitoneal lymph nodes

US testicles ?Malignancy

When I say: Onion skin appearance

Epidermoid cyst

When I say: Multiple hypoechoic masses in testicle

Lymphoma

When I say: Cystic elements and macro-calcifications in testicle

Mixed germ cell tumour

When I say: Homogenous and microcalcificaitons

Seminoma

When I say: Gynecomastia + Testicular tumour

Sertoli Leydig

When I say: Bilateral solid testicular masses Congenital adrenal hyperplasia

Adrenal rests

When I say: Bilateral solid testicular and epididymis masses

Testicular sarcoid

When I say: Bilateral, small, hyper echoic, avascular masses Cowden syndrome

Focal lipomatosis

When I say: Fetal macrosomia

Maternal diabetes

When I say: One artery adjacent to the bladder

Two vessel cord

When I say: Painless vaginal bleeding in the 3rd trimester

Placenta praaevia

When I say: Thinning of myometrium Turbulent doppler

Placenta creta

When I say: Cystic mass in posterior neck - antenatal period

Cystic hygroma

When I say: Pleural effusions & Ascites on prenatal US

Hydrops

When I say: Complex debris filled hydrosalpinx in woman with STI

PID/Tubo-ovarian abscess

When I say: Complex debris filled hydrosalpinx in woman without STI

Primary fallopian tube carcinoma

When I say: Massively enlarged bilateral kidneys

ARPKD

When I say: Bone scan with hot skull sutures

Renal osteodystrophy

When I say: Bone scan with renal cortex activity

Haemochromatosis

When I say: Bone scan with liver activity

Amyloid Hepatoma Liver necrosis

When I say: Bone scan with diffusely decreased bone uptake

Bisphosphonate therapy

When I say: Tramline along periosteum of long bones

Lung ca

When I say: Super hot mandible in adult

Fibrous dysplasia

When I say: Super hot mandible in child

Caffeys

When I say: Periarticular uptake on delayed scan

Reflex sympathetic dystrophy

When I say: PET with increased muscle uptake

Insulin

When I say: Diffuse FDG uptake in the thyroid on PET

Hashimoto

When I say: See the skeleton on MIBG

Neuroblastoma bone mets

When I say: Cardiac tissue taking up FDG more intense than normal myocardium

Hibernating myocardium

When I say: Posterior elbow dislocation

Capitellum fracture

When I say: Chorndroblastoma in adult Malignant epiphyseal lesion

Clear cell chondroblastoma

When I say: Permeative lesion in the diaphysis of a child

Ewings

When I say: T2 bright lesion in the sacrum

Chordoma

When I say: Lytic T2 dark lesion

Fibrosarcoma

When I say: Sarcomatous transformation of an infarct

MFH (Malignant fibrous histiocytoma)

When I say: Epiphyseal lesion that is not T2 bright

Chondroblastoma

When I say: Short 4th metacarpal

Pseudo-pseudo-hypo-parathyroidism Turner syndrome

When I say: Band like acro-osteolysis

Hajdu-Cheney

When I say: Fat containing tumour in retroperitoneum

Liposarcoma

When I say: Sarcoma in foot

Synovial sarcoma

When I say: Avulsion of the lesser trochanter

Pathologic fracture

When I say: Cross over sign

Pincer type FAI

When I say: Segond fracture Deep intercondylar notch

ACL tear

When I say: Reverse segond fracture Arcuate sign/Fibular head fracture

PCL

When I say: Bilateral patellar tendon ruptures

Chronic steroids

When I say: Wide ankle mortise

Proximal fibula (Maisonneuve)

When I say: Bilateral calcaneal fractures

Spinal compression fracture

When I say: Dancer with lateral foot pain

Avulsion of 5 MT

When I say: Old lady with sudden knee pain with standing

SONK

When I say: Looser zones

Osteomalacia or rickets (Vitamin D)

When I say: Unilateral RA with preserved joint spaces

RSD

When I say: T2 bright tumour in finger

Glomus

When I say: Blooming in tumour in finger

PVNS

When I say: Atrophy of teres minor

Quadrilateral space syndrome

When I say: Subluxation of biceps tendon

Subscapularis tear

When I say: Too many bowties in knee

Discoid meniscus

When I say: Celery stalk ACL - T2 Drumstick ACL - T1

Mucoid degeneration

When I say: Acute flat foot

Posterior tibial tendon tear

When I say: Boomerang shaped peroneus brevis

Tear or split/tear

When I say: Meniscoid mass in lateral ankle

Anterolateral impingement syndrome

When I say: Scar between 3rd and 4th MT

Mortons neuroma

When I say: OM in spine with kyphosis

TB (Gibbus deformity)

When I say: Unilateral SIJ lysis

IVDU

When I say: Psoas muscle abscess Rice bodies in joint

When I say: Calcification along periphery of soft tissue mass

Myositis Ossificans

When I say: Calcification more dense in centre of soft tissue mass

Osteosarcoma

When I say: Long lesion in long bone

Fibrous dysplasia

When I say: Large amount of oedema for size of the lesion

Osteoid Osteoma

When I say: Cystic bone lesion that is not T2 bright

Chondroblastoma

When I say: Lesion in finger of a kid

Periosteal chondroma

When I say: Looks like NOF in anterior tibia with anterior bowing

Osteofibrous dysplasia

When I say: RA + Pneumoconiosis

Caplan syndrome

When I say: RA + Big spleen + Neutropenia

Felty syndrome

When I say: Epiphyseal overgrowth

JRA or haemophilia

When I say: Reducible deformity of the joints

SLE

When I say: Destructive mass in bone of leukaemia patient

Chloroma

When I say: Elbow dislocation

Medial epicondyle fracture

When I say: Shrinking breast

ILC

When I say: Thick coopers ligaments

Oedema (CHF)

When I say: Dashes no dots Cigar shaped calcifications

Secretory calcifications

When I say: Popcorn calcifications

Degenerated fibroadenoma

When I say: Breast within a breast

Hamartoma

When I say: Fat fluid level

Galactocele

When I say: Rapid growing fibroadenoma

Phyllodes

When I say: Swollen red breast, not responding to ABx

Inflammatory breast cancer

When I say: Architectural distortion + Calcifications

IDC + DCIS

When I say: Architectural distortion without calcifications

ILC

When I say: Stepladder sign Linguine sign

Intracapsular rupture on US & MRI

When I say: Residual callcs in lumpectomy bed

Local recurrence

When I say: Proximal gallstone ileus

Bouveret syndrome

When I say: Most common mesenchymal tumour in GIT

GIST

When I say: Most common location for GIST?

Stomach

When I say: Most common islet cell tumour

Insulinoma

When I say: Endometrioma transforms into

Clear cell cancer

When I say: Dermoid transforms into (Ovary)

Squamous cell cancer

When I say: Patella dislocation

Almost always lateral

When I say: Most common tibial plateau fracture

Lateral

When I say: Favours medial knee

SONK

When I say: T score <-2.5

Osteoporosis

When I say: Which meniscus is thicker posteriorly

Medial

When I say: Most commonly torn ankle ligament

ATFL

When I say: TB in the spine

Spares the disc space

Where are the following brain tumours found? Oligodendroglioma DNET Ganglioglioma PXA

Cortical

When I say: Oligodendroglioma Ganglioglioma

Brain tumours that calcify

When I say: PXA Pilocytic astrocytoma Haemangioblastoma

Solid/Cystic + Enhancing mural nodule

When I say: Brain tumour that restricts diffusion

Lymphoma GBM

What are the requirements for an FDG PET scan?

Fating 6 hours No insulin and normal glucose Patient at rest post injection

What are the causes of a super scan?

- Sclerotic metastatic disease - Prostate/Breast - Metabolic - Hyperparathyroidism or Renal osteodystrophy - Pagets disease - Myelofibrosis

When I say: Hot nodule on isotope imaging

Thyroid adenoma

When I say: Decreased iodine uptake and hyperthyroidism

De Quervains thyroiditis

When I say: Cold spots on nuclear medicine studies

Hashimoto's thyroiditis

When I say: Thyroid cancer that responds to radio-iodine ablation?

Papillary Follicular

When I say: Thyroid cancers that dont respond to radio-iodine ablation?

Medullary Anaplastic

What do the following findings suggest? Absent cortical mantle Due to bilateral ICA occlusion Destruction of both cerebral hemispheres Cerebellum, midbrain and falx present

Hydranencephaly

What do the following findings suggest? Cortical mantle present Falx present

Severe hydrocephalus

What do the following findings suggest? Cortical mantle present Falx absent

Holoprosencephaly - Alobar

What do the following findings suggest? High T2/FLAIR in medial thalamus High T2/FLAIR in periaqueductal gray, mamillary bodies and tectal plate Enhancement in mamillary bodies

Wernicke Encephalopathy (Thiamine deficiency)

What do the following findings suggest? High T2/FLAIR in corpus callosum Seizures + Muscle rigidity Begins in CC body - genu - splenium Chronic: Thinned CC + Cystic cavities favouring genu + splenium

Machiafava Bignami

What do the following findings suggest? Optic nerve atrophy Haemorrhagic putamen Subcortical white matter necrosis T2 bright putamin CT Hyperdense putamin

Methanol toxicity

What do the following findings suggest? CT Hypodensity in globus pallidus T2 bright globus pallidus

Carbon monoxide

What do the following findings suggest? Young child Post viral illness/vaccination Multiple large T2 bright lesions enhancing in open ring pattern Patchy, large asymmetric white matter lesions Does not involve callososeptal interface Peripheral/incomplete ring enhancement

ADEM (Acute disseminated encephalomyelitis)

What do the following findings suggest? Transverse myelitis - long segment spinal cord enhancement >3 segments Optic neuritis - enhancing optic nerve Periependymal lesions, confluent. Dorsal medulla (Area postrema) High T2/FLAIR lesions in cord and optic nerve

Devics (Neuromyelitis optica)

What do the following findings suggest? Hippocampal atrophy (Medial temporal) Also biparietal atrophy Low posterior temporoparietal region + Posterior cingulate FDG uptake

Alzheimer disease

What do the following findings suggest? Cortical infarcts and lacunar infarcts Generalised brain atrophy Multiple scattered areas of decreased activity on FDG pet, no lobar predominance Motor strip may be involved

Vascular dementia

What do the following findings suggest? Mild generalised atrophy without lobar predominance Hippocampi normal in size Decreased FDG uptake in lateral occipital cortex + Spares posterior cingulate gyrus DAT Scan - decreased striatal uptake (full stop not comma)

Dementia with Lewy Bodies

What do the following findings suggest? Younger patient Severe asymmetric atrophy of frontal lobes - Anterior/Posterior gradient Milder volume loss in temporal lobes Low FDG uptake in frontal + temporal lobes

Frontotemporal dementia

What do the following findings suggest? Extensive basal ganglia and thalamus calcification Extensive calcification in cerebellar dentate nuclei

Fahr disease

What do the following findings suggest? Iron in globus pallidus T2 dark medial basal ganglia with central dot high signal (Necrosis) - Eye of the tiger No enhancement No restricted diffusion

Hallervorden Spatz

What do the following findings suggest? Macrocephaly with metopic beak Beaked inferior L1 anterior vertebral body Enlarged perivascular spaces

Hurler syndrome (Lysosomal storage disease)

What do the following findings suggest? Sparing of midbrain and superior cerebellar peduncles DAT scan periods

Parkinsons disease

What do the following findings suggest? Cerebellar hemisphere/peduncle atrophy Shrunken flat pons Enlarged 4th ventricle Hot cross bun sign - loss of transverse fibres

MSA (Multisystem Atrophy)

What do the following findings suggest? Tegmentum atrophy with sparing of the tectum and peduncles Midbrain volume loss with concave upper surface + relative sparing of the pons

PSP (Progressive supra nuclear palsy)

What do the following findings suggest? T1 and T2 bright basal ganglia T2 bright dorsal medial thalamus T2 bright tegmenjtum with normal dark nuclei & substantia nigra Cortical atrophy on CT

Wilson disease

What do the following findings suggest? X linked Normal head size Parieto-occipital predominance High FLAIR signal Extends across splenium of CC Can restrict and enhance

Adrenoleukodystrophy

What do the following findings suggest? Normal head size Frontal predominance and periventricular and deep white matter tigroid pattern high FLAIR signal U fibers spared

Metachromatic

What do the following findings suggest? big head Frontal predominance high FLAIR signal Can enhance

Alexander disease

What do the following findings suggest? Big head Diffuse bilateral subcortical U fibers high FLAIR signal Elevated NAA

Canavan disease

What do the following findings suggest? Small head Centrum semiovale and periventricular white matter with parieto-occipital predominance high FLAIR signal - High density foci on CT (Thalamus, caudate, white matter) Sparing of subcortical U fibers

Krabbe disease

The following are associated with which syndrome? Optic glioma Astrocytoma

NF 1

The following are associated with which syndrome? Multiple schwannomas Meningiomas Ependymomas

NF2

The following are associated with which syndrome? Haemnagioblastoma

VHL

What do the following findings suggest? Supratentorial tumour - temporal lobe Cyst with nodule No peritumeral T2 signal Age 10-20 Will enhance Dural tail + lepto/pachy-meningeal enhancement

Pleomorphic xanthoastrocytoma

What do the following findings suggest? Child <20 Seizures Temporal lobe Hypodense on CT High T2 signal bubbly/multicystic lesion, bright FLAIR Rim + loss of signal in bubbles Can have calcification Wedge shaped No enhancement, no restricted diffusion

DNET (Dysembryoplastic Neuroeptelial tumour)

What do the following findings suggest? >40yrs Calcification Frontal lobe Expands the cortex, cortical infiltration and marked thickening Can enhance No T2/FLAIR mismatch

Oligodendroglioma

What do the following findings suggest? Any age, usually young <30yrs Temporal lobe, or anywhere Seizures Cystic and solid with focal calcifications No oedema Calcification Can enhance

Ganglioglioma

What do the following findings suggest? 6yrs or 30yrs Floor of 4th ventricle location, can extend to foramen of Magendie and Luschka Parenchymal supratentorial Large on presentation - well defined Cystic/haemorrhagic components Heterogenous enhancement Calcification

Ependymoma

What do the following findings suggest? <10yrs Cerebellar location - vermis/roof of 4th ventricle Projects into 4th ventricle Hyperdense on CT Heterogenous on T1 & T2, enhances homogeneously Restricted diffusion Can calcify Drop mets

Medulloblastoma

What do the following findings suggest? Medulloblastoma Dural calcifications Basal cell cancer Odontogenic cysts

Gorlin syndrome

What do the following findings suggest? Young patient with subependymal nodules Enhancing, T1 + T2 heterogenous Partially calcified lesion Foramen of Monro >5 mm

SEGA

What do the following findings suggest? Adult Interventricular mass - Foramen of Monroe or 4th ventricle Well circumscribed, expansile Hydrocephalus Does not enhance T2 bright

Subependymoma

What do the following findings suggest? <5yrs children Interventricular mass Hydrocephalus Trigone of lateral ventricle Solitary

Choroid plexus carcinoma

What do the following findings suggest? Trigone of lateral ventricles or any intraventricular location Homogenously enhancing mass

Intraventricular meningioma

What do the following findings suggest? CP Angle location Enhances strongly & Heterogenous Widens porus acousticus - ice cream cone IAC Can have cystic degeneration/haemorhhage Acute angle with petrous temporal bone

Vestibular Schwannoma

What do the following findings suggest? CP Angle location Enhances homogeneously Doesn’t invade the IAC Calcification Dural tail, hyperostosis at tail Obtuse angle with petrous temporal bone

CP Angle meningioma

What do the following findings suggest? <6yrs Supra or infratentorial location Most common in cerebellum Large Necrotic features Heterogenous enhancement Calcifications

Atypical teratoma/Rhabdoid tumour

What do the following findings suggest? Cyst with nodule Child <15yrs No flow voids, cyst wall enhances Enhancing nodule Posterior fossa or optic chiasm T2 bright

Juvenile pilocytic astrocytoma (JPA)

What do the following findings suggest? Adult Cyst with nodule Nodule is isodense on CT, Low T1, T2 high, contrast enhancement Flow voids along periphery of cyst Cerebellum

Haemangioblastoma

What do the following findings suggest? Sella location may extend to suprasellar Gland & mass inseparable T1 dark T2 bright lesion Uptake contrast slower than normal pituitary

Pituitary adenoma

What do the following findings suggest? Lesion between anterior and posterior pituitary Cystic + Intra-cystic nodule Bright T1 + Dark on T2 T1 variable T2 very bright No enhancement of cyst

Rathke cleft cyst

What do the following findings suggest? Child Calcified + cystic Sella turcica region - displaces pituitary gland T1 bright, T2 bright, Enhance strongly Solid lesion

Adamantinomatous craniopharyngioma

What do the following findings suggest? Pineal region Precocious puberty Mass containing fat and central calcification Variable contrast enhancement Heterogenous on T1 and T2 (Mixed)

Germinoma

What do the following findings suggest? Childhood Pineal region Invasive Associated with retinoblastoma Heterogenous Enhance vividly Peripheral calcifications (Expanded)

Pineoblastoma

What do the following findings suggest? Adult Pineal region Well circumscribed Non-invasive Solid with expanded calcification pattern Enhancement of solid components

Pineocytoma

What do the following findings suggest? Cystic lesion in pineal region May have thin enhancement T1 dark T2 bright

Pineal cyst

What do the following findings suggest? Dysplastic cerebellar gangliocytoma Breast cancer

Cowdens

What do the following findings suggest? Brain atrophy - cerebellar Periventricular hypo densities T2/FLAIR high signal Thin ependymal enhancement Adult

CMV

What do the following findings suggest? Leptomeningeal enhancement Dilated perivascular spaces filled with mucoid material that doesn’t enhance Basal ganglia lesions - T1 dark T2 bright, ring enhancement

Cryptococcus

What do the following findings suggest? T1 dark, T2 bright ring enhancing lesions Target sign on FLAIR No restricted diffusion Perilesional oedema

Toxoplasmosis

What do the following findings suggest? Basal cisterns - enhancement of basilar meninges with minimal nodularity Dystrophic calcifications Hydrocephalus

TB Meningitis or sarcoid

What do the following findings in haemorrhage suggest? T1 Iso T2 Bright

Hyperacute haemorrhage <24hrs Oxyhemoglobin + Intracellular

What dot the following findings in haemorrhage suggest? T1 iso T2 Dark

Acute haemorrhage <3 days Deoxyhaemoglobin + Intracellular

The following bleed appears as what signal on MR? Early subacute >3 days Methaemoglobin Intracellular

T1 Bright T2 Dark

How does the following bleed appear on MRI? Late subacute >7 days Methemoglobin Extracellular

T1 Bright T2 Bright

What does the following bleed present as on MRI Chronic >14 days Haemosiderrin, Extracellular

T1 Dark T2 Dark Centre - is high on T2

What do the following findings suggest? Haemorrhage in midbrain and pons without extension to lateral Sylvia cisterns or interhemispheric fissure (Anterior to brainstem)

Benign Perimesencephalic haemorrhage

What do the following findings suggest? Multiple dark spots on GE imaging Older patient Multiple peripheral haemorrhagic foci in normotensive elderly patient Convexity SAH

Amyloid angiopathy

What do the following findings suggest? Caudate hypo density

Recurrent artery of heubner infarct

What do the following findings suggest? Supratentorial location Arterial component Nidus - calcified Draining veins Adjacent vein may be gliotic (T2 bright) and atrophic

High flow AVM

What do the following findings suggest? High/Low flow No nidus Acquired

Dural AVF

What do the following findings suggest? Caput medusa - collection of vessels converging towards enlarged vein on venous phase Halo of T2 bright gliosis

DVA

What do the following findings suggest? Popcorn like peripheral rim of haemosiderin on GE No intervening normal tissue Fluid fluid level = intralesional haemorrhage

Cavernous malformation - cavernoma

What do the following findings suggest? Brush like or stippled pattern enhancement GE - blooming Low flow with intervening normal tissue Single lesion in pons is most common Doesn’t bleed

Capillary telangiectasia

What do the following findings suggest? subcortical calcification (seen at an earlier age than plain film) and associated parenchymal volume loss Tram track/double lined gyriform pattern parallel to cerebral folds

Sturge weber

What type of temporal bone fracture is this? Long axis of Temporal bone More common Ossicular dislocation Conductive hearing loss

Longitudinal temporal bone fracture

What type of temporal bone fracture is this? Short axis of temporal bone Less common Vascular injury (Carotid/jugular) Facial nerve injury SNHL

Transverse temporal fracture

What do the following findings suggest? Lesion in petrous apex well defined on CT T1 & T2 bright, T2 dark haemosiderin rim Faint peripheral enhancement No restriction Smooth expansile bony change

Cholesterol granuloma

What do the following findings suggest? Petrous apex lesion T1 dark T2 bright Restricted diffusion Smooth expansile bony change

Cholesteatoma (Epidermoid)

What do the following findings suggest? Young male Nidus centered on sphenopalatine foramen Bone remodelling - bowing of posterior maxillary wall, no destruction Vascular (Enhancing) + Flow voids on MR

Juvenile Nasal Angiofibroma

What do the following findings suggest? Lateral wall of nasal cavity Middle turbinate Focal hyperostosis at tumour origin Cerebriform pattern on MR - T1/T2 similar to brain, high/low signal lines

Inverted Papilloma

What do the following findings suggest? Infection involving submandibular space and sublingual space Gas present in these spaces Fat stranding

Ludwigs Angina (Floor of mouth cellulitis)

What do the following findings suggest? Cystic lesion Lateral - arising from sublingual gland/space Plunging under mylohyoid muscle into submandibular space

Ranula

What do the following findings suggest? Midline Cystic mass - thin walled

Thyroglossal duct cyst

What do the following findings suggest? Sac of marbles - fluid sac with globules of fat Midline

Floor of mouth dermoid/epidermoid

What do the following findings suggest? Inflammation from dental caries around root Cystic degeneration around periodontal ligament Apex of non-vital tooth Well corticated border <2cm

Periapical cyst (Radicular cyst)

What do the following findings suggest? Cyst forming around crown of un-erupted tooth Expansile and unilocular Displace and resorb teeth adjacent to it

Dentigerous cyst

What do the following findings suggest? Mandibular ramus or body Uni/Multilocular Expansile, sharp margins Associated with root, no infection Along length of bone, no significant cortical expansion

Keratogenic Odontogenic tumour

What do the following findings suggest? Multicystic with solid components - soap bubbles Expansion of the mandible Tooth root absorption Permeative cortical bone erosion

Ameloblastoma (Adamantinoma of jaw)

What do the following findings suggest? Most common in parotid (Superficial lobe) Hypoechoic with posterior acoustic enhancement T1 low, T2 high signal, rim of low signal, homogenous enhancement

Pleomorphic adenoma

What do the following findings suggest? Parotid gland - Tail Male smoker Solid cystic, bilateral US: ovoid, with well-defined margins and multiple irregular, small, sponge-like anechoic areas T1: low to intermediate signal T2: heterogeneous T1 C+ (Gd): cystic components do not take up contrast while solid parts usually enhance

Warthins tumour

Which salivary gland tumour is associated with perineural spread?

Adenoid cystic carcinoma

What do the following findings suggest? Bilateral homogenous parotid gland lesions

Lymphoma (Associated with Sjogrens disease)

If there is a mass in the carotid space, which direction will it displace the parapharyngeal space?

Anterior displacement

If there is a mass in the Parotid space, which direction will it displace the parapharyngeal space?

Medial displacement

If there is a mass in the Masticator space, which direction will it displace the parapharyngeal space?

Posterior + Medial displacement

If there is a mass in the Superficial mucosal space, which direction will it displace the parapharyngeal space?

Lateral displacement

What do the following findings suggest? Orbital mass Calcification in the globe Normal or big globe <3yrs Can be bilateral

Retinoblastoma

What do the following findings suggest? Orbital mass Small globe Boys, unilateral No calcification CT - Dense T1 + T2 high signal

Coats disease (Retinal telangectasia leading to leaky blood and exudate)

What do the following findings suggest? Small eye Increased density of vitreous humour No calcification

Persistent hyper plastic primary vitreous (Failure of embryonic occular blood supply to regress)

What do the following findings suggest? V shaped retina

Retinal detachment

What do the following findings suggest? <20 yrs Expansion and enlargement of entire optic nerve

Optic nerve glioma

What do the following findings suggest? Tram track calcifications of the optic nerve Circumferential enhancement around the optic nerve

Optic nerve sheath meningioma

What do the following findings suggest? Bilateral sphenoid wing invasion

Neuroblastoma

What do the following findings suggest? Unilateral sphenoid wing invasion

Ewings sarcoma

What do the following findings suggest? Expanded extra-occular muscle Painful Unilateral + Anterior tendon Lateral & Superior rectus rectus Does not spare muscle insertions T2 dark Contrast enhancement

Idiopathic orbital inflammation

What do the following findings suggest? Expanded extra-ocular muscle Not painful Bilateral Spares muscle tendons T2 dark Contrast enhancement

Thyroid orbitopathy

What do the following findings suggest? Can involve any part of the orbit Bilateral Lacrimal gland and Lateral rectus Spares anterior tendon Bilateral involvement of V2 - infraorbital nerve Not painful

IgG4 Orbital disease

What do the following findings suggest? Ill defined, lack capsule Infiltrative lesion Fluid-fluid levels Does not distend with valsalva

Lymphangioma (Venous lymphatic malformation)

What do the following findings suggest? Ill defined, lack capsule Infiltrative lesion Fluid-fluid levels Distends with valsalva

Orbital varix

What do the following findings suggest? Post traumatic Orbital fat stranding Diffuse extra-orbital muscle enlargement Pulsatile exophthalmos Prominent superior ophthalmic vein with proptosis Prominent cavernous sinus

Carotid-Cavernous fistula

What do the following findings suggest? Vertebral body endplates T1 dark T2 bright

Modic I (Oedema)

What do the following findings suggest? Vertebral body endplates T1 bright T2 bright

Modic II (Fat)

What do the following findings suggest? Vertebral body endplates T1 dark T2 dark

Modic III (Scar/Fibrosis)

What do the following findings suggest? Collection around VB Post surgery Enhancement homogeneously

Epidural fibrosis (Scar)

What do the following findings suggest? Clumped nerve roots Empty thecal sac

Arachnoiditis If enhancement >6 weeks post surgery = infection

What do the following findings suggest? Axial loading injury Anterior & Posterior C1 arch fracture Lateral displacement of fracture fragments Increased distance between lateral masses of C1 and odontoid peg

Jefferson fracture

What do the following findings suggest? Fracture through bilateral pars at C2 Anterior subluxation of C2/3 >2mm Associated anterior inferior C2 corner fracture

Hangmans fracture

What do the following findings suggest? Impaction Hyperflexion injury Fragment of anterior inferior vertebral body

Flexion teardrop injury

What do the following findings suggest? Anterior inferior teardrop fracture fragment Avulsion of ALL Distraction injury Hyperextension injury

Extension teardrop

What do the following findings suggest? Avulsion injury of lower C/T spinous process Hyperflexion

Clay Shovelers fracture

What do the following findings suggest? Flexion distraction fracture 3 column fracture

Chance fracture

What do the following findings suggest? Thoracic spine more than Lumbar Spares IV discs Bone destruction Multilevel disease, sub ligamentous spread Large paraspinal abscess, thin walled calcified Gibbus deformity

TB (Or Brucellosis)

The following optic nerve findings are found in which type of demyelinating disease? Painful visual loss Short segment Anterior, unilateral Enhancing swollen, T2 high signal

The following optic nerve findings are found in which type of demyelinating disease? Long segment Bilateral Posterior Chiasm involvement Cord swelling and high T2

NMOSD

The following optic nerve findings are found in which type of demyelinating disease? Bilateral long segment anterior nerve (Intra-orbital) or optic perineuritis

MOGAD

What is the following describing? Thoracic cord Wide cord Oedema Serpiginous draining meningeal varicosities Hypervascular enhancing pial tumour - cerebellum or cord Cyst with nodule

Spinal Haemangioblastoma

What is the following describing? Conus/Filum terminale (Extramedullary) Haemorrhagic Dark cap on T2 Long segment

Myxopapillary ependymoma

What is the following describing? Adult Central Homogenous enhancement May be haemorrhagic

Ependymoma

What is the following describing? Children Upper thoracic spine Fusiform dilatation of the cord over multiple segments Eccentric T1 dark, T2 bright, heterogenous enhancement Syrinx

Spinal Astrocytoma

What is the following describing? Bilateral, symmetrical Increased High T2 signal in dorsal columns (Inverted V) No enhancement Upper thoracic, ascending/descending

Subacute Combined degeneration (B12 deficiency)

What is the following describing? Longer T2 high signal segment Full transverse diameter of cord Mild cord swelling Thoracic cord Bright focal T2 high signal

NMO (Neuromyelitis optica)

What is the following describing? Young person Post viral illness or vaccination High T2 signal Dorsal white matter

ADEM

What is the following describing? Short segment T2 high signal affecting only half/part of cord Cervical cord May have brain lesions Enhancing lesion if acute

Spinal MS lesion

What is the following describing? Central cord/anterior horn high signal T2 Owls eye sign Long segment >2 segments Diffusion restriction

Spinal cord infarct

What is the following describing? Dumbell (Bilobed) fat density >2cm in the atrial septum spares fossa ovalis Older patient Can cause SVT

Lipomatous hypertrophy of the inter-atrial septum

What is the following describing? Encapsulated Does not spare the fossa ovalis T1 bright, drop out on fat sat Not associated with arrhythmia

Lipoma

When does a PDA usually close?

24hrs post birth functionally Anatomically around 1 month

What is the most common type of ASD? Which is most likely to be symptomatic?

Most common = Secundum, can close without treatment Symptomatic = Primum, due to ECD

What is being described here? Secondary to a fenestrated or unroofed coronary sinus Can lead to paradoxical emboli and chronic right heart volume overload Allows for two way flow from L-R

Coronary sinus ASD

What are the following PAPVRs associate with? Right sided Right sided + Pulmonary hypoplasia

Right sided PAPVR = Sinus venous ASD Right sided PAPVR + Pulmonary hypoplasia = Scimitar syndrome

What is being described here? All of the pulmonary venous system drains into the right side of the heart Veins drain above the heart Snowman appearance

Supracardiac TAPVR (Most common)

What is being described here? All of the pulmonary venous system drains into the right side of the heart Veins drain below the diaphragm (IVC/Hepatic veins) Obstruction leads to pulmonary oedema

Infracardiac TAPVR

What is the most common cause of cyanosis in the first 24 hrs?

Transposition of the great arteries

What is being described here? Figure of 3 sign 4-8th rib notching 1st + 2nd avoided (Costocervical trunk supply)

Aortic coarctation

What is being described here? Left ventricle and aorta are hypoplastic Pulmonary oedema ASD/Large PFO

Hypolastic left heart

What is being described here? Abnormal pulmonary vein draining into the left atrium Fibromuscular membrane causes subdivision of the LA Appears as triple atrium heart Causes pulmonary HTN + Pulmonary oedema

Cor triatriatum sinistrum

What is the following describing in terms of cardiac ischaemic disease? Delayed enhancement Normal thickness myocardium T2 signal from oedema Microvascular obstruction - islands of dark signal in enhanced tissue

Acute MI

What is the following describing? Delayed enhancement Thinned myocardium T2 dark tissue No microvascular obstruction

Chronic MI

What is the following describing? Myocardium intact Mouth wider than body Anterior-lateral wall of myocardium

True ventricular aneurysm

What is the following describing? Mouth narrow compared to body Myocardium not intact (Pericardial adhesions contain it) Posterior-lateral wall

False ventricular aneurysm Has higher risk of rupture

What is the following describing? Cardiac dilatation + End diastolic diameter >55mm Decreased EF No enhancement/linear mid-myocardial enhancement

Dilated cardiomyopathy

What is the following describing? Biatrial enlargement Concentric thickening of the left ventricle Reduced systolic ventricular function Late Gd enhancement of subendocardial circumference Difficult to suppress myocardium

Amyloid cardiopathy

What is the following describing? Bilateral ventricular thrombus

Eosinophilic cardiomyopathy

What is the following describing? Thickened pericardium > 4mm Calcified pericardium Septal bounce - ventricular septum moves toward the LV in wave pattern in diastole No late Gd myocardial enhancement

Constrictive pericarditis

What is the following describing? Late Gd enhancement in non-vascular distribution lateral free wall Epicardial or mid wall (Not subendocardial)

Myocarditis

What is the following describing? Signal in both T2 and Early Gd will be increased Late Gd pattern is middle and epicardial in non-coronary distribution Focal wall thickening from oedema Involves the septum

Sarcoidosis

What is the following describing? Transient akinesia or dyskinesia of the left ventricular apex without coronary stenosis Ballooning of the left ventricular apex No delayed enhancement

Takotsubo Cardiomyopathy

What do the following findings suggest? Fibrofatty degeneration of the RV myocardium Dilated RV with reduced function Normal LV

Arrhythmogenic right ventricular cardiomyopathy

What do the following findings suggest? Abnormal hypertrophy of myocardium compromising diastole Patchy mid wall delayed enhancement of the hypertrophied muscle

Hypertrophic cardiomyopathy Delayed enhancement is also an independent risk factor for sudden death

What do the following findings suggest? Loosely packed myocardium, left ventricle has spongy appearance Increased ventricular trabeculations and deep intertrabecular recesses No myocardial thickening

Left ventricular noncompaction

What do the following findings suggest? Biventricular replacement of myocardium with connective tissue and fat Delayed Gd enhancement in midwall Dilated cardiomyopathy

Muscular dystrophy (Becker - mild, Duchenne - severe)

What do the following findings suggest? Interatrial septum attachment - ball with stalk Calcified May prolapse through mitral valve Enhancement with Gd

Left Atrial myxoma

What do the following findings suggest? Mass within the heart Favours left atrial appendage No enhancement

Cardiac thrombus

What do the following findings suggest? Left ventricle myocardium T2 bright Cardiac tumour Associated with tuberous sclerosis

Rhabdomyoma

What do the following findings suggest? IV septum location Mass Dark on T1/T2 Enhance brightly on perfusion and late Gd

Cardiac fibroma

What do the following findings suggest? 2nd most common primary cardiac tumour Involves heart valves (Aortic/Mitral) Highly mobile Systemic emboli are common

Fibroelastoma

What do the following findings suggest? Pericardial effusion Flattening or inversion of IV septum towards LV Reflux of contrast into IVC/Azygous

Cardiac tamponade

What does the following describe? Post bone marrow transplant Bronchiolitis obliterans (Air trapping - mosaic attenuation)

Graft v Host disease

What does the following describe? AIDS GGO bilaterally + perihilar regions, sparing of lung periphery Thin walled cysts

PCP

What does the following describe? AIDS Flame shaped opacity

Kaposi sarcoma

What does the following describe? Ghon focus - granuloma Ranke complex - Nodal expansion which calcifies May have pleural effusions

Primary TB

What does the following describe? Local progression of parenchymal disease to cavitation Happens to immunocompromised people

Primary progressive TB

What does the following describe? Positive PPD Negative CXR No symptoms

Latent TB

What does the following describe? Endogenous reactivation of latent infection Apical and Posterior UL or Superior LL location Cavitation

Post primary TB

What does the following describe? Aspergilloma in a pre-existing cavity Positional change

Aspergillus

What does the following describe? Immunocompromised Halo sign - consolidation with GG halo (Invasive component) Air Crescent sign - thin crescent of air within consolidate mass (Post treatment)

Invasive aspergillus

What does the following describe? Asthma/CF Upper lobe central saccular bronchiectasis with mucoid impaction (Finger in glove)

ABPA - Allergic Bronchopulmonary Aspergillosis

What does the following describe? Multiple GG or consolidative nodules Immunosuppressed or post bone marrow transplant

CMV

What does the following describe? Multifocal GGO with small nodular opacities Skin lesions before or after

Measles

What does the following describe? Multiple peripheral nodular opacities Small round calcific lung nodules when healed

Varicella

What does the following describe? Multiple round opacities +/- cavitation Lower lobe predominant Peripheral nodular densities with wedge shaped densities Feeding vessel sign - nodule with big vessel going into it

Septic Emboli

What do the following findings suggest: Smoking association Cavitation May have paraneoplastic syndrome e.g. ectopic PTH Central

Squamous cell carcinoma

What do the following findings suggest: Peripheral Large >4cm

Non-Small cell Large cell cancer

What do the following findings suggest: Peripheral Most common Upper lobe Can present in non-smoker and as SPN

Non small cell - Adenocarcinoma

What do the following findings suggest: Central Smoking Central lymphadenopathy Can present with SVCO + Paraneoplastic syndromes

Small cell lung cancer

What do the following lung findings suggest? Smoker and young Centrilobular nodules + Upper lobe predominance Nodules cavitate to thin walled, which then become thick walled and bizarre shapes Spares costophrenic angles

Pulmonary Langerhans cell Histiocytosis

What do the following lung findings suggest? Female child bearing age Thin walled round cysts Uniform/diffuse distribution

Lymphangiomyomatosis (LAM)

What do the following lung findings suggest? Bilateral oncocytomas Chromophobe RCC Thin walled floppy oval cysts Lower zone and paramediastinal regions Fibrofolliculoma - Skin disease

Birt Hogge Dubbe

What do the following lung findings suggest? Associated with autoimmune diseases/HIV Cystic lung disease - thin walled (Perivascular - vessels along cysts) Ground glass

Lymphocytic interstitial pneumonitis (LIP)

What do the following lung findings suggest? AIDS Ground glass appearance Hilar and mid zones Pneumatoceles Bilateral thin walled upper lung predominant cysts

Pneumocystis Pneumonia

What do the following lung findings suggest? Miners/Quarry workers Multiple nodular opacities favouring upper lobes Egg shell calcifications of hilar nodes Perilymphatic nodules

Silicosis

What do the following lung findings suggest? Apical to basal gradient (Worse in lower lobes) Traction bronchiectasis Honeycombing Subpleural basal predominant distribution

Definite UIP

What do the following lung findings suggest? Homogenous inflammation or fibrosis Lower lobe, posterior, peripheral predominance Ground glass opacities Micronodules Sparing of immediate subpleural lung

NSIP

What do the following lung findings suggest? Smoking history Apical centrilobular ground glass nodules Upper lobe predominant

RB-ILD

What do the following lung findings suggest? Smoking Diffuse ground glass opacification Patchy or subpleural distribution Peripheral lower lobe predominant ground glass with small cystic spaces

DIP

What do the following lung findings suggest? Young person 20-40yrs Hilar/Mediastinal nodes bilateral Perilymphatic nodules Upper lobe predominant Upper lobe mass (Nodal conglomerate) with satellite nodules

Sarcoid lung changes

What do the following lung findings suggest? Bilateral hilar lymph node enlargement Arthritis Erythema Nodosum

Lofgren syndrome (Acute sarcoid)

What do the following lung findings suggest? Post lung transplant Bronchiectasis Bronchial wall thickening Air trapping interlobular septal thickening

Chronic rejection/Bronchiolitis Obliterans

What do the following lung findings suggest? Crazy paving - Interlobular septal thickening with ground glass Smoking Central and symmetric Spares apices and costophrenic angles Elevated LDH

Pulmonary alveolar proteinosis

What do the following lung findings suggest? Low attenuation/fat density in consolidation

Lipoid pneumonia

What do the following lung findings suggest? Granulation tissue deposition in alveolar spaces Patchy airspace consolidation or GGO Peripheral or peri-bronchial distribution Reverse halo - consolidation with GG centre

Cryptogenic organising pneumonia

What do the following lung findings suggest? Peripheral oesinophilia Asthma history Bilateral Non-segmental consolidation Favours peripheral lungs and upper lobes Peripheral GGO or consolidation

Chronic eosinophilic pneumonia

What is the Halo sign and what are the causes of it?

Nodule with GG around it Haemorrhage/invasion into surrounding tissues Causes: Invasive Aspergillosis, Fungal infection, Haemorrhagic mets, BAC, Wegeners

What is the Reverse Halo sign? What causes it?

Central ground glass with rim of consolidation Causes: COP, TB, Pulmonary infarct

What do the following lung findings suggest? Patchy ground glass opacities (Increased attenuation) Ill defined centrilobular GG nodules Mosaic perfusion, air trapping (Decreased attenuation)

Hypersensitivity pneumonitis

What do the following lung findings suggest? UIP Picture + Air trapping

Chronic hypersensitivity pneumonitis

What do the following respiratory findings suggest? Spares posterior membrane Diffuse anterior and lateral thickening of the trachea No calcifications Recurrent episodes of pneumonia and inflammation

Relapsing polychondritis

What do the following respiratory findings suggest? Circumferential tracheal thickening Focal or long segment No calcifications Subglottic involvement is common

Wegeners granulomatosis

What do the following respiratory findings suggest? Spares the posterior membrane Cartilaginous and osseous nodules within submucosa of tracheal and bronchial walls

Tracheobronchopathia Osteochondroplastica (TBO)

What do the following respiratory findings suggest? Irregular focal or short segment thickening Can involve posterior membrane Calcifications common

Amyloidosis

What do the following respiratory findings suggest? Upper trachea, prefers posterior lateral trachea Thickening, mass or nodule Not associated with smoking Main or lobar bronchus

Adenoid cystic carcinoma

What do the following respiratory findings suggest? Massive dilatation of the trachea >3cm

Mounier-Kuhn

What do the following respiratory findings suggest? Inflammation of the small airways Tree in bud appearance

Bronchiolitis

What do the following respiratory findings suggest? Reticulations with or without honeycombing Consolidate opacities (COP) Lower lobes favoured

Rheumatoid arthritis

What do the following respiratory findings suggest? Upper lobe fibrobullous disease Unilateral then bilateral

Ankylosing spondylitis

What do the following respiratory findings suggest? NSIP Lower lobe predominant findings Dilated fluid filled oesophagus

Scleroderma

What do the following respiratory findings suggest? Pleuritis Pleural/Pericardial effusion Progressive loss of lung volume

SLE

What do the following respiratory findings suggest? Cirrhotic liver SOB on sitting up Subpleural telangectasia - dilated subpleural vessels

Hepatopulmonary syndrome

What do the following respiratory findings suggest? Nodules with cavitation, random distribution GG changes - haemorrhage Nasal septum perforation

Granulomatosis with polyangiitis (Wegener's)

What do the following respiratory findings suggest? Bilateral coalescent airspace opacities that look like oedema (Haemorrhage) Resolve within 2 weeks Pulmonary haemosiderosis - iron deposition as small, ill-defined nodules

Goodpastures syndrome

What do the following respiratory findings suggest? Circumferential pleural thickening extending to medial pleura Pleura thickness >1 cm Extension into the fissure

Mesothelioma

What do the following respiratory findings suggest? Mediastinal location Cystic appearance Fat Calcifications and teeth

Mediastinal teratoma

The following suggests what kind of PE - chronic or acute? Central clot Venous dilatation Perivenous soft tissue oedema

Acute

The following suggests what kind of PE - acute or chronic? Peripheral clot Web like Shrunken veins with collateral vessels Calcifications within thrombus Mosaic attenuation in lungs Pulmonary HTN

Chronic PE

What do the following respiratory findings suggest? Variant of pulmonary HTN Normal capillary wedge pressure Enlarged mediastinal lymph nodes

Pulmonary veno-occlusive disease

What do the following respiratory findings suggest? Long bone fracture 1-2 days post femur fracture GG nodules in lungs No filling defect to suggest PE Resolves in 1-3 weeks

Fat embolus

What do the following findings suggest? Orificial renal artery stenosis HTN Teenager or child

NF1 - dysplasia of arterial wall

What do the following findings suggest? - Hypertelorism (Frog eyes) - Bifid uvula and cleft palate - Aortic aneurysm with tortuisity or ectatic vertebral arteries

Loeys Dietz Syndrome

What do the following findings suggest? Young patient Heart failure within 1st week of life Narrowing before left subclavian artery Hypoplastic aortic arch Pulmonary oedema

Infantile aortic coarctation

What do the following findings suggest? Leg claudication, BP differential Post ductal - narrowing distal to left subclavian artery Normal diameter aortic arch

Adult aortic coarctation

What do the following findings suggest? Elongation with narrowing and kinking of the aorta No pressure gradient, collaterals or rib notching

Pseudocoarctation

What do the following findings suggest? Anterior scalene muscle causing compression of subclavian vessels and brachial plexus (Nerve**, vein, artery)

Thoracic outlet syndrome

What do the following findings suggest? Anterior scalene muscle compression of subclavian vessels and brachial plexus Thrombus in the subclavian vein

Paget Schroetter (Managed with lysis not stenting)

How is renal artery stenosis treated? How is FMD treated?

RAS = Angioplasty + Stent FMD = Angioplasty

What do the following findings suggest? DVT in left common iliac vein Compression of Left common iliac vein by right common iliac artery

May Thurner syndrome Tx: Thrombolysis and stenting

What do the following findings suggest? Compression/Occlusion of the popliteal artery by the medial head of gastrocnemius Medial deviation of the popliteal artery Normal pulses that decrease with plantar flexion

Popliteal entrapment

What do the following findings suggest? Port wine naevi Bony or soft tissue hypertrophy (Localised gigantism) low flow Venous malformation Persistent sciatic vein Superficial vein in the lateral calf and thigh

Klippel-Trenaunay syndrome

What do the following findings suggest? Blunt trauma at hook of hamate May have emboli with obstruction of digits Corkscrew configuration of superficial palmar arch Occlusion of ulnar artery or pseudoaneurysm of ulnar artery

Hypothenar hammer syndrome

What do the following findings suggest? Young women Large vessel vasculitis - usually aorta Wall thickening and wall enhancement May have occlusion of branches or dilatation of aorta

Takayasu arteritis

What do the following findings suggest? Men Renal***, cardiac, GI Microanuerysm formation at branch points Infarcts

Polyarteritis nodosa

What do the following findings suggest? Children Calcified coronary artery aneurysm

Kawasaki disease

What do the following findings suggest? Nasal perforation Cavitary lung lesions Kidneys - vasculitides

Wegeners (Granulomatosis with polyangitis)

What do the following findings suggest? Asthma/Eosinophilia Transient peripheral lung consolidation + GGO Bronchial wall thickening/Septal thickening Systemic vasculitis

Churg Strauss (Eosinophilic granulomatosis with polyangitis)

What do the following findings suggest? Diffuse pulmonary haemorrhage Kidneys

Microscopic polyangiitis

What do the following findings suggest? Children Doughnut sign for intussusception Scrotum with skin oedema Multifocal bowel wall thickening

Henoch Schonlein Purpura (HSP)

What do the following findings suggest? Smokers Small/medium vessels in legs Extensive arterial occlusive disease with development of corkscrew collateral vessels in fingers Ulnar artery normal Auto-amputation

Buergers disease

What is the ideal site of puncture for the CFA?

Middle of the medial 1/3 of the femoral head

What do the following findings suggest? Leak at the top or bottom of the graft, high pressure

Type 1 endo-leak Requires intervention

What do the following findings suggest? Filling of the sac via a feeder artery Most common Most commonly due to IMA or lumbar artery

Type 2 endo-leak May need treatment, may resolve

What do the following findings suggest? Defect/fracture in the graft

Type 3 endo-leak

What do the following findings suggest? Porosity of the graft

Type 4 endoleak

What do the following findings suggest? Endotension Due to pulsation of the graft wall

Type 5 endoleak

Where would you access if you needed to access a lesion in the iliac vessels?

Ipsilateral CFA or contralateral CFA

Where would you access if you needed to access a lesion in the CFA?

Contralateral CFA

Where would you access if you needed to access a lesion in the SFA?

Ipsilateral CFA

What is the maximum dose of Lidocaine?

4-5mg/kg 1% Lidocaine = 10mg per 1 mL

What abnormality do the following findings suggest? Decreased blood flow/Smaller vessels leads to low attenuation (Dark) areas Normal areas with preserved perfusion are denser (GG) - differences diminish on expiratory imaging Reduced vascular markings

Perfusion abnormality (Mosaic attenuation)

What abnormality do the following findings suggest? Normal blood flow/vessels leads in low attenuation vessels Reduced density on expiration (Lucent) - air trapping Well ventilated areas are denser on expiratory If attenuation differences persist or worsen on expiration Preserved vascular markings

Ventilation abnormality (Mosaic attenuation) - Air trapping

The following gives rise to which kind of rib notching? coarctation lies distal to the brachiocephalic trunk but proximal to the origin of the left subclavian artery

Bilateral rib notching

The following gives rise to which kind of rib notching? Coarctation lies distal to the brachiocephalic trunk but proximal to the origin of the left subclavian artery or right sided aortic arch with aberrant left subclavian artery distal to coarctation

Unilateral right rib notching collaterals cannot form on the left, as the left subclavian is distal to the coarctation

The following give rise to which kind of rib notching? aberrant right subclavian artery arising after the coarctation the coarctation is distal to the origin of the left subclavian artery

Unilateral Left rib notching collaterals form on the left collaterals cannot form on the right, as the aberrant right subclavian artery arises after the coarctation

What do the following findings suggest? LV Dysfunction, LVH, Systolic Anterior Motion of mitral valve, LV Apical aneurysm Isointense to myocardium on T1 & T2 1st pass enhancement, patchy IV delayed enhancement

Hypertrophic obstructive cardiomyopathy (HOCM)

What condition causes superior rib notching?

NF1 (Rare)

What does the following describe? Lungs Homogenous, well circumscribed Non calcified nodule with serpiginous mass connected to blood vessels

Pulmonary AVM

Which chamber of the heart enlarges with the following intracardiac shunt? Membranous VSD Muscular VSD

Membranous VSD = LA Muscular VSD = RV

Which chamber of the heart enlarges with the following intracardiac shunt? PDA ASD

PDA = LA ASD = RA

What do the following findings suggest? Smooth focal outpouching of the thoracic aorta Anteromedial aspect of aorta at aortic isthmus At site of ligamentum arteriosum Calcification + obtuse angle

Aortic ductus bump/diverticulum

What do the following findings suggest? Sharp marginated bulge at inferior surface of aortic isthmus At site of ductus arteriosus

Aortic pseudoaneurysm

The following are CT findings of what? - Eccentric mural thrombus - Mosaic perfusion - Pulmonary artery webs - Bronchial artery & RV Hypertrophy

Chronic PE

What is the following describing? - Congenital left to right shunt (Overoxygentated blood recirculates through lungs, not reaching tissues) - Incomplete ventricular septum - Plethora - Cardiomegaly (LA +/- RV & RV)

VSD

What is the following describing? - Congenital left to right shunt (Overoxygentated blood recirculates through lungs, not reaching tissues) - Incomplete atrial septum - Pulmonary plethora - Cardiomegaly (RA & RV)

ASD

What is the following describing? - Congenital left to right shunt (Overoxygentated blood recirculates through lungs, not reaching tissues) - Opening from pulmonary trunk to aorta persists post birth - Cardiomegaly (LA + LV) - AP window obscured, Pulmonary oedema

Patent ductus arteriosus

What is the following describing? - Congenital left to right shunt (Overoxygentated blood recirculates through lungs, not reaching tissues) - RV Hypertrophied - Reversal of shunt from right to left due to hypertrophy - PA HTN

Eisenmenger syndrome

What is the following describing? - Congenital right to left shunt (Blood bypass lungs = hypoxemia) - Aorticopulmonary septum fails to separate the RV and LV outflow tracts

Persistent ductus arteriosus

What is the following describing? - Congenital right to left shunt (Blood bypass lungs = hypoxemia) - Right ventricle pumps to aorta - LV pumps to pulmonary trunk - Narrow superior mediastinum (Aortic/pulmonary arterial configuration) - Cardiomegaly

Transposition of the great arteries

What is the following describing? - Congenital right to left shunt (Blood bypass lungs = hypoxemia) - Right AV valve fails to develop - Decreased pulmonary vascularity - Normal/Large heart

Tricuspid atresia

What is the following describing? - Congenital right to left shunt (Blood bypass lungs = hypoxemia) - Pulmonary trunk stenosis - Rightward displaced aorta - VSD (VS fails to develop) - RV Hypertrophy - Decreased pulmonary arterial flow

Tetralogy of Fallot

What is the following describing? - Congenital right to left shunt (Blood bypass lungs = hypoxemia) - Pulmonary veins drain into the right heart (Coronary sinus/SVC/Brachiocephalic)

TAPVR

Answer

What is the following describing? 1) Vaginal atresia (Upper 2/3) 2) Absent or rudimentary uterus (Unicornuate/Bicornuate) 3) Normal ovaries 4) Renal abnormality (Agenesis/ectopia)

Mullerian agenesis/MRKH syndrome

What does the following describe? Single uterine cavity +/- rudimentary horn

Unicornuate uterus

The following describes which uterine abnormality? 2 x cervix 2x Uterus 2 x upper 1/3 vagina, +/- vaginal septum

Uterine didelphys

The following describes which uterine abnormality? Unicollis/Bicollis + deep myometrial uterine cleft seperating the uterus May have a vaginal septum Fundal contour <5mm above tubal ostia

Bicornuate uterus

What type of uterine anomaly is linked to DES (Sythentis oestrogen)? What is the appearance?

T shaped uterus

The following describes which uterine abnormality? 2x endometrial canals seperated by fibrous/muscular septum Straight/convex uterine fundus Normal fundal contour >5 mm above tubal ostia

Septate uterus

The following describes which uterine abnormality? Smooth concavity of the uterine fundus Does it have any associated risks?

Arcuate uterus Not associated with infertility or obstetric complications

What is the following describing? Proximal 2/3 fallopian tube, nodular scarring

Salpingitis Isthmica Nodosa (Post inflammatory/infectious)

What is the following describing? Doppler US - Serpiginous and/or tubular anechoic structures within myometrium with high velocity colour doppler flow

Uterine AVM

What is the following describing? on HSG - non-filling of uterus + multiple irregular linear filling defects (Lacunar pattern) + Unable to distend endometrial canal MR - T2 dark bands

Intrauterine adhesions (Ashermans)

What is the following describing? Uterine mass US - Hypoechoic, peripheral blood flow and venetian blind shadow pattern

Uterine fibroid

What are the features of malignant degeneration in a fibroid? What does it transform into?

Rapidly enlarging, areas of necrosis Uterine Leiomyosarcoma

What does the following describe? Marked enlargement of the uterus, with preservation of the uterine contour. US - Heterogenous uterus (Hyperechoic foci with hypoechoic muscular hypertrophy)/Enlargeemnt of posterior wall

Adenomyosis

What does the following describe? Marked enlargement of the uterus, with preservation of the uterine contour. MR - Thickened junctional zone >12 mm, focal or diffuse + Small high T2 signal regions

Adenomyosis

The following MR findings in the endometrium suggest what? Diffusion restriction T2 intermediate signal (Brighter than junctional zone) Enhances less than myometrium

Endometrial cancer

The following describes which type of cystic vaginal/cervical mass? Cervical high T2 signal

Nabothian cyst Inflammation causing epithelium plugging of mucous glands

The following describes which type of cystic vaginal/cervical mass? Anterior lateral wall of upper vagina

Gartner duct cyst Incomplete regression of Wolffian ducts

The following describes which type of cystic vaginal/cervical mass? High T2 signal mass below the pubic symphysis + posterior

Bartholin gland cyst Due to obstruction of the Bartholin glands (Mucin secreting glands of urogenital sinus)

The following describes which type of cystic vaginal/cervical mass? Inferior & Lateral cystic structure

Skene gland cyst Cyst in periurethral glands

What do the following findings suggest? Large cysts >2 cm Ovary with multilocular cystic spoke wheel appearance

Theca Lutein cyst (Due to overstimulation from bHCG)

What do the following findings suggest? Theca lutein cysts Ascites Pleural effusions

Ovarian hyperstimulation syndorme

What do the following findings suggest? Dominant follicle Solid hypoechoic Ring of fire (Intense peripheral blood flow) on doppler Thin echogenic rim Moves with the ovary

Corpus luteum cyst

What do the following findings suggest? Cystic mass Thick echogenic rim Ring of fire (Intense peripheral blood flow) Moves separate from the ovary

Ectopic pregnancy

What do the following findings suggest? Pre-menopausal woman Rounded mass Homogenous low level internal echoes Increased through transmission Fluid-fluid levels

Endometrioma

What cancers do endometriomas transform to?

Endometriod or clear cell carcinoma

What do the following findings suggest? Ovarian mass T1 bright (Blood) T2 dark/shading (Iron/T1 bright lesion getting dark) Fat saturation will not suppress the signal

Endometrioma

What do the following findings suggest? Homogenous ovarian mass Enhanced through transmission Fishnet appearance Absent doppler flow T1 bright No fat saturation, No enhancement

Haemorrhagic cyst

What do the following findings suggest? Cystic ovarian mass Hyperechoic solid mural nodule (Rokitansky nodule) May have septations Dot dash pattern - hair within cyst T1 bright, T2 bright, Fat suppression

Dermoid cyst

What do the following findings suggest? >10 peripheral simple cysts <5mm String of pearls appearance Enlarged ovaries >10 cc Infertility, hirsutism, DM

Polycystic ovarian syndrome

What do the following findings suggest? Unilocular ovarian cyst Few septations Can be bilateral May have papillary projections Associated with peritoneal carcinomatosis

Serous ovarian neoplasm

What do the following findings suggest? Large ovarian mass Multiloculated Thin septa Low level echoes

Mucinous ovarian cystadenocarcinoma

What do the following findings suggest? Middle aged woman Hypoechoic and solid ovarian mass T1 & T2 dark Band of T2 dark signal around tumour on all planes Calcification rare

Fibroma/Fibrothecoma

What do the following findings suggest? Ascites Pleural effusion Benign ovarian tumour (Fibroma)

Meig syndrome

What do the following findings suggest? Tumour like enlargement of ovaries due to ovarian fibrosis T1 & T2 dark signal Black garland sign - T2

Fibromatosis

What do the following findings suggest? Fibrous ovarian mass - T2 dark Calcifications present

Brenner tumour

What do the following ovarian findings suggest? Multilocular cystic mass Intensely enhancing solid component Low T2 in cystic areas

Struma Ovarii (Patient should be hyperthyroid)

What do the following findings suggest? Unilateral enlarged ovary >4cm Mass on ovary Peripheral cysts +/- fluid-debris level Free fluid Lack of arterial/venous flow

Ovarian torsion

What do the following findings suggest? Cogwheel appearance - longitudinal folds of the fallopian tube become thickened String sign - incomplete septa Waist sign = tubular mass with indentations

Hydrosalpinx

What do the following findings suggest? Entire placenta No fetus Snowstorm appearance - Echogenic, solid, highly vascular mass Bunch of grapes = Vesicles enlarge into individual cysts

Complete hydatiform mole

What do the following findings suggest? Only portion of placenta Fetus present - Triploid Enlarged placenta Areas of multiple diffuse anechoic lesions May have fetal parts

Partial Hydatifiorm mole

What do the following findings suggest? Invasion of molar tissue into myometrium Post treatment of hydatidiform mole Echogenic tissue in myometrium MR - Focal myometrial mass, dilated vessels, haemorrhage and necrosis

Invasive mole

What do the following findings suggest? Spreads into myometrium/parametrium then mets distantly Elevated serum bHCG, post evacuation of molar pregnancy Highly echogenic solid mass

Choriocarcinoma

Which zone of the prostate is brightest on T2?

Peripheral zone is most T2 bright

What is the most common location of adenocarcinoma of the prostate?

Peripheral zone

What is the location of hyperplasia in the prostate (BPH)?

Central gland (Transitional zone + Central zone)

What do the following findings suggest? Prostate Dark on T2 Low T1 Dark on ADC Type 3 enhancement

Prostate cancer

What do the following findings suggest? Prostate volume >30 cc Transitional zone involvement Central gland enlarged J shaped ureter - distal ureter curving around enlarged prostate

BPH

What do the following findings suggest? Prostate Transitional zone T2 Heterogenous May restrict diffusion, less ADC dark Can enhance

BPH

What do the following findings suggest? Prostate T2 dark T1 bright (Sometimes) ADC Less dark No enhancement

Peripheral zone haemorrhage (Post biopsy)

The following male pelvic cysts are found where? Prostatic utricle Mullerian duct cyst Ejaculatory duct cyst

Midline

The following male pelvic cysts are found where? Seminal vesicle cyst Diverticulosis of the ampulla of vas deferens

Lateral

What do the following findings suggest? Male 18 - 35 Testicular lump Hx of undescended testicle

Seminoma

What do the following findings suggest? Age 25yrs Testicular mass Homogenous hypoechoic round mass Replaces entire testicle T2 dark homogeneously

Seminoma (Most common)

What do the following findings suggest? Young age Testicular tumour Heterogenous - Solid and cystic Large calcifications

Non-seminomatous germ cell tumour

What do the following findings suggest? Testicular tumour Diffusely enlarged Ill defined hypoechoic testicle Age >60 yrs Bilateral disease

Testicular lymphoma

What do the following findings suggest? Hypoechoic region in testicle No doppler blood flow Hx of acute pain No trauma

Testicular infarct

What do the following findings suggest? Testicular pain Heterogenous massess No increased internal flow on doppler within the masses Hx of trauma Follow up shows resolution

Testicular haematoma

What do the following findings suggest? Onion skin mass - Alternating hypoechoic and hyper echoic rings Non-vascular

Epidermoid cyst (Benign)

What do the following findings suggest? Bilateral Older men Cystic dilatation next to the mediastinum testes

Tubular ectasia of the rete testes

The following in pregnancy suggest what? CR Length >7 mm no heartbeat Mean sac diameter >25 mm + No embryo No embryo with heartbeat >2 weeks post scan which had gestational sac without yolk sac

Pregnancy failure

Which of the following placenta creta are described here: 1. Most common and mild; villi attach to myometrium, without invading 2. Villi partially invade myometrium 3. Villi penetrate through myometrium or beyond serosa

1. Placenta Accreta 2. Placenta Increta 3. Placenta Percreta

Which phase of contrast is most sensitive for detection of renal cell carcinoma?

Nephrogenic phase

What do the following renal findings suggest? Renal mass >15 HU contrast enhancement Calcifications Microscopic fat

Renal cell carcinoma

What is the most common type of RCC? 2nd?

Clear cell 2nd = Papillary

What do the following renal findings suggest? Cystic mass with enhancing components Enhances equal to cortex on corticomedullary phase Microscopic fat or calcification High T2, loss of signal in/out phase

Clear cell RCC

What do the following renal findings suggest? Less vascular - will not enhance equal to cortex on corticomedullary phase T2 dark

Papillary RCC

What do the following renal findings suggest? Associated with sickle cell trait Large renal mass Young patient

Medullary RCC

What do the following renal findings suggest? Bilateral enlarged kidneys Small low attenuation cortically based solid nodules/masses Enhancement less than surrounding renal cortex High density on unenhanced CT Lymphadenopathy Preserve normal reniform shape

Renal lymphoma

What do the following renal findings suggest? Smooth enlarged bilateral kidneys Hypodense cortically based lesions Little involvement of medulla

Renal leukemia

What do the following renal findings suggest? Renal lesion with macroscopic fat Heterogenous enhancement No calcifications If lipid poor - T2 dark

Angiomyolipoma

A renal lesion with the following features is what? Fat with calcifications Fat with no calcifications

Fat with calcifications = RCC Fat with no calcifications = Likely AML

What do the following renal findings suggest? Solid mass with central scar Enhances equal to cortex on corticomedullary phase Spoke wheel vascularity on US

Renal Oncocytoma

What do the following renal findings suggest? Non-communicating fluid filled locules Thick fibrous capsule No solid component or necrosis Protrudes into the renal pelvis Young boys 4yrs or 40yr old women

Multilocular cystic nephroma

What do the following findings suggest? Simple renal cyst <15 HU No enhancement

Bosniak I

What do the following findings suggest? Hyperdense renal cyst <3cm Thin calcifications Thin septations No enhancement

Bosniak II

What do the following findings suggest? Renal cyst Hyperdense >3cm Thin calcifications >2 thin septations

Bosniak 2F

What do the following findings suggest? Renal cyst Thick septations Mural nodule Enhancing septa

Bosniak III

What do the following findings suggest? Renal cyst Any enhancement >15HU Mural nodule - enhancing

Bosniak IV

What do the following findings suggest? Hyperdense renal cyst >70 HU Homogenous

Hyperdense cysts (Haemorrhagic/Proteinacious)

What do the following findings suggest? Progressive enlargement of kidneys Multiple cystic renal lesions Haemorrhagic cysts with calcific walls Seminal vesicle cysts

ADPKD

What do the following findings suggest? Pancreatic cysts, NET Phaeochromocytoma Haemangioblastoma of cerebellum RCC

Von Hippel Lindau

What do the following findings suggest? LAM Rhabdomyosarcoma SEGA AML RCC

Tuberous Sclerosis

What do the following findings suggest? No functioning renal tissue Contralateral VUR or UPJ obstruction No communication with cystic spaces and renal pelvis

Multicystic dysplastic kidney

What do the following findings suggest? Striated nephrogram (Wedge shaped hypo enhancement does not extend to the capsule) Cortical rim sign - spares capsule Flip flop enhancement - Region of hypo density on early phases becomes hyaperdense on delayed imaging

Renal infarct

What do the following findings suggest? Gas localised to the renal collecting system Gas outlining the ureters and dilated calyces

Emphysematous pyelitis

What do the following findings suggest? Filling defects in the calyx Linear streaks of contrast inside the papillae - Lobster claw sign

Papillary necrosis

What do the following findings suggest? Staghorn calculus Bear paw appearance in kidney

Xanthogranulomatous Pyelonephritis

What do the following findings suggest? Calyceal blunting - moth eaten calyx Calyx distortion/papillary necrosis Cavity formation in the medulla Focal stenosis of infundibulum (Absent opacification of calyx)

Renal TB

What do the following findings suggest? Renal doppler - reversed arterial diastolic flow Absent venous flow

Renal vein thrombosis

What do the following findings suggest? Necrosis only affecting renal cortex Reverse rim sign - non enhancing dark cortex, normal enhancement of renal medulla If chronic renal cortex calcifies

Acute cortical necrosis

What do the following findings suggest? 2 weeks post renal transplant Anechoic fluid collection with no separations Rapidly increasing in size Leak of contrast on delayed phase

Urinoma

What do the following findings suggest? 1-2 months post renal transplant Fluid collection medial to transplant (b/w graft and bladder) No leak of contrast on delayed phase

Lymphocele

What do the following findings suggest? Within 1 week post transplant Swollen kidney Reversed diastolic renal artery doppler flow No renal vein flow

Renal vein thrombosis

What do the following findings suggest? Soft tissue nodularity plaques in the bladder & ureters Chronic UTI's

Malakoplakia - not pre-malignant

What do the following findings suggest? Bladder*** more commonly involved Multiple mural filling defects

Leukoplakia (Pre-malignant related to Squamous cell cancer)

The following cause deviation of the ureters in which direction? Retroperitoneal adenopathy Aortic aneurysm Psoas hypertrophy (Proximal)

Lateral deviation of ureters

The following cause deviation of the ureters in which direction? Retroperitoneal fibrosis Retrocaval ureter (Right side) Pelvic lipomatosis Psoas hypertrophy (Distal)

Medial deviation of ureters

What do the following findings suggest? Male Infant Deficiency of abdominal musculature Hydroureteronephrosis Cryptochordism

Prune belly/Eagle Barrett syndrome

What do the following findings suggest? Trauma - Straddle injury Compression of urethra against inferior edge of pubic symphysis Short segment urethral stricture Bulbous urethra

Anterior urethral injury

What do the following findings suggest? Long irregular urethral stricture Distal bulbous urethra

Gonococcal urethral stricture

In terms of the adrenal gland what does the following suggest: Non-contrast CT <10 HU

Adrenal adenoma No further imaging required

When is contrast required in a patient with ?Adrenal adenoma?

When the lesion is >10 HU on non contrast CT

What is absolute washout for adrenal adenoma?

(Enhanced - Delayed)/(Enhanced - Unenhanced) x 100

What is relative washout for adrenal adenoma?

(Enhanced - Delayed)/(Enhanced) x 100

What % of absolute and relative washout suggests an adrenal adenoma on imaging? What MR features fit?

Absolute = >60% Relative = >40% Drop out on in and out of phase MR

What do the following findings suggest? Large adrenal mass >3cm Variable presentation Heterogenous mass with avid enhancement (>120HU) T2 bright

Phaeochromocytoma

Which imaging is used to diagnose pheochromocytoma?

Octreotide MIBG can also be used

Which syndromes are associated with Phaeochromocytoma?

VHL Men II A Men II B

Extra-adrenal phaechromocytoma GIST Pulmonary chondroma (Hamartoma)

Carneys triad

What do the following findings suggest? Parathyroid hyperplasia Pituitary adenoma Pancreatic tumour (Gastrinoma)

MEN 1

What do the following findings suggest? Medullar thyroid cancer Parathyroid hyperplasia (Hypercalcaemia) Phaeochromocytoma

MEN 2

What do the following findings suggest? Medullary thyroid cancer Phaeochromocytoma Mucosal neuroma Marfanoid body habitus

MEN 2B

What do the following findings suggest? Flushing, RHF Mets to liver Ileum hyper vascular mass

Carcinoid syndrome

What do the following findings suggest? Any age Oval Circumscribed mass with homogenous hypoechoic echo texture Central hyper echoic band MR - T2 high, Type 1 enhancement

Fibroadenoma

What do the following findings suggest? Fast growing breast mass Older age >40yrs Oval Circumscribed mass with homogenous hypoechoic echo texture Central hyper echoic band

Phyllodes

What do the following findings suggest? Hard, non-mobile, painless mass Irregular, high density mass Indistinct or speculated mass Pleomorphic calcifications Posterior acoustic shadow with echogenic halo

IDC (Invasive ductal carcinoma)

What do the following findings suggest? Small speculated slow growing mass Associated with radial scar

Tubular IDC

What do the following findings suggest? Confined to the duct Linear branching or fine pleomorphic calcifications Microlobulated mildly hypoechoic mass with ductal extension Normal acoustic transmission Non mass enhancement on MR

DCIS

What do the following findings suggest? Skin changes and palpable lump US - May have mass MRI - Abnormal nipple enhancement and linear clumped enhancement

Pagets of the breast

What do the following findings suggest? No focal palpable mass Skin thickening on mammogram Hypoechoic multiloculated collection Breast feeding woman

Mastitis/Breast abscess

What do the following findings suggest? No focal palpable mass Skin thickening on mammogram Solid mass on US or no focal mass

Inflammatory breast cancer - biopsy (Punch or core)

What do the following findings suggest? Flame shaped hypoechoic mass behind the nipple - radiating posterior Bilateral but asymmetric May be painful

Gynecomastia

What do the following findings suggest? Male Dendritic - like branching pattern, hypoechoic Diffuse glandular subareolar tissue on mammogram - looks like breast tissue

Gynecomastia

What do the following findings suggest? Increase in fat tissue of the breast (Not glandular tissue) No discrete palpable finding Mound of tissue not concentric to the nipple

Psuedogynecomastia

What do the following findings suggest? Eccentric to nipple Unilateral Abnormal lymph nodes Calcifications - coarse associated with mass

Male breast cancer

What do the following findings suggest? Rounding or distortion of breast implant

Capsular contracture (Secondary contraction of the fibrous capsule)

What do the following findings suggest? Dense silicone seen outside capsule Snowstorm - echogenic with no posterior shadowing in axillary lymph nodes T1 dark + T2 bright

Intracapsular with extra capsular rupture

What do the following findings suggest? Linguine sign

Intracapsular rupture

What oesophageal abnormality does this describe? Irregular contour, abrupt shouldered edges, mass in mid oesophagus

Squamous cell carcinoma of oesophagus

What oesophageal abnormality does this describe? Chronic reflux Hx, irregular contour mass with abrupt shouldered edges Stricture/ulcer in lower oesophagus

Adenocarcinoma of the oesophagus

What oesophageal abnormality does this describe? Immunocompromised patient, discrete plaque like lesions, nodularity/granularity/fold thickening due to mucosal oedema Upper oesophagus

Candidiasis

What oesophageal abnormality does this describe? Multiple elevated benign nodules in asymptomatic elderly patient

Glycogen acanthosis

What oesophageal abnormality does this describe? Small multiple ulcers with halo of oedema

Herpes

What oesophageal abnormality does this describe? Large flat ovoid ulcer Distal oesophagus

CMV or HIV

What oesophageal abnormality does this describe? Discrete ulcers surrounded by mounds of oedema

Crohns (Aphthous ulcers)

What oesophageal abnormality does this describe? Lower 2/3 of oesophagus + LES incompetent + NSIP in lungs + Closely spaced valvulae conniventes

Scleroderma

What do the following features of stomach ulcers suggest? Width > Depth Located within lumen Nodular, irregular edges Folds adjacent to ulcer Carmen meniscus sign Can be anywhere

Malignant

What do the following features of stomach ulcers suggest? Depth > Width Project beyond the expected lumen Sharp contour Folds radiate to ulcer Hamptons line Mostly on lesser curvature

Benign

What do the following stomach changes suggest? Regular rugal thickening Involves the fundus Spares the antrum Bimodal age distribution Low albumin

Menetriers disease (Idiopathic gastropathy)

What type of hernia is being described here? Inferior to inferior epigastric vessels Medial to common femoral vein Below pubic tubercle

Femoral hernia Compression of the femoral vein is common

What type of hernia is being described here? Medial and anterior to inferior epigastric artery Defect in Hesselbachs triangle Above pubic tubercle

Direct inguinal hernia Compresses inguinal canal, not covered by internal spermatic fascia

What type of hernia is being described here? Lateral and superior to inferior epigastric artery Processus vaginalis open Above pubic tubercle

Indirect inguinal hernia No compression of inguinal canal contents, covered by internal spermatic fascia

The following bowel changes are suggest what? Affects terminal ileum - narrowed Retracted caecum Caecum pulled up via scarring out of the RLQ Ulcers & areas of narrowing Large necrotic nodes

Colonic TB

The following bowel changes are suggest what? Immunosuppressed patient Deep ulceration

Colonic CMV

Which infections favour the duodenum?

Giardia Strongyloides

Which bowel infections favour the terminal ileum?

TB Yersinia

The following bowel changes are suggest what? Accordion sign - enhancing oedematous mucosa, contrast trapped inside mucosal folds Thumb printing Ulceration & Irregularity

C-Difficile

The following bowel changes are suggest what? Bowel thickening Limited to the caecum Severe neutropenia

Neutropenic colitis (Typhilitis)

The following liver lesion findings suggest what? T1 variable T2 dark Does not enhance

Regenerative nodule

The following liver lesion findings suggest what? T1 bright T2 iso to dark Arterial enhancement but no washout

Dysplastic nodule (Pre-malignant)

The following liver lesion findings suggest what? T2 bright Enhancement - Arterial enhancement + rapid washout on PV phase Dark on delayed phase May contain fat

Hepatocellular carcinoma

The following liver lesion findings suggest what? Hyperechoic, Posterior enhancement on US Doppler flow in vessels adjacent to lesion but not within Peripheral nodular discontinuous enhancement T2 bright Progressive fill in by 15 mins (Centripetal)

Haemangioma

The following liver lesion findings suggest what? >5 cm Hyperechoic on US Doppler flow in vessels adjacent to lesion Peripheral nodular discontinuous enhancement Progressive fill in by 15 mins

Giant haemangioma

The following liver lesion findings suggest what? <2 cm Rapid flash filling on arterial phase Retain contrast - isodense to blood pool No washout

Flash filling haemangioma

The following liver lesion findings suggest what? Spoke wheel on US doppler Marked arterial enhancement, isointense on PV phase Retains HPB specific contrast T1 & T2 isointense Central scar - delayed enhancement

Focal nodular hyperplasia

The following liver lesion findings suggest what? Female on OCP/Male on anabolic steroids Right lobe of liver most common Drop out with in out and out of phase - used to show fat

Hepatic adenoma

The following liver lesion findings suggest what? Cirrhosis Older >50 No calcification Elevated AFP

HCC

The following liver lesion findings suggest what? Younger patient <35 No cirrhosis, normal AFP Central scar, no enhancement + T2 dark Tumour enhancement, calcification

Fibrolamellar subtype of HCC

Of the two liver lesions with central scars, which is being described here? T2 bright Enhancement on delayed phase Mass is sulfur colloid avid

Focal nodular hyperplasia

The following liver lesion findings suggest what? Mass that enhances on delayed imaging Rim arterial enhancement with patchy progressive enhancement - centripetal filling Liver capsular retraction Biliary ductal dilatation (Unliateral and peripheral, unless central lesion) No tumour capsule

Cholangiocarcinoma

Which condition is associated with the following findings: Multiple AVMs in liver and lungs Cirrhosis Massively dilated hepatic artery

HHT (Osler-Weber-Rendu)

The following in the liver are signs of what condition? Main hepatic veins and IVC patent Portal waveforms abnormal (Slow, reversed)

Budd chiari with occlusion of small hepatic venules

The following in the liver are signs of what condition? Elevated CVP Refluxed contrast into hepatic veins Increased portal venous pulsatility Nutmeg liver

Passive congestion Due to stasis of blood within the liver due to compromise of hepatic drainage, complication of CHF or constrictive pericarditis

What do the following liver findings suggest? Filling defect in the portal vein Development of serpiginous vessels in porta hepatis - reconstitute right and left portal veins

Portal vein thrombosis

What do the following liver findings suggest? Intra and/or extra hepatic bile duct strictures & focal dilation - Beaded appearance Cirrhosis Central regenerative hypertrophy Withered tree - on MRCP from abrupt narrowing of branches

Primary sclerosing cholangitis

What do the following liver findings suggest? Middle aged woman Destruction of small/medium intrahepatic bile ducts Normal extra hepatic ducts Lace like pattern of fibrosis

Primary biliary cirrhosis

What do the following GB findings suggest? Hypertrophied mucosa & muscularis Cholesterol crystals deposited in intraluminal location - with rokitansky aschoff diverticulae Comet tail artifact

Gallbladder Adenomyomatosis

What do the following GB findings suggest? Cholesterol and triglyceride deposition within the substance of the lamina, associated formation of cholesterol polyps

Gallbladder cholesterolosis

What do the following GB findings suggest? Extensive wall calcification Increased risk of GB Cancer

Porcelain gallbladder

What do the following GB findings suggest? >1cm Sessile & Solitary Enhancement on CT/MR Flow on doppler

Malignant gallbladder polyp

What do the following findings suggest? Complete fatty replacement of pancreas (Pseudohypertrophy of pancreas) Fibrosing colonopathy (Wall thickening of proximal colon)

Cystic fibrosis

What do the following findings suggest? Pancreatic insufficiency in child Short stature (Metaphyseal achondroplasia) Eczema Lipomatous pseudo hypertrophy of the pancreas

Schwachman-Diamond syndrome

What do the following pancreas findings suggest? Older female Heterogenous, mixed density lesion made up of multiple small cysts Pancreatic head No communication with pancreatic duct May have central scar +/- central calcifications

Serous cystadenoma (Benign)

What syndrome are serous cyst adenomas associated with?

VHL

What do the following pancreas findings suggest? Middle age woman Body and tail No communication with pancreatic duct Unilocular or septated

Mucinous cystic neoplasm (Pre-malignant)

What do the following pancreas findings suggest? Young female Large thick capsule Tail of pancreas Progressive fill in of solid portions

Solid Pseudopapillary tumour of the pancreas (SPEN)

What do the following pancreas findings suggest? Elevated IgG4 Sausage shaped pancreas Loss of pancreatic high T1 signal Capsule with delayed rim enhancement around gland No duct dilatation No calcifications

Autoimmune pancreatitis (IgG4)

What do the following pancreas findings suggest? Soft tissue within the pancreaticoduodenal groove with/without delayed enhancement Duodenal stenosis and/or structures of CBD Little/No biliary obstruction

Groove pancreatitis

What do the following pancreas findings suggest? Young age at onset Multiple large calculi within a dilated pancreatic duct

Tropic pancreatitis or Hereditary pancreatitis

What is the following describing? Treat oesophageal varices Shunt to divert blood around the liver Improves oesophageal varices and ascites

TIPS (Transjugular intrahepatic portosystemic shunt)

What is the following describing? Treat gastric varices with gastro-renal shunt Embolise collaterals to drive blood into river Improves hepatic encephalopathy

BRTO (Balloon occluded retrograde transverse obliteration)

What is the puncture location for a nephrostomy?

Lower pole of a posteriorly oriented calyx - to go through Brodels avascular zone

The following is an indication for what procedure: CBD obstruction (Failed ERCP), cholangitis, bile duct/injury

Percutaneous biliary drainage

The following is an indication for what procedure: Cholecystitis in patients who are not surgical candidates. Septic

Percutaneous Cholecystostomy

What is the best MRI sequence for anal fistula

T1 post contrast or STIR

What does the following describe? Ultrasound Cavernous transformation of the portal vein and the dilatation of bile ducts MRI biliary stenosis wavy appearance of the bile ducts angulation of the CBD upstream dilatation of the bile ducts

Portal biliopathy

What do the following findings suggest? Liver lesions CT - Hypoattenuation with no enhancement, may have enhancing nodule/rim MRI - T1 low T2 High No contrast enhancement No diffusion restriction

Biliary Hamartoma

What do the following findings suggest? Multiple osteomas - mandible/maxilla/skull GI polyps

Gardner syndrome (Variant of FAP)

What does the following describe? Fistula crosses intersphinteric space and does not cross the external sphincter

Intersphincteric rectal/anal fistula (Most common)

What does the following describe? Fistula crosses intersphincteric space, through external sphincter into the ischiorectal fossa

Transsphincteric rectal/anal fistula

What does the following describe? Fistula passes superiorly into the intersphincteric space, over top of puborectalis muscle, through illiococcygeus to skin

Suprasphincteric rectal/anal fistula

What does the following describe? Fistula crosses from perineal skin through ischiorectal fossa and levator ani muscle complex into rectum

Extrasphincteric rectal/anal fistula

What do the following findings suggest? Old patient Medial femoral condyle T1 high signal (Oedema) Subchondral deformity

Spontaneous osteonecrosis of the knee

What is the blood flow to the scaphoid?

Retrograde (Distal to proximal)

What do the following findings suggest? Scaphoid tilts to volar Radial scaphoid space narrows Capitate migrates proximally

Scapholunate ligament tear

What do the following findings suggest? Radial side injury (SL side) Scaphoid move dorsal Widened SL angle >60 Capitolunate angle decreased

DISI (Dorsal intercalated segmental instability)

What do the following findings suggest? Ulnar side injury (LT side) Scaphoid moves volar Narrowed SL angle <30

VISI (Volar Intercalated Segmental instability

What do the following findings suggest? SL >3 mm Worsened on clenched fist view

Scapho-lunate dissociation

What do the following findings suggest? Lunate remains in normal position Capitate moves dorsal

Peri-lunate dislocation

What do the following findings suggest? Lunate moves volar Capitate moves dorsal Radial alignment lost Triquetral fracture

Mid-Carpal dislocation

What do the following findings suggest? Lunate displaced and rotated volarly Capitate remains in position Dorsal radiolunate ligament injury

Lunate dislocation

What do the following findings suggest? Inflammatory condition Hx of trauma/surgery T1 loss of fat in rotator cuff interval Thickened axillary fold

Adhesive capsulitis

What do the following findings suggest? Superior margin shoulder labrum tear - Labrum at insertion of long head of biceps No associated instability Seen in overhead throwers

SLAP Tear

What do the following findings suggest? Incomplete attachment of the labrum at 12 oclock Smooth margins At Biceps anchor High signal (Fluid) Follows contour of glenoid

Sublabral recess

What do the following findings suggest? Absent anterior/superior labrum (1-3 o'clock) Thickened middle GH ligament

Burford complex

What do the following findings suggest? Superficial partial labral injury Cartilage defect No instability Superficial anterior inferior labral tear

Glenolabral articular disruption (GLAD) Mild

What do the following findings suggest? Avulsed anterior-infeiror labrum Medially stripped Intact GH complex periosteum

Perthes

What do the following findings suggest? Medially displaced labroligamentous complex Labrum torn with posterior displacement Absence of labrum on glenoid rim Intact periosteum

ALPSA (Anterior labral periosteal sleeve avulsion)

What do the following findings suggest? Periosteum disrupted Cartilaginous or osseous labrum tear

True Bankart

The following shoulder injuries occur with which type of shoulder dislocation? GLAD Perthes ALPSA Bankart

Anterior shoulder dislocation

What is the effect of a cyst: - At level of supra scapular notch - Spinoglenoid notch

At level of supra scapular notch = Fatty atrophy of Supraspinatus + Infraspinatus Spinoglenoid notch = Fatty atrophy of Infraspinatus

What do the following findings suggest? Atrophy of teres minor

Due to quadrilateral space syndrome - compression of axillary nerve

The following are borders of which space? Teres minor above Teres major below Humeral neck lateral Triceps medial

Quadrilateral space

What do the following findings suggest? Atrophy of muscles supplied by supra scapular and axillary nerves

Parsonage turner syndrome (Idiopathic involvement of brachial plexus)

Which muscles attach to the following locations: Iliac crest ASIS AIIS

Iliac crest = Abdominal muscles ASIS = Sartorius/Tensor Fascia lata AIIS = Rectus Femoris

Which muscles attach to the following locations: Greater Trochanter Lesser Trochanter Ischial tuberosity Pubic symphysis

Greater trochanter = Gluteal muscles Lesser trochanter = Iliopsoas Ischial tuberosity = Hamstrings Pubic symphysis = Adductor group

What do the following findings suggest? Osseous bump at femoral head-neck junction More common in young male Alpha angle >55 degrees

Cam type FAI

What do the following findings suggest? Deformity of acetabulum Acetabulum is malformed causing posterior lip to cross over anterior lip More common in Middle aged woman Acetabular overcoverage

Pincer type FAI

Bakers cysts are found between which muscles?

Semimembranosus Medial head of Gastrocnemius

What do the following findings suggest? Quadricep tendon tear

Patella baja (Unopposed pull of patellar tendon) low patella

What do the following findings suggest? Patella tendon tear

Patella alta (Unopposed pull of Quadricep tendon) high patella

What do the following findings suggest? Soft tissue mass (Tear drop) between 3rd and 4th MT heads Dark on T1 & T2 Projects downward below plantar ligament

Mortons neuroma

What do the following findings suggest? Soft tissue mass between 3rd and 4th MT heads High T2 signal Extends above the transverse ligament

Intermetatarsal bursitis

What do the following findings suggest? Hx of trauma or infection Severe osteopenia (Thin sharp cortex, increased bone lucency) Preserved joint spaces Most common in hand & shoulder Low bone density, High uptake on bone scan

Reflex sympathetic dystrophy (Sudek)

What do the following findings suggest? Female 3rd trimester of pregnancy - unilateral Male - Bilateral Normal hip joint space Osteopenia (Lucent) MR - Oedema Bone scan - Increased focal uptake

Transient osteoporosis of the hip

What do the following findings suggest? Hx of pain in joint Improves then moves to another joint Osteopenia MR Oedema Self limiting

Regional migratory osteoporosis

What do the following findings suggest? Patchy areas of sclerosis Oedema on STIR (High signal) Dark on T1 Serpiginous dark line Joint effusion

Avascular necrosis

What do the following findings suggest? Patchy areas of sclerosis Oedema on STIR (High signal) Dark on T1 Dark line parallel to suchondral bone Joint effusion

Insufficiency fracture

What do the following findings suggest? Band like fracture line - dark on T1 Variable T2 Normal vertebral body signal +/- retropulsed posterior bone fragments

Osteoporotic compression fracture

What do the following findings suggest? Abnormal marrow signal (Low T1 and T2) Involvement of posterior margin

Neoplastic compression fracture

What do the following findings suggest? Tends to spare disc space Skip involvement Large paraspinal abscess Calcified psoas abscess Gibbs deformity - destructive focal kyphosis

Pott disease (Spinal TB)

What do the following findings suggest? Most common Young patient 10-20 Aggressive periosteal reaction (Sunburst, lamellated, codman) May have skip lesions

Conventional intramedullary osteosarcoma

What do the following findings suggest? Posterior distal femur Metaphyseal location Radiolucent line separating mass from cortex Located in outer layer of periosteum Can have marrow extension

Parosteal osteosarcoma

What do the following findings suggest? Diaphyseal - Medial distal femur No marrow extension Inner layer of periosteum

Periosteal osteosarcoma

What do the following findings suggest? Fluid fluid levels on MRI High T1 signal Cystic lesion within bone Young adult

Telangiectatic osteosarcoma

What do the following findings suggest? Permeative lesion + Marked sclerosis Diaphysis young Child Soft tissue component, no calcification Lamellated/onion skin periosteal reaction

Ewing Sarcoma

What do the following findings suggest? Age 40-70 Proximal tubular bone - Distal femur Intramedullary or Peripheral Cortical destruction Cortical scalloping Chondroid matrix (Arcs/Rings)

Chondrosarcoma

What do the following findings suggest? Adults 30-60 Can be found in clivus/sarcum T2 very bright Midline Destructive lytic lesion, with expansile soft tissue mass

Chordoma

What do the following findings suggest? Long lesion in long bone Ground glass matrix Lytic lesion with hazy matrix No periosteal reaction or pain

Fibrous dysplasia

What do the following findings suggest? Polyostotic fibrous dysplasia Cafe au lait spots Precocious puberty

McCune Albright

What do the following findings suggest Polyostotic fibrous dysplasia Soft tissue myxomas Increased risk of osseous malignant transformation

Mazabraud syndrome

What do the following findings suggest? Tibial lesion Mixed lytic and sclerotic lesion - with hazy matrix Potential to be malignant

Adamantinoma

What do the following findings suggest? Children - regresses (Sclerotic) Metaphysis near physis Migrate away from physis with age Eccentric with thin sclerotic border >3cm

Non-ossifying fibroma

What do the following findings suggest? Children - regresses (Sclerotic) Metaphysis near physis Migrate away from physis with age Eccentric with thin sclerotic border <3cm

Fibrous cortical defect

What do the following findings suggest? Multiple non ossifying fibromas Cafe au lait spots Mental retardation Hypogonadism Cardiac malformations

Jaffe Campanacci syndrome

What do the following findings suggest? Lesion of medullary cavity with hyaline cartilage 10-30 Humerus/Femur Arcs and rings matrix (Chrondroid) Speckled calcification

Enchondroma

What do the following findings suggest? Lesion of medullary cavity with hyaline cartilage 10-30 Humerus/Femur Arcs and rings matrix (Chrondroid) Speckled calcification Painful >5 cm

Low grade chondrosarcoma

What do the following findings suggest? Multiple enchondromas

Ollier disease

What do the following findings suggest? Multiple enchondromas Haemangiomas - Lucent centered calcifications

Maffucci syndrome

What do the following findings suggest? <30yrs Solitary***/Multiple Vertebra plana Skull with lucent beveled edge lesions Floating tooth - lytic lesion in alveolar ridge

Eosinophilic granuloma

What do the following findings suggest? Closed physis Lucent lesion + No sclerotic border Abuts articular surface Most common in knee >20yrs Fluid levels on MRI

Giant cell tumour

What do the following findings suggest? 10-25yrs Oval lytic lesion surrounded by dense sclerotic cortical bone Lucent nidus Femoral neck or posterior elements of spine Pain relived by aspirin MR - oedema

Osteoid Osteoma

What do the following findings suggest? Painful scoliosis Convexity pointed away from lesion

Osteoid osteoma

What do the following findings suggest? >30yrs Oval lytic lesion surrounded by dense sclerotic cortical bone Lucent nidus Femoral neck or posterior elements of spine >2cm MR - oedema

Osteoblastoma

What do the following findings suggest? Cystic expansile lesion Thin walled, blood filled spaces Fluid-fluid level on MR <30 Tibia - Vertebrae - Femur Septations may enhance

Aneurysmal bone cyst

What do the following findings suggest? <30yrs Tubular bones - humerus/femur/Calcaneum Central location Fallen fragment sign - pathological fracture

Solitary bone cyst

What do the following findings suggest? Lytic or sclerotic lesions Subperiosteal bone resorption - side of finger/clavicle/rib

Brown tumour (Hyperparathyroidism)

What do the following findings suggest? <25yrs Epiphysis of tibia or epiphyseal equivalent Thin sclerotic rim, extension across physeal plate, periostitis Bone marrow/Soft tissue oedema on MR Not T2 bright

Chondroblastoma

What do the following findings suggest? <30yrs Osteolytic elongated in shape Eccentrically located Metaphyseal lesion Cortical expansion Proximal metaphyseal region of tibia

Chondromyxoid fibroma

What do the following findings suggest? Calcaneal diaphysis (Anterior 1/3) Fat density on CT/MR or Central fragment within lucent lesion

Intraosseous lipoma

What do the following findings suggest? Variation of normal trabecular pattern Central triangular radiolucent area Anterior 1/3 of calcaneum Persistent thin trabeculae and thin nutrient foramen

Calcaneal pseudo-cyst

What do the following findings suggest? Multiple sclerotic lesions centered around a joint Epiphysis Keloid formation

Osteopoikolosis

What do the following findings suggest? Intertrochanteric region of femur lesion Geographic lytic lesion with sclerotic margin How are they managed?

Liposclerosing myxofibroma Followed up due to risk of malignant transformation

What do the following findings suggest? Bone matrix lesion Points away from the joint Bone marrow flows freely into the lesion Normal marrow signal on T1 MR Cartilage cap

Osteochondroma

What do the following findings suggest? Multiple echondondromas

Multiple Hereditary exostosis (Increased risk of malignant transformation)

What do the following findings suggest? Osteochondromas at epiphysis - irregular mass Ankle/Knee Point into the joint Young children

Trevor disease

What do the following findings suggest? <10 yrs Tibia/Fibula Looks like NOF but centered in anterior tibia Anterior tibial bowing

Osteofibrous dysplasia

What do the following findings suggest? Hair on end skull Expansion of facial bones Expanded ribs Extramedullary haematopoeisis Will obliterate the sinuses Erlenmeyer flask deformity Splenomegaly

Thalassemia

What do the following findings suggest? Hair on end skull Expansion of facial bones Expanded ribs Extramedullary haematopoeisis Will not obliterate the sinuses AVN Mild splenomegaly +/- auto infarction H shaped vertebrae

Sickle cell

The following are signs of which condition? Blade of grass - lucent leading edge in long bone Picture frame vertebrae - Cortex thickened on all sides Thick skull with frontal aspect falling over facial bones Bowing of tibia

Pagets disease

What do the following findings suggest? Superior and inferior endplate vertebral sclerosis (Rugger jersey spine) Lateral clavicle reabsorption Paraspinal soft tissue calcifications

Renal osteodystrophy (Osteomalacia + 2ndary Hyperparathyroidism)

What do the following findings suggest? Thick cortical bone Diminished marrow Rugger jersey spine Sandwich vertebrae (Sclerotic lines more well defined) Loss of normal T1 marrow signal, T1 and T2 dark

Osteopetrosis

What do the following findings suggest? H shaped vertebrae - microvascular endplate infarcts Widened disc space

Sickle cell

What do the following findings suggest? Old people Central location (Proximal arms/legs) or thigh Dark-intermediate on T2 Associated with spontaneous haemorrhage

Malignant fibrous histiocystoma/Pleomorphic undifferentiated sarcoma

What do the following findings suggest? Peripheral lower extremities 20-40 Close to joint but doesn't involve the joint Triple sign - high, medium and low signal in the same mass on T2 Bowl of grapes - fluid/fluid levels in mass Painful

Synovial sarcoma

What do the following findings suggest? Peripheral lower extremities 20-40 Close to joint but doesn't involve the joint Soft tissue calcifications + bone erosion

Synovial sarcoma

What do the following findings suggest? Fat signal intensity on all sequences Superficial Fat saturation out No septations

Lipoma

What do the following findings suggest? May have parts that are darker or brighter than fat on T1 Incomplete fat saturation Thick septations

Atypical lipoma/Low grade liposarcoma

What do the following findings suggest? Some elements have fat signal on all sequence Doesn't completely fat saturate or not at all Thick nodular complex septations Enhancing components

High grade liposarcoma

What do the following findings suggest? <20yrs T2 bright T1 dark Not cystic Gadolinium enhancement

Myxoid liposarcoma

What do the following findings suggest? Vertebral body lesion T2 bright Flow voids Intense enhancement Contain fat

Haemangioma

What do the following findings suggest? T2 bright Lower signal than muscle on T1 Soft tissue mass Faint enhancement

Myxoma

What do the following findings suggest? Involves joint synovium and tendon sheath Knee Joint effusion may have marginal erosions Joint space preserved Blooming on GE Low T1 + T2, STIR

PVNS

What do the following findings suggest? Hand (Palmar tendons) Erosions of underlying bone Soft tissue density T1 and T2 dark

Giant cell tumour of tendon sheath

What do the following findings suggest? Hand May have erosions of underlying bone Soft tissue density T1 dark, T2 bright Enhance uniformly

Glomus tumour

What do the following findings suggest? Affects one joint 40-50s Intrarticular loose bodies - ring and arc calcification (Chondroid) May calcify No blooming artifact on GE No erosions

Primary synovial chondromatosis

What do the following findings suggest? Affects one joint 40-50s Degenerative changes Joint loose bodies - ring and arc calcification (Chondroid) May calcify No blooming artifact on GE

Secondary synovial chondromatosis

What do the following findings suggest? Synovial lining Frond like deposition of fatty tissue 50-70s Suprapatellar bursa of knee Associated with trauma/degenerative disease Unilateral T1 and T2 bright, Fat saturation

Lipoma Arborescens

What do the following findings suggest? Big lobular/cystic calcium deposit near joint Fluid-calcium levels on CT No erosion or destruction of the joint Hip, elbow, shoulder GT bursa is most common site

Tumoral calcinosis

What do the following findings suggest? Fine and diffuse soft tissue calcifications Renal and lung calcifications Renal failure (or HighPTH) Elevated calcium

Metastatic calcification

What do the following findings suggest? Circumferential calcifications Lucent center Soft tissue lesion Oedema & enhancement on MRI

Myositis ossificans

What do the following findings suggest? Sclerosis Asymmetric Joint space narrowing Subchondral cysts Osteophyte formation

Osteoarthritis

What do the following findings suggest? Deformity Debris Dislocation Dense subchondral bone Destruction of articular cortex

Neuropathic joint

What do the following findings suggest? Diabetic Foot abnormality - Midfoot Deformity Debris Dislocation Dense subchondral bone Destruction of articular cortex

Charcot foot

What do the following findings suggest? Gull wing deformity Central erosions Postmenopausal women Favours DIP joints

Erosive OA

What do the following findings suggest? Soft tissue swelling Osteoporosis Uniform joint space narrowing Marginal erosions Bilateral & Symmetric Spares DIP joints Proximal

Rheumatoid arthritis

What do the following findings suggest? Erosive change with bone proliferation (Periostitis) Favours IP joints (Distal) Erosions at margins of joint, then progress to central Dactylitis Asymmetric

Psoriasis

The following are findings in which condition? Acro-osteolysis Pencil in cup deformity Ankylosis in finger Ivory phalanx - sclerosis and/or bone proliferation

Psoriatic arthritis

What do the following findings suggest? Severe bone resorption leading to soft tissue telescoping collapse

Arthritis Mutilans

What do the following findings suggest? Bone proliferation Erosions Asymmetric SIJ involvement Affects feet more Urethritis + Conjunctivitis + Arthritis

Reactive arthritis

What do the following findings suggest? Bamboo spine - syndesmophwytes flow from adjacent vertebral bodies Shiny corners Symmetric SIJ involvement (1st)

Ankylosing spondylitis

What do the following findings suggest? Axial arthritis - SIJ and spine Peripheral arthritis IBD

Enteropathic arthritis

What do the following findings suggest? Male >40 Big toe Joint effusion Spares joint space until late disease Juxta-articular erosions Punched out lytic lesions Overhanding edges Soft tissue tophi

Gout

What do the following findings suggest? Old people Favours TFCC Most common at knee Hooked MCP osteophytes with chonedrocalcinosis OA features Atypical joint distribution

CPPD (Calcium pyrophosphate dihydrate disease)

What do the following findings suggest? MCP joints Hooked osteophytes Uniform joint space loss at all MCP joints

Haemochromatosis

What do the following findings suggest? Diffuse paravertebral ossifications Ossification of ALL >4 levels Sparing of disc spaces No SIJ involvement

DISH

What do the following findings suggest? Focal lateral paravertebral ossification Ossification of annulus fibrosis

Psoriatic arthritis

What do the following findings suggest? Reducible deformity of joint without articular erosions Ulnar subluxation of MCPs Increased risk of patellar dislocation

SLE

What do the following findings suggest? Non-erosive arthropathy with ulnar deviation of 2nd to 5th fingers at MCP Post rheumatic fever

Jaccoud's arthropathy

What do the following findings suggest? <16yrs Proximal distribution of destruction Premature fusion of growth plates - ankylosis Enlarged epiphysis in knee and widened intercondylar notch

Juvenile idiopathic arthritis

What do the following findings suggest? Bilateral involvement of shoulders, hips, carpals and knees Joint space preserved Associated with dialysis

Amyloid arthropathy

What do the following findings suggest? Widened of joint space in adult hip Early onset OA Widening of osseous structures

Acromegaly

What do the following findings suggest? Destructive mass in bone of leukaemia patient

Chloroma (Granulocytic sarcoma)

What is the best sequence to demonstrate a NOF Fracture?

Coronal T1

What is the best sequence to demonstrate osteomyelitis?

T1 non fat sat STIR

What do the following findings suggest? Soft tissue calcifications (IM/SC) T2/STIR high signal due to muscle oedema If chronic, fatty infiltration of muscle/calcifications

Polymyositis/Dermatomyositis

What do the following findings suggest? IVD calcifications at every level with disc space narrowing

Ochronosis (Alkaptonuria)

What do the following findings suggest? Seen in lower limb in single sclerotome Thickened, irregular wavy cortex of long bone Intense uptake on bone scan

Melorheostosis

What do the following findings suggest? - valgus stress to flexed and externally rotated knee - posterolateral tibial plateau and mid part of lateral femoral condyle

Pivot shift injury ACL Tear

What do the following findings suggest? anterior force to tibia in a flexed knee (e.g. knees against dashboard in motor vehicle collision, or fall onto flexed knee) contusion pattern: anterior tibia +/- posterior patella

Dashboard injury PCL Injury

What do the following findings suggest? - valgus stress to flexed knee - contusion pattern: lateral femoral condyle and lateral tibial plateau +/- medial femoral condyle from medial collateral ligament (MCL) avulsive stress

Clip injury MCL Injury

What do the following findings suggest? - direct force to anterior tibia with foot planted - contusion pattern: "kissing contusions" of anterior tibial plateau and anterior femoral condyle

Hyperextension injury associated with ACL, PCL, meniscal injuries, and in severe cases knee dislocation

What do the following findings suggest? - twisting injury to flexed knee - contusion pattern: anterolateral lateral femoral condyle and inferomedial patella

Lateral patellar dislocation

What do the following findings suggest? MRI - left anterolateral thigh showed a well-defined crescentic collection extending along superficial fascia overlying the muscle plane, appearing hypointense with hyperintense (fat) strands T1 images and hyperintense on T2 CT - fluid-fluid level resulting from sedimentation of blood components and may or may not contain a capsule surrounding the lesion

Morell Lavellee lesion

The following is the position used to image on US which muscle? Patient position: the arm is in a neutral position, elbow flexed 90�, forearm supinated (palm up).

Biceps

The following is the position used to image on US which muscle? the arm is in a neutral position, elbow flexed 90�, forearm supinated (palm up). Patient position: the arm is kept in the same position as above and is externally rotated

Subscapularis

The following is the position used to image on US which muscle? Patient position: shoulder internally rotated and extended ("reaching to get wallet from back pocket" or "scratching between shoulder blades" positions).

Supraspinatus

The following is the position used to image on US which muscle? Patient position: the patient reaches across their chest and holds the contralateral shoulder with their hand.

Infraspinatus

Which imaging is best for assessing the synovium?

T1 weighted images before and after intravenous contrast - T2 weighted fat saturated - STIR in 2 planes

What do the following findings suggest? Polyarticular Male Widened intercondylar notch Blooming artifact into joint Squared patella, enlarged epiphysis, juxta-articular osteoporosis

Haemophillic arthropathy

What do the following findings suggest? Oligo/Polyarticular Lace like bony resorption of phalanges Multiple cystic lucencies S/C soft tissue masses No joint space narrowing

MSK Sarcoid - CXR to confirm

What do the following findings suggest? Acro-osteolysis Bone resorption + Osteopenia Soft tissue calcification Sclerodactyly Patulous oesophagus

Scleroderma

What do the following findings suggest? Linear bilateral smooth symmetrical periosteal reaction What is the next investigation?

Hypertrophic osteoarthropathy (HOA) CXR to rule out lung cancer

What do the following findings suggest? Short femur, short humerus Champagne glass pelvis Large heads, trident hands, Narrowing of interpedicular distance

Achondroplasia

Which MRI sequence is best to assess the cartilage?

T2/PD

What is the target for a shoulder arthrogram?

Superior medial target

What is the target for hip arthrogram?

Lateral head/neck target

What is the following describing? Lateral displacement of 2nd MT base on AP view Dorsal step off sign on Lateral view >2 mm between 1st and 2nd MT

Lisfranc injury

What is the following describing? Bowing of the radial shaft with increased interosseous space and dorsal subluxation of the distal RU joint. Due to premature closure or defective development of the ulnar 1/3 of the distal physis of the radius Related to Turner syndrome, Achondroplasia, Hurler

Madelung deformity

The following are findings in which syndrome? Absence/dysplasia of the greater sphenoid wing Tibial pseudoarthrosis Scoliosis Lateral thoracic meningocele

NF1

The following skull findings are suggestive of which condition? Beveled hole in the skull Lytic lesion, no sclerotic border Vertebrae plana Floating tooth sign (Mandible)

Langerhans cell histiocystosis

What is being described here? Patietal region most common CT - CSF Density MRI - T1 variable, T2 bright, No enhancement

Epidermoid

What is being described here? Midline Associated with encephaloceles Ct - Heterogenous, calcifications (Internal/peripheral) MR - T1 bright, T2 bright, Wall enhancement

Dermoid

What type of scalp trauma is being described here? Between aponeurosis & periosteum Not limited by suture lines Due to vacuum extraction

Subgaleal haemorrhage

What type of scalp trauma is being described here? Under the periosteum Limited by suture lines Outer border may calcify Due to instrument or vacuum extraction

Cephalohaematoma

What type of scalp trauma is being described here? Superficial to the aponeurosis Not limited by suture lines Due to prolonged delivery

Caput succedaneum

What is the following describing? High lung volumes Perihilar streak opacification

Meconium Aspiration Non GB Neonatal

What is the following describing? Low or normal lung volumes Granular opacities

Surfactant sufficiency disease Group B pneumonia

What is the following describing? Term or post term baby Ropy appearance asymmetric lung disease Hyperinflation with alternative areas of atelectasis - Air trapping Pneumothorax

Meconium aspiration

What is the following describing? Hx of c-section Diabetic mother/maternal sedation Onset at 6 hrs Coarse interstitial marking and fluid in fissures Normal to increased interstitial markings

Transient tachypnoea of the newborn

What is the following describing? Premature baby Low lung volumes Bilateral granular opacities No pleural effusions

Surfactant deficiency disease

What is the following describing? Premature or term infants Low lung volumes Granular opacities Pleural effusions

Neonatal pneumonia - Beta haemolytic strep/GBS

What is the following describing? Asymmetric perihilar densities Pleural effusions Hyperinflation

neonatal pneumonia (Non GBS)

What is the following describing? Linear lucencies

Pulmonary interstitial emphysema

What is the following describing? Premature baby + Ventilator Alternating regions of fibrosis (Coarse reticular opacities) Hyper-aeration (Cystic licences) Band like opacities

Chronic lung disease/Bronchopulmonary dysplasia

What is the following describing? Solitary Unilocular Cyst No communication with the airway

Bronchogenic cyst

What is the following describing? No communication with the airway No communication with the pulmonary arteries Aortic feeder vessel

Bronchopulmonary sequestration

What is the following describing? Most common in LLL or RLLL No pleural cover Pulmonary venous drainage Aortic feeder vessel

Intralobar bronchopulmonary sequestration

What is the following describing? Majority in the LLL, may be subdiaphragmatic Has its own pleural cover Systemic venous drainage Aortic feeder vessel

Extralobar bronchopulmonary sequestration

What is the following describing? Lucent Hyper-expanded lobe +/- mass effect and mediastinal shift Air trapping secondary to bronchial anomaly Favours left upper lobe

Congenital lobar emphysema

What is the following describing? Absent in the 2nd trimester US Right sided normally Pleural based No chest wall invasion or calcification

Pleuropulmonary blastoma

What renal abnormality is a pleuropulmonary blastoma linked to?

Multilocular cystic nephroma

What line is this describing? Umbilical vein to left portal vein to ductus venous to hepatic vein to IVC What is the correct location for the tip?

Umbilical venous catheter IVC - Right atrium junction

What line is being described here? Umbilicus down to umbilical artery to iliac artery to aorta What is the correct location for the tip?

Umbilical artery catheter T8-10 or L3-5

What is the following describing? Unilateral lucent lung - size is smaller than normal lobe Post viral lung infection

Swyer James

What is the following describing? Apical predominance Hyperinflation Mucus plugging (Finger in glove sign) Bronchiectasis

Cystic fibrosis

What is the following describing? Lower lobe predominant bronchiectasis Men are infertile

Primary ciliary dyskinesia

What is the following describing? Anterior mediastinal mass Mostly cystic Fat and calcium

Teratoma

What is the following describing? Anterior mediastinal mass Bulky, solid, lobulated Straddles the midline

Seminoma

What is the following describing? Anterior mediastinal mass Big and ugly Haemorrhage and necrosis Potential to invade the lung

NS GCT

What is the following describing? NG tube stopped in the upper neck Gas in the stomach

N type fistula Oesophageal atresia + Distal oesophageal fistula with trachea (Most common)

What is the following describing? CXR with NG tube stopped in upper neck No gastric bubble

Oesophageal atresia No tracheo-oesophageal fistula

What is the following describing? CXR with NG tube stopped in upper neck Gastric bubble

H Type atresia, so No oesophageal atresia only tracheo-oesophageal fistula

What is the following describing? Posterior trachea impression Anterior oesophageal impression Associated with tracheal stenosis

Pulmonary sling

What is the following describing? Anterior trachea impression Posterior oesophageal impression

Double aortic arch

What is the following describing? Higher anterior tracheal impression

Innominate artery compression

What is the following describing? Posterior oesophageal impression

Right arch with aberrant left or left arch with aberrant right subclavian artery

Which vascular sling is associated with these anomalies? Hypoplastic right lung Horshoe lung TE fistula Imperforate anus Complete tracheal rings

Pulmonary sling

What is the following describing? Non-bilious vomiting 3-6 weeks of age Thickened pylorus wall - 4 mm single wall 14 mm length

Hypertrophic pyloric stenosis

What are the key measurements for hypertrophic pyloric stenosis?

4 mm single wall 14 mm length of canal

What is the following describing? Short microcolon

Colonic atresia

What is the following describing? Long microcolon Contrast reaches ideal loops Filling defects in colon

Meconium ileus

What is the following describing? Long microcolon Contrast will not reach ileal loops

Distal ileal atresia

What is the following describing? Small left colon Transient caliber change - relieved by contrast enema Infants of diabetic mothers who received Mg

Meconium plug syndrome

What is the following describing? More common in boys Rectum small than sigmoid <1 Rectum has sawtooth pattern BNO >72 hrs Forceful passage of meconium post rectal exam

Hirschsprung disease

What is the following describing? Calcified mass in the mid abdomen on plain film

Meconium peritonitis Peritoneal reaction to in utero bowel perforation which seals off before birth so no leak

What is the following describing? Paraumbilical wall defect No surrounding membrane Right sided Elevated maternal AFP Normal umbilicus

Gastroschisis

What is the following describing? Congenital midline defect at base of umbilical cord Surronding peritoneum present Associated with other anomalies

Omphalocele

What is the following describing? >20 yr old cystic fibrosis Distal bowel obstruction Ileum/Right colon

Distal intestinal obstruction syndrome (Obstruction secondary to dried up thick stool)

What is the following describing? Pancreatic fibrosis (Low T1 & T2 signal) Fatty replacement (High T1 signal)

Cystic fibrosis

What is the following describing? Diarrhoea Short stature Eczema

Schwachman diamond syndrome 2nd most common cause of pancreatic insufficiency in children

What is the following describing? Associated with Wilms/Beckwith wiedeman Well circumscribed, solitary Right sided mass May extend into portal veins, hepatic veins and IVC Calcifications 50% of time Elevated AFP

Hepatoblastoma

What is the following describing? Cystic mass/multiple cysts AFP negative No calcifications Large portal vein feeding the mass

Mesenchymal hamartoma

What is the following describing? Cirrhosis (biliary atresia, fanconi syndrome etc) AFP elevated

HCC

What is the following describing? No cirrhosis Normal AFP Central scar, non enhancing, T2 dark Tumour is gallium avid Calcifies

Fibrolamellar HCC

What primary cancers met to the liver in children?

Wilms or Neuroblastoma

What is the following describing? Smoothly enlarged diffusely echogenic kidneys Cysts in the kidneys - tubular/spare cortex Loss of corticomedullary differentiation Liver fibrosis - inversely proportional to cystic changes)

AR PKD

What is the following describing? Multiple AVMs in the liver and lungs Cirrhosis Dilated hepatic artery

Hereditary haemorrhagic telangiectasia

What is the following describing? Newborn jaundice >2 weeks Normal gallbladder

Neonatal hepatitis

What is the following describing? Newborn jaundice >2 weeks Absent gallbladder Associated with polysplenia, trisomy 18 Congenital liver fibrosis Band of bright tissue near branching CBD No scintigraphy (HIDA) tracer in bowel by 24 hrs

Biliary atresia

What is the following describing? 2 x fissures in left lung Asplenia Increased cardiac malformations Reversed aorta/IVC

Right sided heterotaxia

What is the following describing? 1 x fissure on right side Polysplenia Less cardiac malformations Azygous continuation of IVC

Left sided heterotaxia

What is the following describing? Gastric bubble on left Larger part of liver on right Minor fissure on right

Situs solitus (Normal)

What is the following describing? Gastric bubble on right Larger part of liver on left Minor fissure on left Inverted bronchial pattern Associated with primary ciliary dyskinesia

Situs inversus

What is the following describing? Absent minor fissures Interrupted IVC Polysplenia Biliary atresia

Visceral heterotaxy with thoracic left isomerism

What happens to the upper and lower pole in a duplicated system?

Upper pole - obstructs Lower pole - refluxes

What is the weigert-meyer rule?

Upper pole inserts into IM (Inferior/Medial) Lower pole inserts SL (Superior/Lateral)

What is the most common cancer in urachal abnormalities or bladder exstrophy?

Adenocarcinoma

What is the following describing? Midline bladder structure Patent sinus tract

Patent Urachus

What is the following describing? Midline bladder structure Extension of bladder apex with sinus tract

Vesicourachal diverticulum

What is the following describing? Midline bladder structure Cystic structure within the sinus tract leading to umbilicus

Urachal cyst

What is the following describing? Midline bladder structure Dilated sinus at the umbilicus

Umbilical urachal sinus

What is the following describing? Herniation of the urinary bladder through a hole in the anterior infra-umbilical abdominal wall Manta ray sign - unfused pubic bones, wide pubic symphysis on AP pelvis

Bladder exstrophy

What is the following describing? GU + GI both drain into a common opening Females

Cloacal malformation

What is the following describing? Persistent nephrogenic rests >36 weeks No necrosis homogenous appearance, hypodense rind

Nephroblastomatosis

What is the following describing? Benign Involves the renal sinus Polyhydramnios on antenatal US Appears as wilms

Mesoblastic nephroma

What is the following describing? Age 0-3yrs Macroscopic cysts that do not communicate No functioning renal tissue Contralateral renal tract anomalies - PUJ obstruction

Multicystic dysplastic kidney

What is the difference between MCDK and Hydronephrosis?

Hydronephrosis = Cystic spaces are seen to communicate MCDK = Cystic spaces do not communicate

What does renal scintigraphy show in MCDK v Hydronephrosis?

MCDK = No excretory function Hydronephrosis = Excretory function

The following are associated with which syndrome? Wilms tumour Omphalocele Hepatoblastoma

Beckwith Wiedemann

The following are associated with which syndrome? Wilms Aniridia Genital Growth retardation

WAGR

What is the following describing? - Age 2-4yrs and 15-17yrs - Botryoid appearance - multiple round grouped masses (Bunch of grapes) - Big nodular ugly inducing mass in the bladder - History of urinary obstruction

Rhabdomyosarcoma

What is the following describing? Age <2 yrs Calcification common Encases vessels (Doesn't invade) Poorly marginated Mets to bones US - Echogenic + Hypervascular MR - high T2

Neuroblastoma

What is the following describing? Age 4yrs Rarely calcifies Invades vessels Well circumscribed Lung metastases

Wilms tumour

What is the following describing? Age 7-14 Sudden onset pain Blue dot sign on exam Enlarged testicular appendage >5 mm

Torsion of testicular appendages

What is the following describing? Absent or asymmetrically decreased flow on doppler US Asymmetric enlargement of tests Decreased echogenicity of the involved testicle

Torsion of the testicle

What is the following describing? Solid and/or cystic mass Large Mass effect on GI system, hip dislocation, nerve compression leading to incontinence External to pelvis

Saccrococygeal teratoma

What does the following describe? Complete physeal fracture, with or without displacement

Salter Harris I

What does the following describe? Fracture involves the metaphysis, above

Salter Harris II

What does the following describe? Fracture involves the epiphysis, below

Salter Harris III

What does the following describe? Fracture involves the metaphysis and epiphysis, above & below

Salter Harris IV

What does the following describe? Compression of the growth plate Bony bridge across physis

Salter Harris V

What are the elbow ossification centres? What age do these form?

Capitellum - 1 Radius - 3 Internal epidondyle 5 Trochlea 7 Olecranon 9 External epicondyle 11

What are the muscle attachments for these areas: Iliac crest ASIS AIIS Greater trochanter Lesser trochanter Ischial tuberosity Symphysis

Iliac crest - Abdominal muscles ASIS - Sartorius/Tensor fascia lata AIIS - Rectus femoris Greater trochanter - Gluteal muscles Lesser trochanter - Iliopsoas Ischial tuberosity - Hamstrings Symphysis - Adductor group

What does the following describe? Fragment of bone at inferior patella with associated soft tissue swelling 13 yr old boy Acute

Patellar sleeve avulsion fracture

What does the following describe? Fragment of bone at inferior patella with associated soft tissue swelling 13 yr old boy chronic

Sindig-Larsen-Johansson

What does the following describe? Microtrauma to the patellar tendon on the insertion of the tibial tuberosity May be bilateral Common in boys

Osgood-Schlatter

What does the following describe? Most common Rhizomelic (Short femur & Humerus) Large head, trident hand Narrow interpedicular distance Tomstone pelvis

Achondroplasia

What does the following describe? Most common lethal dwarfism Rhizomelic shortening (Humerus/Femurs) Telephone receiver femurs Short ribs & Long thorax Small iliac bones Flat vertebral bones Cloverleaf skull

Thanatophoric

What does the following describe? Fatal Bell shaped thorax + short ribs Too many fingers (Polydactyly) Chronic nephritis Normal vertebral bodies

Asphyxiating thoracic dystrophy (Jeune)

What does the following describe? Osteoporosis Dwarf Wide angled jaw Acro-osteolysis Dystrophic nails + Yellow discoloured teeth Frontal + Occipital bossing

Pyknodysostosis

What does the following describe? Bifid ribs Calcifications of the fall Basal cell cancers Odotogenic keratocysts (Lytic jaw lesions)

Gorlin syndrome

What does the following describe? Collagen defect = brittle bones Totally lucent skull Multiple fractures of hyperplastic callus Legs with fibula longer than the tibia Wormian bones Gracile bones Flat/beaked vertebral bodies

Osteogenesis Imperfecta

What does the following describe? Disorganised sclerotic weak bone Alternating bands of sclerosis parallel to growth plate Bone in bone appearance of vertebral body Picture frame vertebrae Diffusely sclerotic skeleton

Osteopetrosis

What does the following describe? Osteoporosis Wormian bones Acro-osteolysis Wide angled mandible

Pyknodysostosis

What does the following describe? Congenital fusion of the spine Tall skinny cervical vertebral bodies High riding scapula Omovertebral bone (Big vertebral body)

Klippel Feil

What does the following describe? Oval shaped vertebral body with anterior beak Mid beak Thick clavicles and ribs Tall flared iliac wings Wide metacarpal bones with proximal tapering

Morquio

What does the following describe? Oval shaped vertebral body with anterior beak Inferior beak Thick clavicles and ribs Tall flared iliac wings Wide metacarpal bones with proximal tapering

Hurlers

What does the following describe? Anterior tibial bowing Pseudoarthrosis at the distal fibula Scoliosis

Neurofibromatosis 1

What does the following describe? Splenomegaly + Hepatomegaly AVN of femoral heads H shaped vertebra Bone infarcts Erlenmeyer flask shaped femurs

Gauchers

What does the following describe? Continuous C sign Absent middle facet on lateral view Talar beak

Talocalcaneal coalition

What does the following describe? At anterior facet Anteater sign - elongated anterior process of the calcaneus

Calcaneonavicular coalition

What does the following describe? Alpha angle <60 Acetabular angle >30

Developmental dysplasia of the hip

What does the following describe? 12 yr old boy + Hip pain Bilateral Salter Harris proximal femoral physis fracture Kleins line does not cross the lateral epiphysis

Slipped capital femoral epiphysis

What does the following describe? AVN of proximal femoral epiphysis Boys > Girls Age 5 yrs Subchondral lucency on frog leg Asymmetric small ossified femoral epiphysis Flat collapsed femoral head, sterile joint effusions

Legg-Calve-Perthes

What does the following describe? Systemic illness Resolves in a few days Wide joint space from effusion No fever, normal inflammatory markers

Transient synovitis

What does the following describe? Deficient vitamin D Fraying, Cupping Irregularity along physeal margin Rachitic rosary - expansion of anterior rib ends at costochondral junctions

Rickets

What does the following describe? Deficient vitamin C Subperiosteal haemorrhage - lifts up periosteum Haemarthrosis Scorbutic rosary - Expansion of costochondral junctions

Scurvy

What is the following describing? Sagittal split in the spinal cord T9-S1 location Normal cord above and below the split +/- 2 thecal sac Each card has its own central canal + dorsal/ventral horns

Diastematomyelia

What is the following describing? Tigroid pattern high signal in centrum semiovale Spares U fibers

Metachromatic leukodystrophy

What is the following describing? Posterior WM high signal Cerebellar Spinal cord

Krabbe disease

What is the following describing? Symmetric peritrigonal WM splenium high signal

X linked adrenoleukodystrophy

What is the following describing? Anterior WM high signal + Centrifugal direction (Peripherally to central)

Alexander disease

What is the following describing? Centripetal (Medial outwards) White matter high signal Increased NAA

Canavan disease

What is the following describing? XR - well defined lytic lesion, no bony sequestrum MRI - High signal on fluid sensitive sequences, contrast enhancement Medial clavicle high signal

CRMO (Chronic recurrent osteomyelitis)

What type of Osteogenesis imperfecta does this patient have? Blue sclera Antenatal fractures Accordion hips Poor/no skull ossification

Lethal - Type II OI

What type of Osteogenesis imperfecta does this patient have? Grey sclera Triangular face Short stature Wheelchair bound, kyphoscoliosis

Type III - Severe OI

What type of Osteogenesis imperfecta does this patient have? White sclera Long bone bowing, vertebral fractures Walks with brace/crutches

Type IV and V OI

What type of Osteogenesis imperfecta does this patient have? Blue sclera May have no fractures Stature may be normal or kyphoscoliosis

Type I OI

What is the following describing? Neonate Hepatosplenomegaly Extensive bilateral stippled triangular calcification along paravertebral regions Adrenal glands

Wolman disease

What is the most common cause of a neonatal mass lesion?

Hydronephrosis

How is UTI investigated in <6 month old children Responds well to treatment within 48 hrs

US within 6 weeks - If abnormal MCUG DMSA 4-6 months post infection

What is the following describing in <6 month old children Atypical UTI

US during acute infection DMSA 4-6 months post infection MCUG

What is the following describing in <6 month old children Recurrent UTI

US during acute infection DMSA 4-6 months post infection MCUG

What is the following describing? Male child Scrotal pain Hyperaemia on colour doppler To and fro flow, or reversed diastolic flow

Torsion-Detorsion/Reverse torsion

The following CXR views are used for what in paeds? R + L Oblique & AP

NAI

The following CXR views are used for what in paeds? Horizontal beam lateral + AP

Anterior Pneumothorax

The following CXR views are used for what in paeds? AP & R + L Decubitus

FOB Inhalation

The following is describing what? Lytic lesion in the skull Diabetes insipidus Loss of T1 high signal in posterior pituitary Enhancement and thickening of the infundibulum

Langerhans cell histiocytosis

Crack the Core + High Yield Flashcards

(1183 cards)