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1

Perthes lesion
2 mc after bankart

labroligamentous avulsion with medially stripped periosteum

2

ALPSA
ant labrolig periosteal sleeve avulsion

tear of anteroinf labrum without rupture of scapular periosteum; inf GH, labrum and periosteum are stripped

3

GLAD lesion
glenolabral articul disruption

superfic tear of ant labrum attached to fragment of articu cartilage without stripping

4

Scurvy bone findings

osteoporosis
subperiost haemor
wimberger sign - line around epi
white line of frankel - meta
metaphyseal beaking - pelkan

5

Kummell disease

delayed post traumatic collapse
intravertebral vacuum cleft ( osteonecrosis
steroids

6

congenital unilat pedicle absence

overgrowth/sclerosis of contralate
asympto
widening of neural foramen
TP always abnormal

7

sarcoid in bones

10% affected
lacelike phalangeal
acro osteolysis
soft tissue swelling
rapidly destructive
ask for CXR!

8

thalassaemia bone findings

MC/MT/phala widening, squaring, thinned cortices, coarse trabeculae

Skull- widened diploe, hair on end

PNS - obliterated sinuses, incisors pushed forward ' rodent facies'

9

dens fracture types

A - tip LC
B- across base of dens : MC, high rte of non , C1-2 fusion
C- subdental across body of axis; Rx halo

10

gamekeepers, skiers thumb - do MRI

steners

tear of UCL of 1st MCPJ
if torn ligament is superficial to Adductor policis aponeurosis > Steners lesion > prevents apposition to bone >surgery

11

maisonneuve #

prox fibular #
wideneing of medial mall jt space, post malleolar #

12

leptomeningeal cyst

growing #
< 3y, depressed skull #
pia arach herniates through tear
elliptical with bevelled edges

DDx - dermoid, epidermoid, encephaloceo, post surgical defect

13

calcaneonavicular coalition
talocalcaneal coa

young,
osseos, cartila, both

calcaneonavicu - anteater nose sign

talocalc -
c sign,
talar beak ( due to stress on talonav joint)

14

pincer type FA impingement

acetabular over coverage
anterior margin of acet projecting lateral to post margin ( cross over sign )

15

boeler angle

line anterior cal facet - post calcan facet - post cal tuberosity
20-40 deg

16

calcaneal pitch

angle formed by intersection of line along plantar aspect of calcaneus and line parallel to floor
normal 20-30
< 20 hindfoot equinus
>30 hindfoot calcaneus

17

Haglund Xd

retrocalcaneal bursitis
achilles tendionopathy
retroachilles bursitis
exostosis of posterosuperior calcaneus

18

macrodactyly
cong 6
acq 3

congenital
lymphangioma, haemangioma
klippel trenauny
weber
Ollier
NF1
proteus

Acquired:
dactylitis
osteoid osteoma
melorheostosis

19

features of metastatic vertebral #

T1 low/T2 high, T2 high halo ( fluid in osteo)
posterior bulging
no fracture line
soft tissue componenet
DWI +ve
CE +ve
multiple levels, also abnormal signal without #
any vertebrae can be involved
posterior elements involved
out phase - high SI - no fat
cortical destruction

20

superficial siderosis brain

ch recurrent haemorrhages - AVM, tumours, post op

hearing loss, cerebellar dysfunc
pyramidal tract signs
mental deterio

21

H & N dermoid cyst

2-3rd decades
m=f
7% H & N
lateral eyebrow MC
10% floor of mouth
5% malignant change to SCC
excise - above myol- intraoral

CT : 'marbles' due to coalescence of fat - pathognomonic

22

Huntington disease

diffuse cortical atrophy
caudate and putamen most affected
heart shaped frontal horns

23

Temporal bone #
types 2

Longitudinal 70-90%
parallels long axis of PTB
conductive hearing loss, disloc ossicl, CSF otorhinorrhoea

Tranverse #
perpendicular
occiput/frontal blow
sensorineural HL
sev vertigo, nystagmus FN palsy 30-50%

24

DNET

benign supratentorial
partial complex seizures
occ cystic
focal cortical lesion MC temporal
hypodense CT
T1 hypoin, T2 hyper
bright rim sign FLAIR
minimal CE
bubbly appearance

DDx ganglioglioma, low grade astro, PXA

25

spinal cord infarction

artery of Adamkiwicz T8- conus
central high T2 signal
initial cord expansion later atrophy
owl eye appearance

26

Cowden disaese

Lhermitte duclos disease ( cerebell gangliocytoma - striated mass) half have cowden
AD phakomatosis
colonic polyps
cutaneos tumours
meningioma
glioma
thyroid/Br neoplasms

27

adrenoleukodystrophy

XL R
nl head size
5 -10 yrs
adrenal insuff, abnormal sk pigmentation

periatrail WM + splenium
No grey matter involvement

28

Lemierre Xd

septic jugular vein thrombophelbitis
after oropharyngeal infections
tonsillitis etc
life threatening
young

29

MEN 2

medullary thyroid ca - always

phaeochromocytoma - common

a - parathyroid hyperplasia

b - mucosal neuromas

30

septo optic dysplasia

mildest form of holoprosencephaly
hypoplas ON
absence of septum pel
squared off frontal horns
endocrine abnormlaities
migration anomalies
schizencepha 50%
periventricular cysts

31

Bilateral coloboma

outpouching of posterior globe
CHARGE Xd

32

clay shoveller #

# one or more spinous processes
mc C7

33

Hoffa #

posterior tangential # of one or both femoral condyles
can be invisible on frontal

34

Chauffeur # aka Hutchisons

radial styloid #

35

Tillaux #
Maisonneuve

avulsion of anterolateral margin of distal tibia
SalterH type 3

Maisonneuve
medial malleolus
Prox fibula

36

Cottons #

Trimalleolar #

37

Aviators #

# neck of talus

38

Hangmans #

C2
hyperentension
pedicles of C2 with anterolisthesis of C2 on C3
no deficit
teardrop # inferior aspect of C2/3

39

Malgaigne #

unstable pelvic # 14%
vertical shearing ant + post arches
pubic rami and sacral #

40

Chopart fracture

fracture dislocation of midtarsal joints (sup disloc navi and cuboid

41

Jefferson #

burst fracture of C1
bilateral lateral mass offset
no neuro deficit

42

Barton

Dorsal rim distal radius with intraarticular ext

43

Potts #

lower end of fibula and medial malleolus

44

non traumatic ICH

Underlying lesion : tumour, AVM, cavernoma, aneurysm

Amyloid angio
Dural VT
Hypertensive angio
coagulopathy

45

capillary telangiectasia

do not touch
brainstem
radiation
no T2
brush like CE
dark on SWI

46

caroticocavernous fistula

dilated SOV
proptosis
enlarged EOM
retrobulbar FS
bowed CS
can be indirect - low flow

47

miliary mets

thyroid ca
RCC
breast
melanoma
pancreatic
osteosarc
trophoblastic

48

Miliary opacities
Afebrile

(TB) both
(fungal) both
varicella healed
mets
sarcoid
pneumoconiosis -siol/Cwp
haemosiderosis
HP can be febrile
LCH
PAProteinosis
multifocal micronod pneumocyte hyperplasia

49

cannonball mets
5

RCC
chorio
prostate
synovial
endometrial

50

primaries which freq met to lungs
6

chorio
ewings
melanoma
osteo
testicular
thyroid

51

MC primaries which give pulmonary mets

Breast
CRC
RCC
uterine leiomyo
H + N SCC

52

Bezolds abscess

rare complication of acute suppurative mastoiditis
infection erodes mastoid tip and extends into neck/SCM
Abscess formation
torticollis
also ass with cholesteatomas

53

Basilar invagination
PF ROACH

PAgets
FD
Rickets/OM/
Osteogenesis
Achondroplasia
Cleidocranial
Hyperpara

54

posterior vertebral body scalloping
congenital
dural ectasia
increased canal pressure

OI
mucopolysacc
achondroplasia

NF
Ehlers
Marfan

Syrinx
spinal canal tumour

55

cholesteatoma
key sequence

DWI restriction

beware epidermoid

56

subchondral osteonecrosis of knee

now called subchondral insufficiency # of knee

post op
stress related
diff location to OCD but similar appearance

57

Hemitruncus arteriosus

main PA continues as LPA
RPA arises from Asc Ao

58

Xd associated with gallstones

Bouveret - gastric outlet obstruction from GS

Mirizzi

Gilbert - congenital enzyme def > GS

59

Modified Fisher Scale Grading for SAH

I - thin < 1mm , no IVH/ICH
2 - thin < 1mm, IVH
3 - thick > 1 mm, no IVH
4 - thick , IVH

60

AICA vascular loops in CP angle
Types

I - lying in CPA not entering IAC
II - extending < 50% of length of IAC
III - > 50% of length of IAC

61

Achondroplasia
key findings

Skull
Chest
Limbs/hands
Spine
Pelvis

Skull :
macrocephaly
Frontal bossing
NARROWED FM
comm hydrocephalus
large AF

Chest:
ant rib flaring
Short AP Diameter

Pelvis
Tombstone ilia
horizontal acetabulum
champagne pelvis
trident acetabulum

Limbs/hands
Rhizomelic shortening/ bowing/ shortening MC/MT
Trumpet shaped tubular bones
Trident hand
Chevron sign ( inverted V epiphyses)

Spinal
bullet shaped vertebra
posterior vertebral scalloping
prog decrease in interpedicular distance


check for FM narrowing!

62

MRI features of adhesive capsulitits
4

Capsular thickening > 9mm
T2 high in axillary recess
Abnormal ST in rotator interval
Thickening of coracohumeral ligament > 4mm

63

Vascular malformation types
Tumours
low flow vascul mal
high flow vasc

Tumours:
infantile haemangioma - involute

Low flow:
Venous : phleobliths, CE
Lymphatic
perc sclerotherapy

High flow
AVM - embolisation

64

Muller Weiss Syndrome
Adult Kohler

adult onset osteonecrosis of navicular
affects lateral aspect

65

BIRADS risk of malignancy

0 - incomplete
1 - 0%
2 - 0 % - routine FU
3 - < 2% prob benign - 6/12 FU
4a - low suspicion >2 < 10%
4b - mod susp >10<50%
4c - high suspicion > 50 < 95%
5 highly suggestive > 95%
6 bx proven

66

Biliary hamartomas
von meyenburg complexes

incidental 1-5%
small < 1cm benign lesions
CT : hypo
US hypo, may contain echogenic cholesterol
MR : high T2, no or rim CE

67

Focal hepatic hot spot sign
"hot quadrate (IV)"

SVC obstruction
(collateral venous pathway : int mamm>paraumbil>left portal vein)

Focally inc bld flow to segment IV
Tc99m sulphur colloid inc activity
Intense early CE on CT

68

flip flop enhancement of the liver

Budd Chiari

69

pancreatic lipomatosis
causes 5

CF
Steroids
DM
Cushings
Scqachman diamond Xd

70

Fat ring sign

mesenteric panniculitis
fat rim around vessels

71

hepatic honeycomb sign

hepatic melioidosis abscess

72

Right paraduodenal hernia

through fossa of waldeyer
located behind SMA

73

Left paraduodenal hernia

fossa of landzert

IMV lies in its anterior wall

74

MR spect finding in CNS Tuberculosis

Inc lipid lactate peak
Reduced NAA (mets, other tumours)

75

Erlenmeyer flask def
CHONG

C - craniometaphyseal dysplasia
H -haemoglobinopathies
Osteopetrosis
Nieman-Pick
Gauchers

76

Glutaric aciduria Type 1

B/L widened sylvian fissures
mitochondrial
macrocephaly
symm BG lesions

77

atretic parietal cephalocoele

underlying anomalies : persistent falcine sinus, sinus pericranii, absence of straight sinus
Ass with mat folate def/ valproate use

78

Leukoencephalopathy with anterior temporal cysts
3

Congenital CMV infection ( periven Ca)

megalencephalic leukoencephalopathy

vanishing white matter disease

79

Radial scar of the breast
( complex sclerosing lesions)

Idiopathic
not related to surgery
trauma

archi distortion, central lucency, black star appearance
may contain micro ca
different on diff projections
Ddx - ca, surgical,fat necro
Excision biopsy

ass atypical ductal hyper/ca ? upto 50%

80

bilateral breast skin thickening

CHF
nephrotic
dermatologic
SVC obst
lymphatic obstruction
scleroderma
dermatomyositis

81

unilat breast skin thickening

inflamm cancer
radiation
infection/inflamm
axillary lLN obstruction
occ CHF

82

reduction mammoplasty
mmg findings

elevated, flatter breast
more tissue in LQ
elevatged nipple
swirled pattern
fat necrosis
dystrophic ca
suture ca
skin thickening
subareolar fibrotic band

83

H Shaped vertebrae

SCD
spherocytosis
Gaucher
Thalassaemia

84

Nail patella Xd
(Fong disease)

4 features

fingernail dysplasia, triangular lunula

absent/hypo patella

posterior iliac horns ( 80%)

dysplastic radial head

85

centre edge angle for femoral head coverage

vertical line from centre of FH

second line through edge of acetabular roof

angle between them shd be more than 25 degrees. If less then DDH

86

Rf for HCC

cirrhosis
haemachromatosis
aflatoxin
alpha 1
hepatitis
Wilsons

87

patella baja associations

polio
ch juvenila idio pathic arthirtis
achondroplasia

88

Bilroth types
2

I - gastroduodenal end-end anastamosis

II - gastrojejunal side-side anastamosis. prox duodenal loop closed off

89

CT sign of unequivocal prostate enlargement

> 1cm above symphysis pubis

90

Chest uses of Ga 67 scintigraphy

Sarcoid disease activity

Lymphoma staging

P carinii pneumonia early detection

91

111 indium oxine WCC scanning

detects areas of infection/inflammation

18-24hrs after injection

superior to Ga67 ( excreted by colon) in abdo imaging

highest radiation dose to spleen ( hotter)

donor blood may be used esp in sev neutropenia but usually own cells

92

MIBG
'hot' scans

all NET
Phaeochromocytoma
carcinoid
ganglioneuroma
medullary thyroid ca
neuroblastoma

labelled wiht I 123 or 131

image 4-24 hrs (123) or 1-4 days (131)

preferable to octreotide due to renal accumulation of oct

93

Tc pertechnetate or DTPA in testicular torsion

reduced activity cf thigh/contralteral

nubbin sing - increased activity in internal pudendal artery with abrupt cutoff at testis

ring/bullseye sign - inc activity in dartos muscle with central photpenia

94

lymphoscintigraphy

Tc nanocolloid

web interspace

dx congenital lymphoedema ( milroys - pooling in foot)

in venous obs - increased drainage

not sensitive for malignant LN but sentinel node is useful

95

nuclear cisternography

111 in or Tc DTPA injected into subarachnoid space in LS

imaged sequentially up spine

basal cisterns in 2-4 hrs
vertex - 24-48 hrs

normally no or minimal reflux into lateral ventricles ( transient is ok)

96

scheuermans disease

adolescents
thoracic kyphosis > 40
thoracolumbar kyphosis > 30
> 3 vertebral bodies
disc narrowing ante
disc invagination
scoliosis 25%
>75 deg surgery

97

PHACE syndrome

posterior fossa malformation - dandy walker
H aemangioma
A rterial anomalies
C oarctation
E ye anomalies
S ternal cleft

98

early u fibre involvement

MS
ADEM
Alexandre disease
PML
galactosemia

Late :
Canavan

99

medulloblastoma
assoc Xd

Turcot - colon plyps/brain tum
Cowden
Li Fraumeni
Gorlin Goltz