SPOTTERS in radiology with explanations

few important radiology spotters with answers

1. SPOTTERS DR.M.SATHIYA SENIOR RESIDENT Govt Medical college,Tiruppur

2. 1 1) Idendify the finding,diagnosis 2)Mention the specific MRI sequence

3. 1.Multiple sclerosis 1) Dawson fingers  are a radiographic feature of demyelination characterized by periventricular demyelinating plaques distributed along the axis of  medullary veins, perpendicular to the body of the lateral ventricles and/or callosal junction. This is thought to reflect perivenular inflammation 2)double inversion recovery (DIR) a sequence that suppresses both CSF and white matter signal and offers better delineation of the plaques

4. 2 1)Name the xray view 2)Indication for this view?

5. 2 1)Waters view( Occipito mental) 2) maxillary sinus

6. 3 1)Mention the finding 2)It is associated with which condition?

7. 3 1)optic nerve glioma 2)NF 1

8. 4 1)mention the finding 2)DD for this condition

9. 4 1)IVORY VERTEBRA 2) Pagets disease,sclerotic mets,lymphoma ,

10. 5 1)Identify the fracture 2)Mechanism of injury

11. 5. 1)   Jefferson fracture - burst fracture of the atlas (C1).Four-part fracture with double fractures through the anterior and posterior arches. 2)Axial loading along the axis of the cervical spine

12. 6 1)Identify the finding 2)This Associated condition to be ruled out

13. 6 Segond fracture  is an avulsion fracture  involves the lateral aspect of the tibial plateau. Very frequently (~75% of cases) associated with disruption of the anterior cruciate ligament (ACL). On the AP knee radiograph, it may be referred to as the  lateral capsular sign .

14. 7 1)identify the sign 2)other xray findings associated with this condition

15. 7 1)HAMPTONS HUMP - peripheral wedge of airspace opacity and implies lung infarction 2) Westermark sign - Regional oligaemia Palla sign - Right descending pulmonary artery enlargement Chang sign - dilated right descending pulmonary artery with sudden cut-off Fleishner sign - Central pulmonary artery enlargement knuckle sign - Abrupt pulmonary artery tapering

16. 8 Diagnosis DD

17. 8 1) GCT 2)DD – ABC CHONDROBLASTOMA

18. 9 1) findings 2)DD

19. 9 DAI - several small regions of susceptibility artifact at the grey-white matter junction, in the corpus callosum , and in more severe cases in the brainstem, surrounded by FLAIR hyperintensity .  Amyloid angiopathy Chronic hypertensive encephalopathy Cavernoma

20. 10 1)finding 2)diagnosis

21. 10 1) colpocephaly 2)corpus callosal agenesis

22. 11 1)finding 2)DD

23. 11 1) myositis ossificans - It has a zonal organization  1 : peripheral, well-organized mature lamellar bone intermediate osteoid region central immature non-ossified cellular (fibroblasts) focus Typical finding is circumferential calcification with a lucent center and a radiolucent cleft (string sign) that separates the lesion from the cortex of the adjacent bone. 2) DD – parosteal osteosarcoma

24. 12 1) Finding,DD 2)associated findings

25. 12 1)cyst with mural nodule DD – hemangioblastoma Pilocytic astrocytoma 2) hemangioblastoma – associated with VHL

26. 13 Mention the sign Other named signs associated with this condition

27. 13 1) Foot ball sign 2) Air under diaphragm leaping dolphin sign - outlining of the diaphragmatic muscle slips by free intraperitoneal gas cupola sign (on supine film) -  underneath the central tendon of the diaphragm in the midline continuous diaphragm sign

28. bowel-related signs ​​double wall sign (also known as  Rigler signor bas-relief sign) telltale triangle sign (also known as the triangle sign or telltale triangle)  peritoneal ligament-related signs football sign falciform ligament sign lateral umbilical ligament sign (also known as inverted "V" sign) urachus sign right upper quadrant signs cupola sign fissure for ligamentum teres sign hepatic edge sign lucent liver sign Morison pouch sign (doge cap sign) periportal free gas sign

29. 14 1)Diagnosis 2)Treatment

30. 14 1)emphysematous pyelonephritis 2) PCN Severe cases - nephrectomy

31. 15 1)mention the finding,diagnosis 2)other findings associated with this condition

32. 15 1)B/L schwannoma,NF 2   Multiple Inherited Schwannomas,Meningioma,Ependymomas

33. 16 1)Diagnosis 2)Specific xray view

34. 16 1)SCFE Slipped capital femoral epiphysis The slip occurs is posterior   and, to a lesser extent, medial.more easily seen on the  frog-leg lateral view  rather than the AP hip view. AP View a line drawn up the lateral edge of the femoral neck line of Klein fails to intersect the epiphysis ( Trethowan sign) .  The metaphysis is displaced laterally and therefore may not overlap the posterior lip of the acetabulum as it should normally ( loss of triangular sign of Capener ). The  metaphyseal blanch sign , a sign seen on AP views, involves increases in the density of the proximal metaphysis . It represents the superposition of the femoral neck and the posteriorly displaced capital epiphysis.

35. 17 1)Diagnosis 2)Mention Other xray findings

36. 17 1)Rickets 2) deficiency of normal mineralization is most evident at metaphyseal zones of provisional calcification where there is an excess of non-mineralized osteoid resulting in growth plate widening and abnormal configuration of the metaphysis : Fraying: indistinct margins of the metaphysis Splaying: widening of metaphyseal ends Cupping: concavity of metaphysis   pseduofracture on the compression side of bone known as Looser's zone.

37. 18 Diagnosis Other xray findings associated with this condition

38. 18 1) Ankylosis spondylitis 2) Sacroiliitis  is usually the first manifestation and is symmetrical and bilateral Small erosions at the corners of vertebral bodies with reactive sclerosis:  Romanus lesions  of the spine ( shiny corner sign ) Vertebral body squaring Noninfectious  spondylodiscitis :   Andersson lesion Diffuse syndesmophytic ankylosis can give a " bamboo spine " appearance linear ossification along the central spine; representing interspinous ligament ossification can give a " dagger spine " appearance Ossification of spinal ligaments, joints and discs Apophyseal and costovertebral arthritis and ankylosis Enthesophyte  formation from  enthesopathy Pseudoarthroses may form at fracture sites Dural ectasia

39. 19 1)Diagnosis 2)Complications associated with this conition

40. 19 1) Meconium peritonitis 2) Sterile chemical peritonitis due to intrauterine bowel perforation and spillage of fetal meconium into the fetal peritoneal cavity. Complications  Ascites : tends to be more echogenic than simple ascites Bowel obstruction from the formation of fibro-adhesive bands M econium pseudocyst  formation

41. 20 Finding ,diagnosis Other findings associated with this condition

42. 20 1)salt and pepper/rain drop skull – Hyperparathyroidism Radiographic features Subperiosteal bone resorption classically affects the radial aspects of the proximal and middle phalanges of the 2 nd  and 3 rd  fingers Subchondral resorption lateral end of the clavicles symphysis pubis sacroiliac joints Subligamentous resorption ischial tuberosity trochanters inferior surface of calcaneus and clavicle Intracortical resorption : cigar/oval-shaped or tunnel-shaped radiolucency in the cortex terminal tuft erosion ( acro-osteolysis ) Brown tumors chondrocalcinosis

43. Findings in secondary (and tertiary) hyperparathyroidism are often associated with the  osteosclerosis  of renal osteodystrophy and the  osteomalacia  of vitamin D deficiency: subperiosteal bone resorption osteopenia osteosclerosis , e.g.  Rugger jersey spine soft tissue calcification superscan : generalized increased uptake on Tc-99m pertechnetate bone scan (focal uptake with adenoma) superior and inferior rib notching

44. 21 Diagnosis complications

45. 21 1)Horse shoe kidney – flower vase appearance,shaking hand appearance Complications Hydronephrosis secondary to  pelviureteric junction obstruction Renal calculi increased susceptibility to trauma Infection and  pyeloureteritis cystica Increased incidence of malignancy Wilms tumor transitional cell carcinoma (TCC) of the renal pelvis renal  carcinoid Renovascular hypertension

46. 22 1)Name the procedure 2)Diagnosis

47. 22 1)VCU - Voiding Cysto Urethrogram 2) Neurogenic bladder – christmas tree appearance/Pine cone bladder.

48. 23 1) Procedure,Diagnosis 2)List Other anomalies

49. 23 1) HSG,Arcuate uterus   Müllerian duct anomaly classification class I:  uterine agenesis/uterine hypoplasia class II:  unicornuate uterus/ unicornis unicollis class III:  uterus didelphys class IV:   bicornuate uterus class V:   septate uterus class VI:   arcuate uterus class VII:  in utero diethylstilbestrol (DES) exposure (T-shaped uterus)

50. 24 1)Finding , diagnosis 2)staging criteria

51. 24 1)NCC 2) There are four main stages (also known as Escobar's pathological stages): Vesicular:  viable parasite with intact membrane and therefore no host reaction.  Colloidal vesicular:  parasite dies within 4-5 years    untreated, or earlier with treatment and the cyst fluid becomes turbid. As the membrane becomes leaky edema surrounds the cyst. This is the most symptomatic stage. Granular nodular:  edema decreases as the cyst retracts further; enhancement persists. Nodular calcified:  end-stage quiescent calcified cyst remnant; no edema.

52. 25 . 1)identify the procedure 2)indications for the procedure

53. 26 1)Diagnosis 2)mention few similar named conditions

54. 27 1)identify the sign 2) diagnosis

55. 28 1) identify the abnormal condition 2) other findings

56. 29 1) sign,diagnosis 2)classification

57. 30 1) sign,diagnosis 2)treatment