2 Flashcards
Acalcular cholescystitis
Uss description
Associated with
Thick gall bladder wall
With no hyperechoic stone or acoustic shadow
Major surgery
Severe trauma
Severe burn
Total parental nutrition
Barium swallow
Achalasia
Description :
Barium swallow
Dilated esophagus , tapering at distal end
Bird peak sign
Achalasia
Benign
Meningioma of spine
MRI T1
Description
MRI T1 sagital spine with IV contrast
Intradural extramedullary enhanced mass
Meningioma
MRI T2
MRI T2 sagital spine
Intradural , extramedullary mass with anteriorly displaced cord
Glioblastoma or metastasis of spinal cord
MRI description
MRI T2 sagital spine
Intradural intramedullary mass with surrounding edema
Pneumoperitonium
CXR description:
CXR erect
Crescent shaped air under diaphragm
Normal X- ray Abdomen
Description
Randomly distributed air
“ no Anatomical detail “
X ray AP view Abdomin
Air pushed up indicate :
Large mass “ appear as round large o pacification “
Most common cause of small bowel obstruction is ……
Modality X ray Abdomen AP view
Supine …..
Erect….
Adhesion
Supine appear valvula conniventis “ coil spring sign”
Erect appear multiple air fluid level “ step ladder sign”
Large bowel obstruction
X ray supine description:
X ray abdomen AP supine : Haustra “ incomplete mucosal fold away from each other “
Describe
X ray lateral decubitus position
Pneumoperitonium
Crescent air between lateral border of the liver , chest wall & diaphragm
- used in small pneumoperitonium & sick patient “
Rigler’s sign & Falciform sign
Seen in
Wall of stomach & Falciform ligament
- pneumoperitonium
“ X ray Abdomen AP view “
Best modality for Diagnosis of pneumoperitonium:
CT scan
Then
X ray lateral decubitus position
CXR PA view erect
Necrotising enterocolitis
In newborn
X ray
Complication :
X ray abdomen AP view
Pneumatosis intestinalis
Pneumoperitonium
Foot ball sign seen in :
Pneumoperitonium in newborn
X ray Abdomen AP view supine
Air filling the flanks
Medical importance of porcelain Gall bladder “ Calcified G.B wall “ :
Precancerous condition
Barium swallow
Normal esophaugus show normal indentation because of
Arch of Aorta.
…………..: normal oesophagus finding in old age
Barium swallow
Cork screw esophagus
Disc space
Intravertevral Disc are ( opaque / lucent ) in plain radiograph
Disc space narrowing either due to …. Or …..
Lucent ( disc space )
By compare disc space with each other , can detect disc space
Narrowed due inflammation or degenerative process
Preferred diagnostic test for disc herniation
Raised leg test ( 30-70” ) !
MRI T2 sagital spine
Axial spine
Show hypointense IVD , herniation at left lateral disc
Dx:
L4 L5 dehydrated lumbar disc herniation
Vertebrae inflammation = spondylitis
Can be due to :
-
-
Difference :
TB “ intracellular ; need cells ,which need blood “ affect body of vertebra , sparing Disc = spondylitis
Staph aureus “ no need for Blood”
Affect body of vertebra & disc = spondylodiscitis
Vertebra vascular , disc Avascular
MRI T1 saguaro spine with IV contrast
Show 2 consecutive vertebral enhancement in B
DX:
Spondylodescitis
How TB spread from one vertebra to another :
Paraverbral abscesses
Multiple ring enhanced lesion on sides of vertebra below kidneys on MRI T1 coronal spine
Not affecting disc “ spondylitis “
Deformity seen in pott’s disease :
Gibbus deformity
Acute angular ion of the spine with loss of normal kyphosis
Reactive Arthritis “ Ritter “
Can’t
Can’t
Can’t
Can’t see “ uveitis “
Can’t pee “ urethritis “
Can’t walk “ arthritis “
CT abdomen with IV contrast
Potts disease “ way of spread
Description
CT abdomen axial with IV contrast
MRI T1 coronal abdomen with IV contrast
Large paravertebral abscesses with vertebral enhancement sparing the disc
Sacroillitis
Plain radiograph
Description
Sclerosis of the end plate particularly at the illiac side
Irregular joint end plate
Widening of joint spaces
Sacrollitis B/L + diarrhea
Etiology
Next step :
Enteropathic arthritis
Can be ulcerative colitis / crohn’s
Colonoscopy , biopsy
X ray PA view spine
X ray PA view pelvis
Ankylosing spondylitis
Describe
Signs
Complication
Ossification of intraspinous ligament
“Extensive calcification with fused vertebra”
Ossification of SI joint
Bambo stick appearance & sydenmophytes
Spinal fracture
Ivory vertebra sign
Describe :
Differential diagnosis :
Next Step :
Radiopaque shadow of the vertebral body
Osteosarcoma
Paget disease
Metastasis
Lymphoma
CT , skeletal survey X ray
Osteoporosis
Lead to fracture of vertebra called :……..
Sequence of effect of osteoporosis on vertebra
Compression fracture
Can be seen on CT spine sagital spine
Loss of height , vertebral collapse
Also biconcavity can be seen
Ostepenia> biconcavity > compression fracture > Burst fracture
Osteoporosis can be due to
Next step in management : Dexa scan , skeletal survey
Steroid induced
Menopausal “ physiological cause”
-
-
Subdural” intradural” lesion can be :
-
-
-
Abscess
Disc
Hematoma
Abscess
Hematoma
Metastasis
Schwannoma
Primary tumour of the cord : ependymoma
Metastasis
Lymphoma
