deck_1042070 Flashcards
Acro-osteolysis
PINCH OFPsoriasis / pyknodysostosisInfectionNeuropathicCollagen vascular diseaseHyperparathyroidismOther -polyvinyl alcoholFamilial- Hadju Cheney
Generalised bone sclerosis - Adults
Regular Sex Makes Occasional Perversions Much More Pleasurable and FunRenal OsteodystrophySickle cell dsMyelofibrosisOsteopetrosisPyknodysostosis MastocytosisMetastasisPaget’sFluorosis AthletesLymphomaWith splenomegaly - myelofibrosis, mastocytosis, lymphoma
Linitis plastica
CALM RAGECancer - Gastric, pancreatic (local invasion)AmyloidosisLymphoma - non-hodgkin’s typeMetastasis - lung, breast, melanomaRadiationAlkali and other corrosivesGranulomatous ds - Crohn’s, TBEosinophilic enteritis
Renal papillary necrosis - causes
NSAID OR EthanolNSAIDSickle cell disease / ShockAnalgesicsInfection - TB, Pyelonephritis / Infants in ShockDiabetes / DehydrationObstructive uropathyRenal vein thrombosisEthanol abuse
Apthous Ulcers
ACHE BABYASA/medsCrohn’sHerpesETOHBehcetAmebiasisBad AIDSYersinia
Stomach - Bull’s eye / target lesion
BLACK PaNBreast metastasis / Melanoma metastasis, other - bronchus, pancreas, carcinoidLeiomyomaAdenocarcinomaCancer - lymphomaKaposiPancreatic ‘rest’Neurofibroma
Lymphangitic Carcinomatosis
Certain Cancers Spread By Plugging The LymphaticsCervixColonStomachBreastPancreasThyroidLarynx
Crazy Paving (CT)
Acute- Oedema- haemorrhageChronic- PAP- Sarcoid- PCP- Fibrosis
Pulmonary Nodules - Multiple / Mass > 3 cm
Days of Week MTWTFSSMets / carcinoma / lymphomaTB/GranulomaWegenersRheumatoid nodules / Round pneumoniaFungalSarcoid / SilicosisSeptic pulmonary emboli
Pulmonary Coin lesion < 3 cm
CHANGECarcinoma / congenitalHamartoma / HematomaAVM / AbscessNeoplasm - metsGranulomaEsoteric - TB pneumonia
Pulmonary Bronchovascualr spread
SKILLSarcoidKaposiInfection - PCP / TBLymphomaLymphangitic spread
Pulmonary - Unilateral hyperlucent lungs
POEMSPoland / PneumothoraxOligemia / Obstruction (PE)EmphysemaMastectomySwyer-James
Pulmonary nodules multiple - perilymphatic
A SKILLAmyloidSarcoidKaposi’sInfection (PCP)LymphomaLymphangitis carcinomatosis
Pulmonary nodules multiple - centrilobular
HERB has GAsHypersensitivity PneumonitisEGRB-ILDBAC / BOOPGVHDvAsculitis
Pulmonary - Bronchiectasis
CAPT Kangaroo has Mounier KuhnCystic fibrosisABPAPostinfectiousTBKartagenersMounier Kuhn
Pulmonary - calcified nodules
MASH PoxMetastasisAlveolar microlithiasisSilicosis / SiderosisHistoplasmosisPox (varicella)
Pulmonary - reticular (CXR) / cystic opacities (CT)
ELECT CHIP from NorthamptonEGLAMEmphysemaCFTuberous SclerosisCoccidiomycosisHydrocarbonInfectiousPCPNeurofibromatisis
Pulmonary Interstitial / Alveolar opacities - LZ
CADCFA/ Connective tissue disorders (Rh Arth, Scleroderma)Asbestosis / AspirationDrugs
Pulmonary Interstitial / Alveolar opacities - UZ
BREATHSBeryliosisRadiationEAAAnkylosing Spondylitis / ABPA / AsbestosisTBHistiocytosis XSarcoid / Silicosis
Pulmonary Interstitial / Alveolar opacities - MZ
TSBTBSarcoid / SilicosisBeryliosis
Pulmonary Interstitial / Alveolar opacities - Peripheral
four PsPEThree pneumonias- COP- Chronic Eosinophilic pneumonia- Usual interstitial pneumonia
Pulmonary Interstitial / Alveolar opacities - Central
two CsCardiac faliure (acute)pCp
Mandibular lesion - cystic
RaD FOAAMDental - RaDRadicular cyst / Periapical cyst Dentigerous cystNon-dental - FOAAMFibrous dysplasiaOdontogenic keratocystAmeloblastomaAneurysmal Bone CystMetastasis / MyelomaSimple Bone CystBrown tumourGiant cell tumourLCHHaemangioma
Basilar Invagination
PF ROACHUpward extension of C-spine into foramen magnum. McGregor’s line (post tip of hard palate and base of occiput) - odontoid tip not more than 5 mm above.Paget diseaseFibrous DysplasiaRicketsOsteogenesis Imperfecta , OsteomalaciaAchondroplasiaCleidocranial dysplasiaHyperparathyroidism, Hurler syndrome
Erlenmeyer Flask Deformity
CHONGOCraniometaphyseal dysplasiaHaemoglobinopathiesOsteopetrosisNiemenn PickGaucher’s DiseaseOther - Lead
Pancreatic Calcification
TIGAR-O# Toxic-Metabolic - smoking / alcohol / diet / Hyperparathyroidism / Kwashiorkar# Tumour - cystadenoma and cystadenocarcinoma# Idiopathic - Tropical calcific pancreatitis# Genetic - Cystic fibrosis gene, serine protease inhibitor Kazal type 1# Autoimmune# Recurrent and severe acute pancreatitis (post necrotic, vascular)# Obstructive (pancreatic divisum)
Fluid-Fluid level MRI
HOT MASSHaemangiOmaTelengiectatic osteosarcomaMetastasisABC / GCTSynovial cell Sarcoma
Sacral lesion
CANChondrosarcoma / ChordomaABC / GCTNeurofibromatosisAlways - Mets / Myeloma / Lymphoma
Soft tissue calcification
My GHOSTSMyositis OssificansGoutHyperparathyroidism / HaematomaOchronosisScreroderma / Connective tissue disorders (Dermatomyositis)Tumoral calcinosisSarcoma (Synovial cell) / Synovial osteochondromatosis
Bone - Cortical lesion
MOFOSMetastasisOsteomyelitisFibrosarcomaOsteoid osteomaStress fracture
Bone - Diaphyseal lesion
CEMENTCystsEnchondromaMetastasisEosinophilic Granuloma (EG)Non-ossifying fibroma (NOF)TB / infections
Chondral calcification
HOGWASHHyperparathyroidismOchronosisGoutWilson’s diseaseArthritispSeudogout (CPPD)Haemochromatosis
Sternoclavicular screrosis
STOPSAPHO syndromeTraumatoic osteolysisOsteomyelitis / OsteosarcomaPagets
Distal clavicle erosion
SHIRT Men Medium Complete with PocketSclerodermaHyperparathyroidismInfectionRheumatoid arthritisTraumatic osteolysisMetastasisMultiple myelomaCleidocranial dysplasiaPyknodysostosist
Subchondral cysts
COORSCPPDOAOsteonecrosisRhematoid arthritisSynovial based tumours
Bone within bone
SHARPS POOLSickle cell diseaseHypervitaminosis DAcromegalyRicketsPaget’s DsScurvyPost radiation therapy / thyrotrast / Hevy metal poisoning and oxalosisOsteopetrosisOsteomyelitisLeukemia
Madelung deformity
HITDOC Oh My!Hurlers syndromeInfectionTraumaDyschondrosteosisOsteochondroma Congenital - Turner’s syndromeOllier’s DiseaseMultiple Epiphyseal Dysplasia
Low density Basal Ganglia
Hypo! …Call WilsonHypoxiaHypotensionHypoglycaemiaCO poisoningWilson’s disease
Basal Ganglia calcification
PIE MAPS-Physiological-Infection:CMV, toxoplasma, congenital rubella, HIV-Endocrine: Hypoparathyroidism (Pseudo/PseudoPseudo), Hyperparathyroidism, Hypothyroidism- Metabolic: Leigh ds, Fahr ds, Wilson’s ds- Anoxia: at birth, CVA- Poisoning: CO, Lead- Syndromes: Down’s, Cockayne’s, Neurofibromatosis
Paediatric Pulmonary Mass
RAP’ N FOREGUTRound pneumoniaAbscessPseudo tumourNeoplasm (RARE) - hamartoma, blastomaFOREGUT malformationsBronchopulmonary Foregut malformations- CLE- CCAM- Sequestration- Bronchogenic cyst
Paediatric - Chest wall mass
RENAL MetsRhabdomyosarcomaEwingsNeuroblastomaAskin tumour / PNETLymphoma Mets
Multiple Wormian Bones
Abnormal if seen after 1 year, large (> 6 x 4 mm) and numerous (> 10 in number)PORK CHOPSIPyknodysostosisOsteogenesis ImperfectaRickets in healingKinky Hair syndrome (Menkes)Cleidocranial DysostosisHypothyroidism / HypophosphatasiaOtopalatodigital syndromePachydermoperiostitisSyndrome of Down’sIdiopathic - normal in first year of life
Epiphyseal lesion
CIGSChondroblastoma / Clear cell Chondrosarcomainfection (Osteomyelitis)Giant cell tumour / Granuloma (EG)Subchondral cyst (Geode)
Congenital Heart Ds with Right sided aortic arch
TTT PVTruncus arteriosusTetrology of FallotTransposition of great vesselsPulmonary atresiaVentricular septal defect.
Cynotic Heart Ds
With Pulmonary oligemia - TPFTricuspid atresiaPulmonary stenosisFallot’s tetrologyWith Pulmonary plethora - TTTTransposition of great vesselsTruncus arteriosusTotal anomalous pulmonary venous drainage
Generalised increased bone density - children
- DysplasiaOsteopetrosisPyknodysostosisCraniotubular dysplasiaCraniotubular hyperostosis- MetabolicRenal osteodystrophy- PoisoningLeadFluorosisHypervitaminosis DHypervilaminosis A- IdiopathicCaffey’s Ds (Infantile cortical hyperostosis)Idiopathic hypercalcemia of infancy
Multiple Sclerotic Bone lesions
- DevelopmentalFibrous DysplasiaOsteopoikilosisOsteopathia striataTuberous sclerosis- NeoplasticMetastasis (Prostate, Breast)LymphomaMastocytosisMu;tiple healed or healing bening or malignant bone lesions (mets after RT or chemo, EG, Brown tu)Multiple MyelomaOsteomata (Gardners)Mutifocal osteosarcoma- IdiopathicPagets Ds- Vascular bone infarcts- Traumatic Callus
Subarticular Lucent bone lesion
- ArthritidesOsteoarthritisRACPPDGoutHaemohilia- NeoplasticMetastasis / multiple myelomaABCGCTChondroblastomaPVNS- OthersPost-traumaticOsteonecrosisTuberculosis
Permeative Bone lesion
Massive FIRE- Mets/Myeloma- Fibrosarcoma (Desmoid / Malignant Fibrous Histiocytoma)- Infection- Round cell tumours (Ewings, Bone lymphoma, small cell osteosarcoma)- EG
Periosteal Reaction - Bilaterally symmetrical ADULTS
HD TV Flat PanelHypertrophic Osteoarthropathy (HOA)Diffuse Idiopathic Skeletal Hyperostosis (DISH)Thyroid acropachyVascular insufficiencyFlurosisPachydermoperiostitis
Periosteal Reaction - Bilaterally symmetrical Children
CRASH Lane No. NineCaffey’s diseaseRicketsArthritis - Juvenile idiopathicScurvy / Syphilis (congenital)Hypervitaminosis ALeukemiaNAINormal variant before age of 4 months
Metaphyseal Bands - Dense
Dense - LINES CORD- Lead poisoning- Infantile growth arrest- Normal, 3 yr- lEukemia treated- Syphilis- Congenital Hypothyroidism- Osteopetrosis- Radiation- hypervitaminosis D
Metaphyseal Bands - Lucent
Lucent - Normal Tender Sweet Loving Care Makes Healing Imminent- Normal (neonates)- TORCH- Scurvy- Leukaemia, lymphoma or metastatic neuroblastoma- Chronic illness- Metaphyseal fracture (NAI)- Healing Rickets- Intrauterine perforation
Metaphyseal Bands - Alternate radiolucent and radiodense
Team GBR Came Close to One- Treated leukemia- Growth arrest (Harris and Park’s line)- Bisphosphonate therapy- Rickets- Chemotherapy- Chronic Anaemias -sickle cell and thalassemia- Osteopetrosis
Metaphyseal lines - dense vertical
Congenital Rubella- celery stalkOsteopathia striata +/- exostosisHypophosphatasiaLocalised metaphyseal injury
Gracile Bones
NIMRODNeurofibromatosisImmobilisationMuscular DystrophyRheumatoid ArthritisOsteogenesis imperfectaDysplasias
Irregular or stippled Epiphysis
Mayor Who CAN Truly Please Masses Cannot FailMeyer dysplasia / Multiple epiphyseal dysplasiaWarfarin embryopathyCongenital HypothyroidismAvascular necrosisNormal - particularly distal femurTrisomy 18 and 21Prenatal infectionMorquio’s syndromeChondrodysplasia punctataFetal alcohol syndrome
Benign Lytic bone lesion
FEGNOMASHICFibrous DysplasiaEnchondromaEosonophilic GranulomaGiant Cell tumourNonossifying fibromaOsteoblastomaMets / MyelomaAneurysmal bone cystSolitary Bone CystHyperparathyroidism (Brown tumour)HaemangiomasInfectionChondroblastomaChondromyxoid fibroma
Ivory vertebral body
Mets…LP HIMMetastasisLymphomaPagetsHaemangiomaInfection (low grade)Mastocytosis
Tibial lesion
FOAMFibrous DysplasiaOsteofibrous DysplasiaAdmantinomaMetastasis
Posterior vertebral body lesion
GO TAPEGiant Cell TumourOsteoblastomaTBABCPagetsEG
Intraspinal Mass
Extradural- prolapsed sequestrated disc- Mets/ Myeloma/ Lymphoma deposits- Neurofibroma- Neuroblastoma / ganglioneuroma- HaematomaIntradural/ Extramedullary- Meningioma- Neurofibroma- Metastasis- Subdural EmpyemaIntramedullary- Ependymoma- Astrocytoma- Dermoid- Infarct (expanding in acute phase)- Haematoma
Apparently normal CT head
- Basilar artery thrombus- HSV enchephalitis- venous sinus thrombosis
Apparently normal CXR
MAD PC LASHed on My Best Room MateMastectomyApical opacityDextrocardia (look at side marker)PneumothoraxPectusCystic lung disease / Bronchiectasis (subtle)Left lower lobe collapseAir under the diaphragmSurgical emphysemaHiatus herniaBone lesionRetro-pacemakerMiddle lobe collapse / consolidation
Deviated ureters
Medial DeviationAPRIL Showers are Normal- Aneurysmal dilatation of iliac vessels- Pelvic lipomatosis- Retroperitoneal fibrosis- Retrocaval ureter- Iliac Lymphadenopathy- Surgery - AP resection- Normal variantLateral DeviationPAN Fried Halibut- Paracaval / paraaortic lymphadenopathy- Pelvic mass- Aneurysmal aortic dilatation- Neurogenic tumourFluid Collection (abscess/urinoma/haematoma)Hypertrophy of Psoas
Apparently Normal Spine MRI
- AAA- Hydronephrosis- Lymphadenopathy- Pleural Effusion- Soft tissue abscess
Superscan - Bone scan
Differential Diagnosis-MetabolicHyperparathyroidismOsteomalaciaRenal osteodystrophy- MalignancyProstatebreast- HaematologicalLymphomaMyelofibrosisMastocytosis
Apparently Normal Barium Enema
- Skeletal Abnormality - mets, sacroiliitis- Bowel distribution - malrotation, organomegaly- serosal colonic pathology - serosal mets ov ca- Endometriosis- Abnormal calcification
Fold thickening in Non-dilated small bowel - Smooth and Regular
Vascular- Intramural haematomatraumableeding diathesis- Ischemiaacute - embolus, HSPchronic - vasculitis, atheroma, FMDRadiotherapy- Acute- ChronicOedema- Adjacent inflammation- hypoproteinemia- Venous obstruction- lymphatic obstruction- angioneuroticEarly infilteration- Amyloidosis- Eosinophilic enteritisCoeliac diseaseAbetalipoproteinemia
Fold thickening in Non-dilated small bowel - Irregular and Distorted
Inflammatory- Crohn’s disease- Zollinger-Ellison SyndromeNeoplastic- Lymphoma- Metastases- CarcinoidInfilterative- Amyloidosis- Eosinophilic enteritis- Mastocytosis- Whipple’s diseaseInfective- TuberculosisInfestation- Giardiasis- Strongyloides
Stomach abnormality with thickened small bowel mucosal folds
- Lymphoma / metastases- Zollinger-Ellison syndrome- Menetriers disease- Amyloidosis- Eosinophilic enteritis
Hepatic Calcification
- Multiple and SmallHealed granulomas (TB, histoplasmosis, brucellosis, coccidioidomycosis)- CurvilinearHydatid AbscessCalcified Gallbladder (Porcelain)- Localised in massMetastases - Colloid carcinoma rectum, colon, stomachAdenoma- Sunray spiculationHaemangiomaMetastasesAdenoma- Diffuse increased densityHaemochromatosis
Adrenal Calcification
PIC CAGPhaeochromocytoma (egg shell)Inflammatory - primary TB, histoplasmosisCarcinomaCystic diseaseAddison’s DsGanglioneuroma
MIBG Imaging(Meta-iodo-Benzyl- Guanidine)
Normal- Myocardium- Liver and Spleen- Bladder- Adrenal Glands- Salivary glands- Nasopharynx- Thyroid- ColonAbnormal- Phaeochromocytoma- Neuroblastoma- Carcinoid tumour- Paraganglioma- Medullary thyroid carcinoma- Ganglioneuroma
Bone lesion with ABC like features
CCC FFO GOChondroblastomaChondromyxoid fibromaChondrosarcomaFibrosarcomaFibrous DysplasiaOsteoblastomaGCTOsteosarcoma
Finger tip lesion
GEMSGlomus tumourEpidermoid / EnchondromaMetastasis (lung almost exclusively)Sarcoid
Phalangeal ‘cyst-like’ bone lesion
Sarcoidosis (osseous)Implantation dermoidGout (low signal tophi on MRI)Rhematoid arthritisEnchondroma
Lofgren’s Syndrome
TriadErythema NodosumArthralgia (classically involving ankles)Mediastinal Lymphadenopathy
McCune–Albright syndrome
Polyostotic fibrous dysplasiaCafé-au-lait spotsPrecocious puberty
Vertebra plana
I MELTInfectionMets / MyelomaEGLymphoma / LeukemiaTB / Trauma
Charcot joint
6 D’s of Charcot jointDeDestructionDensity (subchondral sclerosis)Debris (intra-articular loose bodies)DisDisorganizationDislocationDistentionCauses - D S6DiabetesSteroidSclerodermaSyphilisSyringomyeliaSpina bifidaSpinal Cord injury
Rib lesion
Fine COMBE PleaseFibrous DysplasiaChondrosarcomaOteochondromaMets/myeloma/plasmacytoma/askin/ewingsBrowns tumourEnchondroma/EGPagets
Arthropathy- Classic areas of involvement
Scleroderma - erosions 1st Carpo-metacarpal Jnt.
Short Metacarpals
BIC PENB - basal Cell Nevus syndrome (Gorlin’s Syndrome)I - idiopathic / Infection (trauma)C - chromosomal–Turner’s syndromeP - Pseudohypoparathyroidism / PseudoPseduohypoparathyroidism
Gorlin’s Syndrome (Basal Cell Nevus syndrome)
Short 4th metacarpalodontogenic keratocystMedulloblastoma (also with Turcot’s and Gardner’s synd)
Turner’s syndrome
Short metacarpalMadelung’s deformityHorseshoe kidney
Periarticular Erosions (DIP joint)
PsoriasisGoutSclerodermahyperparathyroidismThermal injury
SURGICAL SIEVE
VINDICATEVASCULARINFECTIONNEOPLASMDRUGSIDIOPATHIC CONGENITALAUTOIMMUNETRAUMATICENDOCRINE
Sellar/suprasellar/juxtasellar masses
STOMACHSarcoidTeratoma/TBOptic nerve gliomaMeningioma/MetsAdenoma/AneurysymCraniopharyngioma/cleft cyst (Rathke)Hypothalamic glioma/hamartoma/tuber cinereum hamartoma/histicytosis
CP Angle mass
AMENA - Acoustic schwannoma ( 80% )M - Meningioma ( 11% )E - Ependymoma ( 4% )N - Neuroepithelial cyst (arachnoid / epidermoid) ( 5% )SAMES - schwannoma A - aneurysm, arachnoid cystM - meningioma, metastasisE - epidermoid cyst, ependymoma
Low signal masses in synovium
PACSP - Pigmented villonodular synovitis (PVNS)A - amyloidC - chronic bleeding disorders (e.g. haemophilia)S - synovial chondromatosis
Post fossa mass Paeds
APEs like PNETAstrocytoma -brainstem gliomaPilocytic astrocytomaEpendymomas likePNET - medulloblastoma
Age for Paediatric Hip Pathologies
Delhi Public School 0-5 DDH5-10 Perthes10-15 SUFE
Bone Automatics - Must Mention in every Case
older than 40- Infection- Mets / MyelomaYounger than 30- Infection- EG
Multiple lytic lesions - Bone
FEEMHIFibrous DysplasiaEnchondromas , EGMets / MyelomaHyperparathyroidism (brown tumour) / HaemongiomasInfection
Liver lesions with central scar
FNHFibrolamellar HCCHaemaongiomas (large)HCCCholangiocarcinomaMetastasesRegenerative nodules in Budd-Chiari syndrome(and other vascular disorders)Hepatic Adenoma (rare)
Tuberous Sclerosis - Vogt’s triad
Facial angiofibromasMental retardationSeizures
Immunocompromised patient - CNS lesion
With Mass effect- Toxoplasmosis- Primary CNS lymphoma- TB abscess- bacterial abscessWithout Mass effect- Progressive multifocal leucoencephalopathy- HIV encephalitis- CMV encephalitis
Umbilical catheters
-UACUA - internal iliac artery- infrarenal aorta-UVCUV - portal sinus (junction of left and right portal vein) - ductus venosus - IVC - end in the RA
Enlarged intercondylar notch of distal femur
HP sauce Just Tastes RankHaemophiliaPsoriasisJuvenile idiopathic arthritisTBRA
Copper Beaten skull
- Normal finding during periods of rapid brain growth (2-3 yrs, 5-7 yrs)- Craniosynostosis- Obstructive hydrocephalus- intracranial mass
J shaped sella
Normal variantOptic chiasm gliomaNeurofibromatosisAchondroplasiaMucopolysaccharidosisChronic hydrocephalus
Increased density of Liver on CT
- Drugs: Amiodarone- Heavy metal poisoning: Gold, Copper, Thyrotrast, Thallium, Iron, Iodine- Haemocromatosis- Glycogen storage disease- Acute massive protein deposits
Metastases
Pleural- Lung, breast, ovary, GI tractCalcified lung mets- osteosarcoma, other sarcomas, colon, ovary. thyroid
Moth eaten bone in a Child
Neuroblastoma metsLeukemiaLong bone sarcoma - Ewings, osteosarcoma, lymphomaLCHAcute osteomyelitis
Paediatric tumours that metastasize to bone
NeuroblastomaLeukaemiaLymphomaClear cell sarcoma (Wilm’s variant)RhabdomyosarcomaRetinoblastoma
Syndromes and bone dysplasias with multiple fractures
Reduced density- osteogenesis imperfecta- hypophosphatasia- Cushings syndnormal bone density- Cleidocranial dysplasia- fibrous dysplasiaIncreased bone density- Osteopetrosis- Pyknodysostosis
Oh My God Lesions
PagetsFibrous DysplasiaNeurofibromatosisCharcot joints
Rib lesion
FAME OO- Fibrous Dysplasia- ABC- Metastases (Neuroblastoma) / Myeloma / lymphoma / primary (Ewings / Askin)- EG / Enchondroma- Osteochondroma - Osteomyelitis
Iliac wing lesion
FUC MEFibrous DysplasiaUnicameral bone cystChondrosarcomaMets / myeloma / PlasmacytomaEwings
Platyspondyly in child
LOST My Shoe- LCH- Osteogenesis Imperfecta- Sickle cell anaemia- Thnatotrophic dwarfism- Morquio’s - Scheuermann’s