Images Flashcards
1
Q
NG tube position checklist
A
2
Q
A
Extradural
3
Q
A
Contusion
4
Q
A
Subdural haematoma
5
Q
A
Intracapsular NOF
6
Q
A
Digital subtraction angiography showing occlusion of left common iliac artery
7
Q
A
Sigmoid volvulus
8
Q
A
Apple core lesion - oesophageal carcinoma
9
Q
A
ERCP with stone in common bile duct
10
Q
A
Colles’ fracture
11
Q
A
Pneumothorax
12
Q
A
Hiatus hernia
13
Q
A
Diaphragmatic hernia
14
Q
A
Misplaced NG
15
Q
A
Barium enema - diverticulosis
16
Q
A
Ruptured AAA
17
Q
A
AAA
18
Q
A
Polycystic kidney disease
19
Q
A
Raised hemidiaphragm (phrenic nerve injury) due to lung cancer
20
Q
A
C6 fracture
21
Q
A
Radioisotope bone scan showing metastases
22
Q
A
Small bowel obstruction
23
Q
A
Large bowel obstruction
24
Q
A
Fracture in left parietal bone with fracture under scalp
25
Pneumoperitoneum
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AC joint dislocation
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Dynamic hip screw (DHS)
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Hip replacement
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Extracapsular NOF
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Tibia and fibula fractures
31
This is therefore a **junctional supraventricular tachycardia (SVT):** a narrow-complex tachycardia originating from the AV node.
Treatment includes vagal manoeuvres followed by adenosine.
Atrial flutter would be a reasonable differential as the rate is regular and close to 150. However, there is no variation in the baseline and not a hint of sawtooth appearance so this is less likely than SVT.
32
**IVH** - On CT imaging it appears as hyperdensity within the dark CSF spaces within the ventricles.
33
**Colles - ‘dinner fork type deformity’**
Features of the injury
1. Transverse fracture of the radius
2. 1 inch proximal to the radio-carpal joint
3. Dorsal displacement and angulation of the distal radius
34
**Smith's fracture (reverse Colles' fracture)**
1. Volar angulation of distal radius fragment (Garden spade deformity)
2. Caused by falling backwards onto the palm of an outstretched hand or falling with wrists flexed
35
Optic disc swelling secondary to raised ICP – **papilloedema**
Mimics:
* Papillitis = inflammation of optic disc, optic neuropathies
* Malignant HTN
* Uveitis
* Graves’ compressive ophthalmopathy
* Pseudopapilloedema (optic disc drusen, hypermetropic discs, tilted discs)
Investigations:
* BP
* Urgent neuroimaging with MR venography to rule out cavernous sinus thrombosis
36
**Heart failure**
Alveolar batwing shadowing
Kerley B lines
Cardiomegaly
Upper lobe Diversion
Pleural Effusion
37
**R renal stones** (also horseshoe kidney)
38
**Pleural effusion**
Opaque shadowing with blunting of costophrenic angle and meniscus
Transudative (protein <25): CCF, nephrotic syndrome, CLD, hypothyroidism, Meig’s syndrome
Exudative (protein >35): infection, inflammation, malignant
Light’s criteria used if protein 25-35. Exudative if:
* Effusion:serum protein >0.5
* Effusion:serum LDH >0.6
* Pleural LDH >⅔ upper limit of normal serum
39
**AV nipping – Grade 2**
**Hypertensive retinopathy**
Grade 1 – mild-moderate arteriolar narrowing 🡪 copper wiring
Grade 2 – moderate-severe arteriolar narrowing; exaggerating light reflex; arteriovenous crossing changes 🡪 silver wiring, AV nipping
Grade 3 – retinal arteriolar narrowing and focal constriction, retinal oedema, retinal haemorrhage, cotton wool spots
Grade 4 – above + optic disc swelling
40
**Gout of MTP**
Soft tissue swelling in early disease
Periarticular erosions ‘punched out lesions’ in late disease
Normal joint space
41
**Type B aortic dissection** - decending aorta
42
**Ring enhancing lesion** (T1 w/contrast)
DDx - abscess, TB, neurocysticercosis, mets, glioblastoma, lymphoma, toxo
43
**Sub retinal haemorrhage** = rupture of choroidal vessels under fovea in interface between choroid and retina
Commonly a/w age-related macular degeneration
44
**Psoriatic arthropathy**
Pencil in cup
X-ray showing some of changes in seen in psoriatic arthropathy. Note that the DIPs are predominately affected, rather than the MCPs and PIPs as would be seen with rheumatoid. Extensive juxta-articular periostitis is seen in the DIPs but the changes have not yet progressed to the classic 'pencil-in-cup' changes that are often seen.
45
Pancreatic cancer - lumpy area in the middle
46
Small bowel obstruction
47
**tension pneumothorax**
Small chest drain in situ
Basal atelectasis left
Surgical emphysema within mediastinum and soft tissue
48
Digital Subtraction Angiogram Left leg demonstrating occlustion of the left SFA – reconstituting lower through collaterals
49
Left NOF
50
Barium enema demonstrating diverticular disease within the sigmoid colon
51
AP Pelvis demonstrating a Left THR
52
Left subdural with some midline shift
53
Achalasia
54
Double contrast enema. Apple core stricture with lead piping of sigmoid colon (UC). Some diverticular disease
55
UC with loss of haustration, lead piping
56
Autosomal Dominant Polycystic Kidney Disease
57
Autosomal dominant polycystic kidney disease
## Footnote
CT of the abdomen (coronal reformats) demonstrates both kidneys to be markedly enlarged by innumerable cysts ranging in size from a few millimetres to multiple centimetres. These cysts also vary in density: most are near-water density, some are hyperdense, others are calcified.
Also present are numerous cysts in the liver. The pancreas is unremarkable.
Features are consistent with autosomal dominant polycystic kidney disease, which was subsequently confirmed.
58
Sigmoid volvulus
## Footnote
dilation causes the classic coffee-bean sign, a pathognomonic of sigmoid volvulus.
59
Patient presenting with hypercalcaemia
Multiple osteolytic lesions secondary to multiple myeloma
Also know as 'rain-drop skull'
60
Subcapital fracture (intracapsular)
61
Pneumothorax
62
63
Causes of white out on CXR
64
Pleural plaques: associated with asbestos exposure (but also previous empyema or radiotherapy); classically apex sparing
65
Upper zone opacification
RUL = limited by horizontal fissure
LUL = indistinct heart border if lingula
66
Middle lobe opacification
Indistinct heart border
67
Lower lobe opacification
Indistinct diaphragm border
68
Lobar collapse on CXR
raised hemidiaphragm, tracheal deviation - may be from obstruction WITHIN airway e.g. tumour/mucous plugging/inhaled FBAO or OUTSIDE the airway e.g. tumour/lymphadenopathy
69
Right upper lobe collapse
70
Right middle lobe collapse
Depression of the horizontal fissure with subtle middle zone pacification
71
Right lower lobe collapse
Sail sign = triangular opacity with double R heart edge
72
Left upper lobe collapse
Veil sign = whole left lung field covered by veil (extends from left hilum and fades inferiorly) with elevated left hemidiaphragm and tracheal deviation
73
Left lower lobe collapse
Sail sign = triangular retrocardiac opacity with apparent double R heart edge
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Retrocardiac mass: lung cancer until proven otherwise
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General approach for AXR interpretation
84
85
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SBO vs LBO
87
88
89
Sigmoid vs caecal volvulus
90
Pneumatosis intestinalis (intramural gas): ischaemia until proven otherwise - shows as foci of gas densities that outline bowel wall
91
Pneumoperitoneum: perforated viscus; Rigler's sign may be visible; proceed to erect CXR after 15 minutes
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97
98
Anterior vs posterior shoulder dislocation on XR
99
Anterior shoulder dislocation
100
Posterior shoulder dislocation
101
Hill Sachs
102
Bankart lesion
103
Normal XR elbow
104
Radial head dislocation
105
106
Classification of supracondylar fractures
107
Supracondylar fracture (Gartland 1 - minimally displaced)
108
Supracondylar fracture (Gartland 2 - displaced, posterior cortex intact)
109
Colles vs Smith fracture
109
Supracondylar fracture (Gartland 3 - displaced, complete)
110
Colles fracture
## Footnote
Typically FOOSH forwards
Extra-articular radial # with dorsal (posterior / back of hand) angulation and displacement
111
Smith Fracture
## Footnote
Typically FOOSH back of hand
Extra-articular radial # with volar (anterior / palmar) angulation and displacement
112
Monteggia vs Galeazzi
113
Galeazzi Injury
Galeazzi = Radial # (near wrist) Ulnar dislocation
## Footnote
GRUesome MURder
114
Monteggia Injury
Monteggia = Ulnar # (near elbow) Radial dislocation
## Footnote
GRUesome MURder
115
Radial styloid fracture
typically blunt trauma or FOOSH
(AKA Chauffeur / Hutchinson)
116
Ulnar styloid fracture: typically blunt trauma or FOOSH
117
Scaphoid fracture: FOOSH / sporting / steering wheel injury
Presents with pain in anatomical snuffbox / on telescoping thumb +/- wrist joint effusion
118
Boxer's fracture
Fracture neck 5th metacarpal (little finger) due to axial loading
119
Bennett fracture
Forced abduction of the thumb = intra-articular fracture proximal first metacarpal
120
Osteoarthritis
121
Rheumatoid arthritis
122
Psoriatic arthritis
123
Arthritis hands: compare osteoarthritis, rheumatoid arthritis and psoriatic arthritis
124
Normal hip xray
125
Anterior hip dislocation
126
Posterior hip dislocation
127
128
129
Intracapsular (Garden classification)
130
Intracapsular NOF fracture
Garden classification type I
131
Intracapsular NOF fracture
Garden classification type II
132
Intracapsular NOF fracture
Garden classification type III
133
Intracapsular NOF fracture
Garden classification type IV
134
Extracapsular (intertrochanteric) fracture
135
Extracapsular (subtrochanteric) fracture
136
137
138
139
Knee XR: gout vs pseudogout
140
congenital bipartite patella
141
Patella dislocation
142
Subdural on CT head
143
Extradural on CT head
144
Subarachnoid haemorrhage on CT head
145
SAH
146
Causes of a ring enhancing lesion on CT/MRI
DR MAGICAL
147
Cerebral oedema: loss of greywhite matter differentiation; may be result of:
- Vasogenic oedema (disrupted BBB)
- Cytotoxic oedema (normal BBB, ischaemic damage)
148
Hydrocephalus: ventriculomegaly with compression of the brain parenchyma
149
**Intraventricular haemorrhage**: hyperintense (bright) blood within the ventricles (with a fluid level); may be **primary**: started in ventricles or **secondary**: extension of extra-ventricular bleed (usually SAH or intracerebral e.g. basal ganglia)
150
151
Basal ganglia bleed
