Most common 3 Flashcards
LS
MC site of intraosseous ganglion cysts
medial malleolus of the tibia
The proximal radius and ulna most often dislocate where?
posteriorly
Perilunate dislocations may be accompanied by fractures of the carpal bones, most commonly the?
scaphoid and/or capitate
MC acetabular injury
both-column fractures
A lucent lesion in the anterior calcaneus is most commonly a?
simple bone cyst
MC Satler Harris type in trauma of the skeletally immature distal tibial epiphysis
Salter-Harris type II
Least stable of all joints
shoulder
Only true articulation between the shoulder girdle and the axial skeleton
sternoclavicular joint
MC malignant soft tissue mass
rhabdomyosacroma
MC arthropathies in childhood
juvenile RA, hemophilia, and pigmented villonodular synovitis (PVNS)
After primary degenerative joint disease, the next most commonly encountered arthropathy in the forefoot
RA
Chondroblastomas are eccentric intramedullary
l esions with lobulated margins and endosteal
sclerosis most commonly seen in the?
proximal
tibial metaphysis
MC malignant osseous lesions in adults
mets
MC fracture of C2
traumatic spondylolysis of C2 (hangman’s fracture)
Hyperextension teardrop fracture, an avulsion fracture
of the anteroinferior margin of the vertebral body caused
by excessive stress on the ALL, occurs most
commonly at?
C2
Next mc site of spine fracture after the cervical spine
thoracolumbar junction (T12 to L2)
Most commonly involved in spinal mets
thoracic and lumbar regions
MC primary tumors to produce spinal metastases
ca of the breast, lung, prostate, and kidney > lymphomas
In the thoracic spine, what discs herniate most commonly?
T11 and T12 discs
Synovial cysts as consequence of facet joint degenerations are usually seen in?
lower lumbar spine, most commonly at L4-L5
MCC of acquired stenosis
degenerative change
Most cases of edidural lipomatosis involve the?
thoracic spine
Ossification of the LF is generally seen in the setting
of OPLL. It is found most commonly in?
cervical and thoracic regions
MC signs of arachnoiditis by MRI
nerve root clumping and enhancement
Erosion of the dens by inflammatory pannus (synovial hypertrophy) is common in RA and is most frequently found in the?
retrodental space
Vertebral hemangiomas are most often located in the?
thoracic or lumbar regions
MC benign cause of vertebra plana
LCH
MC CT manifestation of myeloma
diffuse osteopenia
MCC of epidural hematoma
trauma
Epidural hematomas are generally located in the dorsolateral aspect of the spinal canal and most commonly involve the?
upper thoracic region
Beam hardening is most commonly seen in
body CT between the dense bones of the hips
Most dependent portion of the peritoneal cavity
pelvis
MC tumors to spread by diffuse metastatic seeding of the peritoneal cavity
ovarian ca in females and stomach, pancreas, and colon ca in both sexes (abdominopelvic)
Tumors most likely to extend into the IVC as tumor thrombus
renal, hepatic, and adrenal ca
MC ventral hernia
umbilical hernia
Most frequently injured intraabdominal organ
spleen
MC liver injury
lacerations
2nd most commonly injured abdominal organ
liver
Most specific CT sign of bowel injury
discontinuity of the bowel wall
MC causes of pancreatic injuries
penetrating trauma, knife and gunshot wounds
MCC of pancreatitis in children
blunt abdominal trauma, often assoc w/ child abuse
MC location of renal artery occlusions in renal trauma
proximal 2 cm of the renal artery
Most specific CT sign of portal hypertension
visualization of patent paraumbilical collateral veins
MCC of tumor extending into the portal vein
HCC
MC findings in the liver in hereditary hemorrhagic telangiectasia
telangiectasias
MC CT appearance of liver metastases
well-defined low-attenuation solid mass w/ vague peripheral enhancement producing a target appearance
MC hypervascular liver metastases
carcinoid, choriocarcinoma, melanoma, PNET, pheochromocystoma, RCC, and thyroid ca
MC primary hepatic malignancy
hepatoma / hepatocellular carcinoma
2nd MC focal mass lesion in the liver, exceeded in frequency only by mets / MC benign liver lesion
cavernous hemangioma
MC associated findings in pyogenic liver abscess
biliary obstruction and thrombophlebitis
MC etiologic agent of pyogenic liver abscess
E. coli
MC site of hydatid disease
liver
Gradual tapering of a dilated duct is seen most commonly with?
benign disease such as inflammatory stricture
Most commonly affected part of CBD in autoimmune pancreatitis-associated cholangitis
distal part
MCC of gas or contrast material in the biliary tree
iatrogenic
MC malignancy of the biliary system
gallbladder ca
MC anomaly of the pancreatic ductal system
pancreas divisum
Pancreatic calcifications occur most frequently in?
chronic pancreatitis because of alcoholism and hereditary pancreatitis
MC region of involvement of autoimmune pancreatitis
head or uncinate process
MC pancreatic involvement of lymphoma
direct extension from peripancreatic lymphadenopathy
MC lymphomas
non-Hodgkin B-cell lymphoma
MC primary tumors of metastases to the pancreas (unusual)
melanoma and ca of the kidney, lung, or breast
MC cystic lesion in and around the pancreas
pseudocyst
MC location of serous cystadenomas
head
MC location of mucinous cystic neoplasms
distal body and tail
MC location of branch-duct IPMNs
uncinate process
Most characteristic finding of splenic infarction
extension to the splenic capsule
MC malignant tumor of the spleen
lymphoma
MC sources of splenic metastases
melanoma and lung, breast, and ovarian ca
MC benign neoplasm of the spleen
hemangiomas
MC CT appearance of splenic angiosarcoma
multiple enhancing nodules w/ irregular and poorly defined contours
Involved lymph nodes in RCC are most common in
renal hilum, pericaval, and periaortic regions
Hematogenous mets in RCC are mc in?
lung, liver, and bone
MC sites of distant metastases from recurrent RCC
lungs, mediastinum, bone, liver, contralateral kidney or adrenal gland, and brain
MC late mets (>10 yrs after surgery) from RCC recurrence
lung, pancreas, bone, skeletal muscle, and bowel
Most commonly affected segment by ureteral uroepithelial tumors
distal ureter
MC lymphoma types to involve the kidney
B-cell non-Hodgkin lymphoma and Burkitt lymphoma
MC CT appearance of lymphoma
multiple bilateral renal masses
MC primary tumors to metastasize to the kidneys
lung, breast, and GI adenocarcinomas
MC CT pattern of renal metastasis
multiple bilateral low-attenuation renal nodules
Isolated solitary mets is seen most commonly with?
colon cancer and melanoma
MC location of multilocular cystic nephroma / simply cystic nephroma
upper pole
MC extrapulmonary site of infection of TB
urinary tract
MC anomaly of the urinary tract
duplication of the ureters
Most phleboliths are found in what veins?
perivesical veins, periprostatic veins in men, and periuterine and perivaginal veins in women
MC location of extra-adrenal myelolipomas
presacral space and retroperitoneum
MC finding in adrenal involvement by lymphoma
total encasement of the adrenal gland by retroperitoneal adenopathy
Most adrenal calcifications in both children and adults are sequelae of?
adrenal hemorrhage
Most (90%) pheochromocytoma arise in the?
adrenal medulla
MC location of extra-adrenal pheochromocytomas (10%)
organ of Zuckerkandl near the origin of the IMA
MC primary tumors of metastases to the adrenal glands
lung, breast, and colon adenoca, and melanoma
Most adrenal masses larger than __ cm are malignant.
5 cm
MC benign tumor of the esophagus
leiomyoma
MCC of nonerosive gastritis
H. pylori infection
MC location of wall thickening in gastritis? - often focal
antrum
Best CT sign of gastritis
thickened gastric folds
Nodes most likely to be involved in gastric ca
nodes near the celiac axis and in the gastrohepatic ligaments
MC location of nodal recurrence in gastric ca
along the course of the hepatic artery or in the paraaortic
MC mesenchymal tumor
GIST
Most GISTs arise in the __________ throughout the GIT.
muscularis propria (60-70% stomach, 20-30% small bowel)
MC sites of mets from malignant GIST
liver and peritoneal cavity
MC location of gastric varices
fundal region
MC location of small bowel lymphomas
ileum
MC primary tumors of metastases to the small bowel
malignant melanoma and breast, lung, and RCC
Most commonly involved segments in transient intussusception (in small bowels)
jejunojejunal
MC malignancy seen in the mesentery
lymphoma
MC site of desmoid tumor (mesenteric fibromatosis)
mesentery of the small bowel
MCC of acute abdominal pain
acute appendicitis
MCC of mucocele
obstructing benign or malignant neoplasm of the appendix
MC location of lipomas
colon > small bowel > stomach > esophagus and pharynx
Epiploic appendagitis are most numerous in which colonic segment?
sigmoid
MCC of occult GI bleeding
angiodysplasia
MC sites of hematogenous metastases from bladder carcinoma
liver, lungs, bones, and adrenal glands
MC cystitis
acute bacterial cystitis (usually E. coli)
MC site of recurrence in cervical ca
top of the vaginal cuff
MCC of adnexal torsion
benign cystic teratomas, hydrosalpinx, or functional cyst
2nd mc malignancy in males
prostate ca
Cysts most commonly found in the prostate gland
cysts associated with BPH - usually located laterally
MC pattern of spread in testicular cancer
lymphatic spread
MC testicular malignancy in men older than 60 yrs
B-cell lymphoma
MC example of a fluid collection originating within the space around the great vessels that can communicate with the retroperitoneum
aortic hemorrhage
MC clinical example for pancreaticoduodenal effusions
pancreatitis
MC location of esophageal duplication cysts
distal esophagus
MC mesencymal tumor of the esophagus / benign tumor of the esophagus
leiomyoma
MC benign mucosal neoplasm of the esophagus
papillomas
MC location of squamous cell carcinoma in the esophagus
proximal and mid
MC location of esophageal adenocarcinoma
distal (because assoc w/ chronic GERD)
MC distant metastatic sites of esophageal adenocarcinoma
lung and liver
MC metastatic cancer to the esophagus
gastric adenoca
Tracheoesophageal fistula is most commonly a complication of?
malignancy
MCC of esophageal perforation
upper endoscopy (iatrogenic)
MCC of gastric perforation
ulcer disease
MC site of traumatic esophageal tears
cervical and upper thoracic esophagus
Uphill varices are most commonly seen in the setting of?
cirrhosis and portal hypertension
Esophagectomy is most commonly performed for?
primary esophageal ca
Reconstruction in esophagectomy is most commonly via a?
gastric pullup
MC location for GIST
stomach
Majority of benign gastric tumors
hyperplastic polyps
MC malignancy in the stomach
adenocarcinoma
MC site for lymphoma in the GIT
stomach (still a rare disease)
MC site of involvement for primary GI lymphoma
stomach
MC gastric infection
H. pylori
MC etiology of infection with a gas-performing organism that may cause gastric pneumatosis
E. coli
MC causes of emphysematous gastritis
caustic ingestion and alcohol abuse
Most commonly performed weight loss surgery because of the increased weight loss when compared to other procedures
gastric bypass with Roux-en-Y gastrojejunostomy
Internal hernias w/ increased incidence in laparoscopic Roux-en-Y gastric bypass are most commonly through the?
transverse mesocolon
MC location of duodenal diverticula (most are acquired)
2nd and 3rd portions
MC congenital abnormality in the GIT / MC congenital anomaly of the GIT
Meckel diverticulum
MC congenital anomaly of the GIT
Meckel diverticulum
MC presentation of Meckel diverticulum in the adult
obstruction
Small bowel diverticula are more common in the?
jejunum
MC benign tumor of the small bowel
GIST
MC site of malignant GISTs in the small bowel
distal small bowel
MC primary tumor in the small bowel / 2nd MC small-bowel malignancy
carcinoid / carcinoid (neuroendocrine) tumor
MC primary tumor of the duodenum
adenocarcinoma (rare in the remainder of small bowel)
Up to 70% of small bowel adenoca occur in the?
duodenum or jejunum
MC location of adenocarcinoma of the small bowel (rare)
duodenum, especially near the ampulla
MC appearance of hematogenous metastases in the small bowel (often from lung ca and melanoma)
round masses along the antimesenteric border of the small bowel
Peritoneal carcinomatosis is most commonly seen in?
ovarian, colon, gastric, and breast
Account for almost 75% of SBO
adhesions > hernias and tumor
2nd MCC of small-bowel obstruction, next to adhesions
hernias
MC lesions producing obstruction
adhesions, hernias, and intussusception
Strangulation is most commonly seen in the setting of?
closed-loop obstruction
MCC of closed-loop obstructions
internal hernias or an adhesive band
Mural edema (in vasculitis) can occur throughtout the GIT, most commonly in the?
small bowel
MC inflammatory condition of the small bowel
Crohn disease
MCC of intramural hematoma of the small bowel (?)
overanticoagulation
Most commonly affected site in GIT in patients with amyloidosis
small bowel
MC rotational abnormality
nonrotation of the bowel
MC benign tumor of the colon and rectum
adenoma
2nd MC benign tumor in the colon
lipoma
Segment involved in the majority of cavernous hemangioma of the colon
rectum
3rd MC cancer / 2nd MCC of cancer death in developed countries
colorectal ca
MC primary in metastatic disease involving the colon
ovarian (peritoneal seeding) (*hematogenous - lung and breast)
MC appendiceal tumor / MC neoplasm of the appendix
carcinoid / carcinoid tumor
MC location of carcinoid (neuroendocrine) tumors
appendix (50%) > mesenteric small bowel (20%)
MC location of carcinoid tumor of the appendix
distal third (most cause no symptoms)
MC site of diverticulitis
sigmoid colon
Most commonly involved site in Crohn colitis
right colon and rectum
Most widely accepted terminology in perianal fistulas
Parks classification
MCC of ischemic colitis
small vessel disease
Ischemic colitis occurs most commonly in the setting of?
low cardiac output in a patient with extensive but nonocclusive vascular disease
MC locations affected in ischemic colitis / Most commonly affected segments in ischemic colitis
splenic flexure (watershed between SMA and IMA) and rectosigmoid colon (watershed between IMA and inferior hypogastric arteries) / watershed areas at the splenic flexure and rectosigmoid
MCC of pseudomembranous colitis
Clostridium difficile (in the setting of antibiotic therapy)
Toxic megacolon most commonly occurs in the setting of?
ulcerative colitis
Findings of radiation colitis are most commonly seen in the?
pelvis (cervical or prostate ca)
Cecum in cecal volvulus lies most often in what quadrant?
LUQ
2 MC variations in the hepatic arterial anatomy
origin of the left hepatic artery from the left gastric artery and origin of all or some right hepatic artery branches from the SMA
MC site of incomplete accessory hepatic fissures formed by invaginations of the diaphragm
right lobe superiorly
MC anomaly of the liver
Riedel’s lobe
Most important patient-related factor affecting the magnitude of hepatic ontrast enhancement
body weight
2nd MC benign hepatic tumor / Tumor most resembling fibrolamellar HCC
FNH
Most specific finding of focal nodular hyperplasia
normal or increased radionuclide uptake within the tumor on technetium-99m sulfur colloid-labeled liver scan
Most characteristic feature of an adrenal rest tumor
presence of fat
5th MC cancer worldwide / Accounts for 90% of primary malignant hepatic neoplasms
HCC (10% - intrahepatic cholangio)
MC pattern of HCC on gross pathology
nodular > massive > diffuse/diffusely infiltrating (least common)
Most sensitive pre-operative imaging test for detecting small HCCs / Most sensitive imaging method for pre-op staging of hepatic metastases
computed tomography arterial portography (CTAP)
MC enhancement pattern of hepatic metastases in arterial phase imaging
continuous ring-like enhancement at the periphery of the lesion
Calcification occurs most commonly in hepatic metastases from what primary?
mucinous colon carcinoma
MC complications after tumor ablation
pneumothorax, pleural effusion, hepatic abscess, intrahepatic or peritoneal hemorrhage, and bile duct injuries resulting in stricture, fistula, or intrahepatic biloma (less common: segmental hepatic infarction)