Page 8 Flashcards
SPIDER WEB pattern of collateral VEINS and LYMPHATICS
Budd-Chiari syndrome
alternating web-like stenoses and aneurysms
(medial) fibromuscular dysplasia
Presents with very large aneurysmal aortic root with sinotubular ectasia
Aortitis - Marfan syndrome
Infectious process with the following pattern of LN involvement where 1 = right paratracheal, 2 = right hilar, and 3 = left hilar LN enlargement
sarcoidosis
solid round mass within an upper lobe cavity with an air crescent separating the mycetoma from the cavitary wall
aspergilloma
Parasitic pulmonary infection wherein if the cyst develops a communication with the bronchial tree and the pericyst ruptures, a thin crescent of air will be seen around the periphery of the cyst
pulmonary echinococcal cyst
collapsed/crumpled cyst wall floating on top of the fluid within an uncollapsed pericyst
ruptured pulmonary echinococcal cyst
dense opacities occupy the central / perihilar regions of lung and extend laterally to abruptly marginate before reaching the peripheral portions of the lung
airspace disease (almost exclusively,
individually opacified lobules / interspersion of normal and diseased lobules
airspace processes, most clasically
confluent bilateral dense micronodular opacities that, because of their high intrinsic density, produce the black pleura sign at their interface with the chest wall
alveolar microlithiasis
volume of involved lobe may be increased by exuberant inflammatory exudate
Kleb. pneumoniae
narrowing or waist of the diaphrgm on the herniated viscus
traumatic diaphragmatic hernia
contact between the posterior ribs and the liver (right-sided injury) or stomach (left-sided)
traumatic diaphragmatic hernia
curvilinear bronchovascular bundle entering the anterior inferior margin / hilar aspect of the mass
rounded atelectasis / folded lung
air dissects between the pericardium and central diaphragm below to allo visualization of the central portion of the diaphragm in continguity with the right and left hemidiaphragms
pneumomediastinum (may be seen in pneumopericardium)
spiculated margins; linear densities radiating from the edge of the nodule into the adjacent lung
highly suspicious for malignant nodule
suggestive of malignant nodule
geographic ground glass opacities superimposed upon thickened interlobular and intralobular septa / reticulation
pulmonary alveolar proteinosis, pulmonary edema (mc) particularly permeability edema, atypical pneumonia, pulmonary hemorrhage, rarely bronchoalveolar cell ca
filling of the airspaces with mucoid material produced by the malignant cells creates low-density airspace opacification surrounding the enhanced pulmonary arteries that traverses the consolidated regions
diffuse form of bronchioloalveolar ca (also seen in other airspace-filling diseases, bacterial pneumonia,
lymphoma, and lipoid pneumonia)
zone of relative decreased attenuation surrounding a dense, mass-like opacity
invasive aspergillosis
lateral costophrenic sulcus appears abnormally deep and hyperlucent
pneumothorax
visualization of the anterior costophrenic sulcus owing to air anteriorly and inferiorly as the dome and anterior portions of the diaphragm are outlined by lung and air, respectively
pneumothorax
peripheral lung markings are accentuated
chronic bronchitis
tumor extension from the paravertebral space into the spinal canal via an enlarged intervertebral foramen
neurofibroma
rare causes: sarcoidosis, Hodkin’s lymphoma (after irradiation), histoplasmosis, amyloidosis, and TB; also, scleroderma (mediastinal)
mc: silicosis and coal dust exposure
subtended lung remains collapsed against the lateral chest wall
tracheobronchial injury
buckling of posterior tracheal membrane
tracheobronchomalacia
density through which the normal hilar vessels can be seen
mass superimposed on the hilum
vascular structures that converge only as far as the lateral margin of the increased hilar density
enlargement of intrahilar vessels
when viewed en face, appear as geographic areas of opacity
pleural plaques
cystic spaces 0.3-1 cm in diameter whose walls consist of fibrous tissue
mc: IPF, connective tissue disease, and sarcoidosis
tracheal stenosis
incomplete septation of the cartilage rings producing a long segment tracheal narrowing
congenital tracheal stenosis
small intraluminal but large extraluminal soft tissue component
carcinoid tumor of the central bronchi
small, sharply defined triangular opacity that projects upward from the medial half of the hemidiaphragm at or near the highest point of the dome, usually related to cephalic displacement of an inferior accessory fissure
RUL or LUL atelectasis (less common: RML)
overinflated superior segment of the lower lobe occupies the space vacated by the apical segment; apex of the hemithorax contains aerated lung. Sometimes, this lower lobe segment inserts itself medially between the apex of the atelectatic upper lobe and the mediastinum, allowing visualization of the aortic arc. The overinflated superior segment is seen as crescent of hyperlucency.
LUL atelectasis (also RUL but less common)
small airways disease (indirect sign), pulmonary arterial occlusive disease, PCP, DIP
involvement of the peripheral portion of the cartilage and has the appearance of two fingers
male costal cartilage
hamartoma
patchy ground-glass opacities surrounded by crescentic regions of more dense consolidation
COP but not specific
osteogenesis imperfecta and NF1
if overcirculation, TA; if undercirculation, TOF
associated with truncus arteriosus and TOF
central convex mass partially preventing the usual fissure concavity seen in RUL atelectasis; downward bulge is in the medial portion of the minor fissure
mass causing RUL atelectasis (any lobe
dilated thick-walled circular lucency with an adjoining smaller pulmonary artery (*if mid-lung, tram tracks)
cylindric bronchiectasis (upper and lower
empyema
thickened intralobular lines
IPF, UIP, alveolar proteinosis
varicose bronchiectasis
cystic bronchial dilatatation interrupted by focal areas of narrowing
varicose bronchiectasis
clusters of rounded lucencies, often containing air-fluid levels
cystic/saccular bronchiectasis
if the thoracic inlet mass is posterior or paravertebral in location, it is sharply outlined by the apical lung (in contrast to the anteriorly located thoracic inlet mass whose lateral border above the clavicle is indistinct)
posteriorly located thoracic inlet mass
rare; localized PERIPHERAL OLIGEMIA w/ or w/o distended proximal vessels
pulmonary embolism (pulmonary thromboembolism w/o hemorrhage or
infarction)
enlargement of a major pulmonary artery
pulmonary thromboembolism w/o hemorrhage or infarction
abrupt tapering of vesse
pulmonary thromboembolism w/o hemorrhage or infarction
wedge-shaped consolidation
pulmonary thromboembolism w/
infarction
stripes of intraluminal contrast media trapped b/w nodular areas of wall thickening
Pseudomembranous colitis
constricting lesion, markedly narrowing the lumen
colon ca
decreased or absent folds in fundus and body
atrophic gastritis
Primary Sclerosing cholangitis
alternating areas of dilatation and constriction of the main pancreatic duct
Chronic pancreatitis
Achalasia
tightly twisted mesentery
Small bowel volvulus
Small bowel volvulus
barium coating of a polyp when viewed obliquely
colonic polyp
produced by acute angle of attachment of polyp to the mucosa
gastric polyp
polyp, diverticula
two concentric rings produced by visualizing a pedunculated polyp end-on
pedunculated polyp
large flat-based ulcer with heaped up edges that fold inward to trap a lens-shaped barium convex toward the lumen
Malignant gastric ulcer
air bubbles rise to the highest point of contrast column (while fecal materila remains dependent)
colonic air bubbles
enhancing fibrovascular bundles centered within many of the dilated ducts; patulous bile ducts surrounding the portal veins
Caroli disease / Caroli intrahepatic ductal ectasia
Eosinophilic gastroenteritis
deep ulcerations forming fissures between nodules of elevated edematous mucosa; transverse and longitudinal fissuring of the mucosal surface with extension of knifelike clefts into the submucosa and muscularis propria; carpet of nodules in the luminal surface
Crohn disease
fibrofatty infiltration around inflamed bowel segments with engorged mesenteric vessels forming the comb
Crohn disease
luminal narrowing particularly in the terminal ileum due to fibrosis and progressive wall thickening
Crohn disease
Crohn colitis
cecal volvulus
barium trapped between intussusceptum and receiving bowel
Intussusception
most often in the RUQ
Intussusception
deeper ulcerations of thickened edematous mucosa w/ crypt abscesses extending into submucosa
ulcerative colitis
Adenomyomatosis
bright fluid within the Rokitansky-Aschoff sinuses
Adenomyomatosis
intrahepatic venous collaterals
Budd-Chiari syndrome
bright inner, dark middle, bright outer rings
benign small bowel disease
fissures within gallstones containing nitrogen gas appearing as branching linear lucencies
Gallstones
stone layer dependently within, allowing a crescent of bile to outline the anterior portion of the stone
stone within the bile duct
posterior wall of the aorta cannot be identified and is closely applied to the spine
impending rupture of aortic aneurysm
dilatation of both CBD and pancreatic duct in the head of pancreas usually caused by a tumor at the ampulla
tumor at the ampulla
numerous ineffective tertiary contractions throughout the esopahgus
Diffuse esophageal spasm
tiny bubbles at the top of the barium column
fulminant Candida esophagitis
barium forms tracks paralleling the colon lumen and often connecting multiple perforated sacs
colonic diverticulitis
dark inner, bright outer rings
benign small bowel disease
hemorrhage in mural thrombus or in the wall of the aneurysm
impending rupture of aortic aneurysm
band-like peripheral enhancement
Liver metastases
multiple regular, thin, transverse folds in the esophagus
suggestive esophagitis
fatty liver dark on CT and bright on US
Fatty liver
arterial = central liver enhance prominently, weak peripheral enhancement; delayed = periphery of liver enhanced while washed out central liver
Budd-Chiari syndrome
thinned folds tethered together
scleroderma
oblique lines created by orientation of the transition zones
Sigmoid volvulus
medial displacement of the lateral edge of the liver
ascites (usually massive, more commmonly malignant)
soft tissue infiltration of the mesentery
Sclerosing mesenteritis
high signal focus within a low intensity nodule (high signal focus avidly enhances on arterial phase)
HCC developing from dysplastic nodule
apex of distended sigmoid colon may extend cephalad to transverse colon
Sigmoid volvulus
tumor nodules in on peritoneal surfaces
Peritoneal mesothelioma/ metastases
inflammation surrounding central fat
epiploic appendagitis
confluent enlarged lymph nodes engulfing mesenteric vessels but sparing the rind of fat surrounding the vessels
mesenteric lymphoma
series of ring-like strictures
eosinophilic esophagitis
barium trapped in the clefts between fronds
villous tumors of the stomach
masses of retroperitoneal nodes may sillhouette segments of the normally echogenic wall of the aorta
masses of retroperitoneal nodes
regular pattern of thickened folds
Intramural hemorrhage of duodenum
row of small gas bubbles oriented horizontally or obliquely across the abdomen
Small bowel obstruction
radiating soft-tissue density in the mesenteric fat due to mesenteric fibrosis
carcinoid tumor (SI)
stiff narrowed stomach
Scirrhous carcinoma/linitis plastica
multiple nodular defects along the colon
ischemic colitis (also seen in pseudomembranous colitis)
barium-filled sock within lumen of descending duodenum
Intraluminal duodenal diverticula
eroded femoral neck due to pressure erosion of multiple non-ossiified loose bodies in the joint
non-ossified synovial
flexion at the PIP and hyperextension at the DIP
RA
hyperextension at the PIP and flexion at the DIP
RA
flexion at the MCP and hyperextension at the IP
RA
radial deviation of the wrist and ulnar deviation at the MCP
RA
normal body of the meniscus
vertical longitudinal tear that can result in the inner free edge of the meniscus becoming displaced into the intercondylar notch
Arachnoiditis (type III)
divison of the tendon into 2 parts
ongitudinal split tear of the peroneus
Arachnoiditis (type II)
slight overlap of the humeral head with the glenoid
normal AP shoulder
fragmentation and compaction of subchondral bony fracture debris leading to the development of a subchondral lucent area along the fracture line
eg)osteonecrosis of the femoral head
line of low signal intensity reflecting bone sclerosis and an inner zone of high signal intensity indicating granulation tissue. Chemical shift misregistration artifact contributes to the double line sign.
osteonecrosis
focal radiodense areas in the cranial vault
Paget’s disease (inactive osteosclerotic)
condensation of bone which are prominent along the contours of the vertebral body
Paget’s disease (inactive osteosclerotic)
uniform increase in osseous density which can also be seen in mets or lymphoma
Paget’s disease (inactive osteosclerotic
biconcave/step-off deformities
Paget’s disease, osteoporosis, osteomalacia, and hyperparathyroidism
funnel-like defect through a vertebra dividing it into right and left halves
hyperextension of the MTP joint and flexion of the PIP and DIP joints
OA (of the IP joints of the toes)
hyperextension of the MTP, flexion of the PIP, and hyperextension of the DIP
OA (of the IP joints of the toes)
MTP is in a neutral position and there is flexion of the PIP and DIP
OA (of the IP joints of the toes)
concaviity on the inferior surface of the lower lumbar vertebrae
normal
flexion of the DIP
OA (of the IP joints of the toes)
steplike central depression of the endplates
sickle cell anemia, Gaucher’s disease
single centrl radiodense line related to ossification of the supraspinous and interspinous ligaments
ankylosing spondylitis
3 vertical radiodense lines related to ossification of the supraspinous and interspinous ligaments and apophyseal joint capsules
ankylosing spondylitis
pathognomonic
sickle cell anemia
sclerotic bands at the vertebral body endplates
hyperparathyroidism / renal osteodystrophy
renal osteosclerosi
endplates are densely sclerotic (to differentiate from rugger jersey spine, sandwhich vertebrae appearance is much denser and more sharply defined)
osteopetrosis
vertebrae have a small replica of the vertebral body inside the normal one
osteopetrosis
Intrauterine rubella
area of increased uptake corresponding to the reactive sclerosis + second area of increased uptake corresponding to the nidus
osteoid osteoma
piece of cortex breaks off after a fracture and sinks to the gravity-dependent portion of the lesion
solitary bone cyst
thinning and small areas of discontinuity or gaps
regional osteoporosis in RA
sharp leading edge of the lytic lesion
lytic phase of Paget disease
thickened cortical new bone that accumulates near the ends of long bones, usually on one side
melerheostosis
unilateral closure of sagittal suture
premature synostosis of multiple sutures, frequently accompanied by hypoplasia of the midportion of the face, hydrocephalus, and mental retardation
bilateral sacral stress fracture
Leprosy (Hansen’s disease)
spinal subdural hematoma
Plasmacytoma involving a vertebral body; tendency to spare some of the bone, leaving struts of cortical bone and giving the appearance of a cut brain specimen
plasmacytoma/multiple myeloma
lunate or perilunate dislocation
costochondral junctions of the middle ribs
rickets
anterior bowing of the lower part of the leg due to the strong posterior pull of the Achilles tendon on the calcaneus
rickets (infancy and early childhood),
continued accumulation of osteoid in the frontal and parietal regions resulting in a squared configuration
rickets (first months of life)
intrusion of the hip and spine into the soft pelvis
rickets (increasing age
superior and outward displacement of the anterior fat pad
hypertrophied terminal tufts of the distal phalanges
acromegaly
(+) space between navicular and lunate
rotatory subluxation of the navicular
short tubular bones of the extremities with marked metaphyseal widening
metatropic dysplasia
large trochanters, typically the lesser trochanter, especially in infancy
metatropic dysplasia
metatropic dysplasia
particularly characteristic site of erosion in the medial surface of the proximal tibial shaft
Congenital syphilis
