Radiology 1 Flashcards

1
Q

How to calculate the estimated height of a child?

A
  1. Add mother and father’s height in cm
  2. Add 13 cm for boys or subtract 13 cm for girls
  3. Divide by 2

Child (at the puberty) should fall into the centile that is above or below 8 cm from the above target/estimated height

*children with parents having very different heights (e.g. very short and very tall) tend to go either way

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2
Q

Ix in case of suspected congenital hypothyroid

A

If TSH elevated on skin prick test:

1. If elevated >10 → start treatment with thyroid hormone

2. If elevated but no too much → test for T3 and T4 and if low then start treatment

*also radiological Ix e.g. USS scan in order to detect any anatomical abnormalities of thyroid gland

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3
Q

What’s a depression of diaphragm sign of on CXR?

A

Tension pneumothorax

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4
Q

What’s that?

A

Pneumomediastinum

Thin parietal pleural layer stripped of mediastinum as gas gets into mediastinal compartment

Causes: ruptured oesophagus, asthma, barotrauma, hyperventilation (e.g. in metabolic acidosis)

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5
Q

What’s continuous diaphragm sign?

A

If gas between heart and diaphragm → sign of pneumomediastinum

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6
Q

What’s that?

A

Middle lobe consolidation → pneumonia

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7
Q

What’s that?

A

Right lower lobe consolidation e.g. in pneumonia

We know it’s R lower lobe, as lower lobe has the same radiographic density as hemidiaphragm

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8
Q

What’s that?

A

Lingular consolidation pneumonia

Obscuration of a heart border with a diaphragm intact

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9
Q

What’s the diagnosis?

A

Bilateral perihilar airspace shadowing

Pneumocystic jiroveci pneumonoa

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10
Q

What’s that?

A

Ground glass perihilar airspace shadowing = pneumocystis jiroveci pneumona

  • tends to spare peripheries and bases
  • no lymphadenopathy
  • no pleural effusions
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11
Q

What’s that?

describe CXR

A

COVID-19 pneumonia

  • bilateral consolidation (either symmetrical or asymmetrical)

*but diagnosis should be made by PCR

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12
Q

Diagnosis

A

Miliary TB

  • lots of nodules (no larger than 3 mm)

*but diagnosis made together with clinical features

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13
Q

What are Kerley B lines?

A

Areas of the interlobular septum (so the gaps between individual lobules) which fill with fluid that oozes out of pulmonary veins

  • sign of HF
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14
Q

(2) findings on this CXR

A
  • Kerley B lines
  • early alveolar and interstitial pulmonary oedema
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15
Q

How do Kerley B lines happen?

A

Oozing out from pulmonary veins into interlobular septa

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16
Q

What’s Bat’s wing sign?

A

It’s alveolar pulmonary oedema

*usually with small bilateral pleural effusions

17
Q

(2) findings

A
  • Bat’s wing → pulmonary oedema
  • wrongly placed NG tube
18
Q

What’s lamellar ‘pleural’ effusion?

A

Lamellar ‘pleural’ effusion

It’s actually not a pleural effusion, it’s a fluid oozing out of intralobular septa into the gap between visceral pleura and the lung

*sign of a HF

19
Q

What’s that?

A

Left Lower Lobe collapse

  • Sail sign behind cardiac shadowing
  • Remaining lung looks less dense than on the R

*most likely cause in an adult pt is endobronchial cancer

20
Q

What’s that?

A

Left upper lobe collapse

  • increased density over the lung field
21
Q

What’s that?

A

R MIDDLE lobe collapse

Middle lobe collapse is:

  • denoted by a shallow, wedge-shaped opacity
  • R heart border is lost
  • often seen in asthmatics (mucous plague), possible in an endobronchial tumour
22
Q

What’s that?

Requirements for that

A

Correctly placed NG tube

  • it should go through oesophageal junction into the stomach
  • it should bisect carina

*x-ray quality needs to be good, it needs to be well-centered and not rotated

23
Q

Requirements for confirmation of correct NG tube placement (CXR)

A
  • it should go through oesophageal junction into the stomach
  • it should bisect carina
  • it should take a left turn as it enters gastro-oesophageal junction

*x-ray quality needs to be good, it needs to be well-centred and not rotated

*if we are not sure → NEVER feed the patient, eek advice from radiologist, senior doctor

24
Q

What’s that?

A

Misplaced NG tube

*there is also a pulmonary oedema

  • it goes to R main bronchus and R lower lobe bronchus
  • it needs to be pulled out immediately and replaced
25
Q

Is that NGT placed correctly?

A

There is a deviation to the R at the level of the carina

(always be suspicious if NGT is not bisecting carina and heading to the left)

Another exposure: tube is in R lower lobe

26
Q

What may happen if NGT is placed incorrectly and when it went too far?

A

Be prepared to expect PNEUMOTHORAX

27
Q

Describe + possible causes

A

‘Whiteout‘→ opacification of L hemithorax

Look at the previous film it that was + know the history:

  • Actue change: pneumonia, pleural effusion (including hemothorax), and collapse/atelectasis
  • Longstanding possible pneumonectomy
28
Q

Interpret

A

Subtle pneumoperitoneum on erect CXR

*surgical clips can be seen so the possible cause is laparotomy

29
Q

Interpret

A

Flail segment → fracture of two or more ribs in two or more places

30
Q

What’s that?

A

Large pleural effusion