Radiology

Question 1

On what scan is the pituitary well seen?

Answer 1

MRI

Question 2

Where is the pituitary found?

Answer 2

In sella turica
Closely related to sphenoid sinus
Found inferior to optic chiasm and hypothalamus

Question 3

How is the pituitary connected to the brain?

Answer 3

Pituitary stalk

Question 4

Where do the carotid arteries lie in relation to the pituitary?

Answer 4

Laterally

Question 5

What is the thyroid gland well visualised on?

Answer 5

CT
USS
Nuclear medicine

Question 6

Where is the thyroid in relation to the common carotid arteries and the internal jugular veins?

Answer 6

Medial

Question 7

When is a thyroid USS used?

Answer 7

Euthyroid patients with goitre/palpable nodules

Hyperthyroud patients with focal masses/radioisotope uptake

Question 8

What chemicals are used for thyroid scintigraphy?

Answer 8

Iodine-123
OR
Tc 99m:
     - Used in Ninewells
     - Injected IV -> Patient imaged after 20 mins

Question 9

What are scintigraphy images assessed for?

Answer 9

Pattern and quality of tracer uptake

Question 10

Homogenously increased tracer uptake, >3% of total tracer in gland. What condition is this seen in?

Answer 10

Grave’s disease

Question 11

Homogenously reduced tracer uptake?

Answer 11

Thyroiditis

Question 12

Focal uptake right upper pole.

Answer 12

Multi-nodular goitre with dominant nodule

Question 13

What scans are the adrenal glands readily seen on?

Answer 13

CT

MRI

Question 14

Where does the right adrenal gland lie?

Answer 14

Posterior to IVC

Question 15

Where does the left adrenal gland lie?

Answer 15

Lateral to aorta

Lateral to left diaphragmatic crus

Question 16

How do long bones start developmentally and what happens?

Answer 16

Start as cartilage

Undergo endochondral ossification

Question 17

Where do cartilaginous bones ossify first and then second?

Answer 17

First -> Within diaphysis

Second -> Within epiphysis

Question 18

How is bone girth increased?

Answer 18

By cells from the periosteum laying down circumferential new bone on periphery of existing cortex

Question 19

What condition is characterised by diffusely brittle bones?

Answer 19

Osteoporosis

Question 20

What conditions are characterised by diffusely soft bones?

Answer 20

Rickets/Osteomalacia

Paget’s Disease

Question 21

What are some radiographic features of Rickets?

Answer 21

Non-ossification of soft osteoid
Widened growth plates
Irregular, flat metaphyses

Question 22

What are some radiographic features of Osteomalacia?

Answer 22

Non-ossification of soft osteoid

Poor cortico-medullary differentiation

Question 23

What are some radiographic features of Paget’s Disease?

Answer 23

Initial lytic phases -> Well defined lucencies
Later slcerotic phase:
     - Enlarged bone
     - Increased density
     - Coarse trabecular pattern

Question 24

What is seen in lytic bone destruction?

Answer 24

Medullary lucency and loss of trabeculae
Loss of inner cortex (endosteum)
Complete loss of cortex
Loss of both cortices

Question 25

What is seen in a sclerotic bone lesion?

Answer 25

Subtle medullary density and loss of trabeculae
Spreading zone of density which includes cortex
Featureless white bone
Expansion beyond normal bone limits, with cortical destruction