1
Q
How does pneumoperitoneum appear on an erect XR?
Supine XR?
A
Erect - Free gas under diaphragm or liver
Supine - Gas outlines both sides of bowel wall (White line)
Oval gas over liver or hyper lucent liver
2
Q
What are the differentials for pneumoperitoneum?
A
Perforation (Peptic ulcer, Inflammation, Infarcted bowel)
Malignant neoplasm
Obstruction
Pneumatosis coli
Iatrogenic
Pneumomediastinum
Pneumothorax due to congenital pleuroperitoneal fistula
3
Q
How long does iatrogenic pneumoperitoneum remain?
A
Up to 3 weeks, and can be seen up to 14 days post surgery
4
Q
What are the differentials for a gasless abdomen in an adult?
A
Ascites
Pancreatitis (Acute) excess vomiting
Fluid filled bowel - closed loop SBO, Colitis
High obstruction - GOO or atresia
Large abdominal mass
Normal
5
Q
What are the differentials for upper 1/3rd oesophageal pouch/diverticulae?
A
Zenkers diverticulum
Lateral pharyngeal pouch and diverticulum
Lateral cervical oesophageal pouch and diverticulum
6
Q
What are the differentials for middle 1/3rd oesophageal pouch/diverticulae?
A
Traction diverticulae
Developmental
Intramural
7
Q
What are the differentials for lower 1/3 oesophageal pouch/diverticulae?
A
Epiphrenic
Ulcer
Mucosal tear
Post Hellers operation
8
Q
What are the differentials for oesophageal ulceration?
A
Inflammatory - Reflux oesophagitis, Barretts, Candida
Crohns disease
Viral or drug induced
Bechets disease
Intramural diverticulosis
Carcinoma
Leimyoma/Leimyosarcoma
Lymphoma
Melanoma
9
Q
What are the differentials for oesophageal strictures - Smooth
A
Inflammatory - Peptic, Scleroderma, Corrosive, Iatrogenic
Neoplastic - Carcinoma, Mediastinal tumours, Leiomyoma
Others - Achalasa, Skin disorders (Epidermolysis bulls, Pemphigus)
10
Q
What are the differentials for irregular oesophageal strictures
A
Neoplastic - carcinoma, Leiomyosarcoma, Lymphoma
Inflammatory - Reflux, Crohns
Iatrogenic - Radiotherapy, Fundoplication
11
Q
What are the differentials for tertiary contractions in the oesophagus
A
Reflux oesophagitis
Presbyoesophagus
Obstruction at the cardia
Neuropathy - Early achalasia, DM, Alcoholism
12
Q
What are the differentials for stomach masses and filling defects
A
Primary malignant neoplasm - Carcinoma, Lymphoma, GIST
Polyps - Hyperplastic, Adenomatous, Hamartomatous
Submucosal - Leiomyoma, Lipoma, Neurofibroma, Mets
Extrinsic indentation - Pancreatic tumour/pseudocyst, Splenomegaly/Hepatomegaly
Other - Nissen, Bezoar, Lymphoid hyperplasia
13
Q
What are the differentials for thick stomach folds and wall
A
Inflammatory - Gastritis, Zollinger Ellison syndrome, Pancreatitis
Infiltrative/Neoplastic - Lymphoma, Carcinoma, Eosinophilic gastroenteritis
Others - Menetriers disease, Varices
14
Q
What are the differentials for Linitis Plastica
A
Neoplastic - Gastric carcinoma, Lymphoma, Mets, Local invasion
Inflammatory - Corrosives, Radiotherapy, Crohns, TB, Eosinophilic enteritis
15
Q
What are the differentials for bulls eye lesion in stomach
A
Submucosal mets = Melanoma, Lymphoma, Breast/Bronchus/Pancreas, Carcinoid
Leiomyoma
Pancreatic rest
Neurofibroma
16
Q
What are the differentials for decreased/absent duodenal folds
A
- Scleroderma (often with dilatation)*.
- Crohn’s disease*.
- Strongyloides.
- Cystic fibrosis*.
- Amyloidosis.
17
Q
What are the differentials for duodenal mural/fold thickening or mass
A
Neoplastic - Adenocarcinoma, Lipoma, Adenoma, GIST, Lymphoma
Inflammatory - Duodenitis/Ulcer, Crohns disease, Groove pancreatitis
Varices, Diverticulum
18
Q
What are the differentials for dilated small bowel with normal folds
A
- Mechanical obstruction
- Paralytic ileus
- Coeliac disease, dermatitis herpetiformis, tropical sprue
- Scleroderma.
- Iatrogenic – vagotomy and gastrectomy may produce dilatation
due to rapid emptying of stomach contents.
19
Q
What are the differentials for dilated SB with thick folds
A
- Ischaemia.
- Crohn’s disease* – combination of obstructive and inflammatory
changes. - Radiotherapy.
- Lymphoma*.
- Zollinger–Ellison syndrome
- Extensive small bowel resection
- Amyloidosis.
20
Q
What are the differentials for strictures in the SB
A
- Adhesions
- Crohn’s disease*
- Ischaemia
- Radiation enteritis
- Tumours - Lymphoma, Carcinod, Carcinoma, Mets
- Endometriotic deposits
21
Q
What are the differentials for thickened folds in non-dilated SB, smooth and regular
A
Vascular - Intramural haematoma, Ischaemia
2. Radiotherapy
3. Oedema - Acute inflammation, Hypoproteinemia (Renal or liver disease) , Venous obstruction
Early infiltration - Amyloid, Eosinophilic enteritis
4. Coeliac disease
22
Q
What are the differentials for thickened SB folds, non-dilated irregular and distorted (Localised)
A
Inflammatory - Crohns disease, Zollinger Ellison
Neoplastic - lymphoma, Mets, Carcinoid
Infective - TB
23
Q
What are the differentials for thickened SB folds non-dilated irregular and distorted and widespread
A
Infiltrative - Amyloidosis, Eosinophilic enteritis, Macrocytosis
Inflammatory - Crohns disease
Infestations -Giardiasis, Strongyloides
24
Q
What are the differentials for SB mural thickening with avid contrast enhancement
A
Ischaemia - shock bowel
Acute IBD
Malignancy
25
What are the differentials for SB mural thickening with moderate homogenous contrast enhancement
Chronic IBD
Chronic ischaemia
Chronic radiation enteritis
Malignancy
26
What are the differentials for SB mural thickening with moderate heterogenous enhancement
Malignancy
GIST
Endometriosis
Lymphoma
27
What are the differentials for SB mural thickening with layered enhancement
IBD
Ischaemia
Vasculitis
Angioedema
Infection
28
What are the differentials for multiple nodules in the SB
Inflammatory - Nodular lymphoid hyperplasia, Crohns disease
Infiltrative - Whipples, Waldenströms macroglobulinema, Macrocytosis
Neoplastic - Lymphoma, Polyposis - PJ, Gardeners, Canada Cronkhite, Metastases
Infective - Typhoid, Yersinia
29
What are the differentials for polyposis syndromes causing SB nodules
Peutz-Jeghers syndrome
Gardners syndrome
Canada Cronkhite syndrome
30
What are the differentials for lesions in the terminal ileum
Inflammatory - Crohns disease, UC, Radiation enteritis
Infective - TB, Yersinia, Actinomycosis
Neoplastic - Lymphoma, Carcinoid, Mets
Ischaemia
31
What are the differentials for colonic polyps
Adenomatous - Simple, tubovillous, or villous
Familial polyposis coli
Gardner syndrome
Hyperplastic - Solitary/multiple, nodular lymphoid hyperplasia
Hamartomatous - Juvenile polyposis, Peutz jeghers, Inflammatory - UC, Crohns
Infective - Schistosomiasis, Amoebiasis
32
What are the differentials for colonic strictures
Neoplastic - carcinoma, Lymphoma
Inflammatory - UC, Crohns, Pericolic abscess
Ischaemia
Infective - TB, Ameoboma, Schistosomiasis
Extrinsic mass
33
What are the differentials for diffuse colitis
UC
CMV
E.Coli
Pseudomembranous colitis
34
What are the differentials for predominantly right sided colitis
Crohns
Salmonella
TB
Yersinia
Amoebiasis
Typhilitis
Ischaemic colitis
35
What are the differentials for predominantly left sided colitis
UC
Ischaemic colitis
Diverticulitis
Gonorrhoea, Lymphogranuloma venerum
Radiation
Epiploic appendigitis
36
What are the differentials for pneumatosis intestinalis
Benign - Idiopathic, Pulmonary - Asthma, COPD
Intestinal - Pyloric stenosis, Pseudoobstruction
Iatrogenic
Medication - steroids
Life threatening
1. Intestinal ischaemia.
2. Intestinal obstruction – especially strangulation.
3. Enteritis.
4. Toxic megacolon.
5. Trauma.
37
What are the differentials for Megacolon in adult
Non-toxic (No mucosal abnormalities)
1. Distal obstruction
2. Ileus
3. Pseudo-obstruction
Toxic (Mucosal abnormalities)
1. Inflammatory - UC, Crohns, Pseudomembranous colitis
2. Ischaemic colitis
3. Dysentry - Amoebiasis, Salmonella
38
What are the differentials for thumb printing in the colon
Colitides
1. Ulcerative colitis*.
2. Crohn’s disease*.
3. Ischaemic colitis
4. Pseudomembranous colitis.
5. Amoebic colitis.
6. Schistosomiasis.
Neoplastic
1. Lymphoma*.
2. Metastases
39
What are the differentials for Apthoid ulcers (Barium central with halo of oedematous mucosa)
In colon
1. Crohn’s disease*
2. Yersinia enterocolitis.
3. Amoebic colitis.
4. Ischaemic colitis.
5. Behçet’s disease
In small bowel
1. Crohn’s disease*.
2. Yersinia enterocolitis.
3. Polyarteritis nodosa.
40
What are the CT Signs of intestinal ischaemia
Vascular occlusion
Dilatation
Hyperenhancement
Reduced enhancement
Mural thickening
Mesenteric hyperattenuation
Pneumatosis
Gas in PV system
41
What are the differentials for increased mesenteric attenuation - misty mesentery
Inflammatory - Pancreatitis, Cholecystitis, Diverticulitis, TB, IBD
Haemorrhage
Oedema
Neoplastic - Lymphoma, Primary peritoneal malignancy, Secondary malignancy
Idiopathic - mesenteric panniculitis
42
What are the differentials for widening of the retrorectal space/presacral mass (>1.5 cm)
Normal variation (Obese pt)
Inflammatory - UC, Crohns, Radiotherapy, Diverticulitis, Abscess
Neoplastic - Carcinoma, Mets
Sacral tumours - Mets, Chordoma, Plasmacytoma
Retrorectal developmental cyst - Epidermoid, Dermoid, Enteric cyst
Anterior sacral meningocele
43
What are the differentials for retroperitoneal cystic mass
Pancreas - pseudocyst, cyst adenoma, VHL
Kidney mass
Para-aortic cystic nodes - Cervix carcinoma, Testicular teratoma
Retroperitoneal cystic tumour - Lymphangioma, Leimyosarcoma, Mullerian cyst
Haematoma, Abscess
44
What are the imaging methods of localising GI bleeding?
Tc99m labelled RBC - 0.2 ml/min
MDCT Angiogram - 0.3 ml/min
Conventional angiography - 0.5 ml/min
45
What are the differentials for non-malignant FDG uptake on PET in the abdomen
1. Attenuation correction artefacts.
2. Granulomatous disease – e.g. TB.
3. Abscesses.
4. Recent surgery – up to 6 weeks.
5. Foreign body.
6. Inflammation – diverticulitis, gastritis, pancreatitis.
7. Physiological uptake – liver, spleen, kidneys, bowel, urine.
8. Fat necrosis.
9. Retroperitoneal fibrosis.
10. Paget’s disease.
11. Bone marrow stimulation.
12. Brown fat – e.g. supra-adrenal.
46
What are the differentials for abdominal malignant with poor FDG PET avidity
Hepatoma
MALT lymphoma
Necrotic/metastatic mucinous adenocarcinoma
RCC
End stage pancreatic cancer
Prostate cancer
47
What are the differentials for filling defect in the GB
Multiple
1. Calculi
2. Cholesterosis
Single and small
1. Calculus
2. Adenomyomatosis
Single and Large
1. Calculus
2. Carcinoma
48
What are the differentials for biliary tract dilatation
Benign
1. Common bile duct stone.
2. Bile duct stricture.
3. Chronic pancreatitis
4. Mirrizzi’s syndrome.
5. Adenoma.
6. Iatrogenic – e.g. after cholecystectomy.
7. Bile duct cysts.
Malignant
1. Cholangiocarcinoma.
2. Periampullary carcinoma.
3. Gallbladder carcinoma.
4. Porta hepatis lymphadenopathy.
5. Parenchymal metastases.
6. Pancreatic carcinoma.
49
What are the differentials for thickened GB wall
1. Cholecystitis.
2. Hepatitis.
3. Hypoalbuminaemia.
4. Cirrhosis.
5. Congestive heart failure.
6. Renal failure.
7. Following rapid intravenous fluid resuscitation
50
What are the differentials for gas within the bile ducts
Incompetence of the sphincter of Oddi
1. Following sphincterotomy.
2. Following passage of a gallstone.
3. Patulous sphincter in the elderly.
Postoperative
1. Choledochoenterostomy.
2. Cholecystoenterostomy.
Spontaneous biliary fistula
1. Passage of a gallstone directly from an inflamed gallbladder
into the bowel
2. Duodenal ulcer perforating into the common bile duct
3. Malignancy or trauma
51
What are the differentials for gas within the gallbladder
same causes as within bile ducts
Emphysematous cholecystitis
52
What are the differentials for gas in the portal veins
Bowel infarction
Diverticulitis
Haemorrhagic pancreatitis
Pneumonia
Air embolus from barium enema (Double contrast)
Acute gastric dilatation
53
What are the differentials for hepatic calcification
Multiple and small - Healed granuloma
Curvilinear
1. Hydatid
2. Abscess
3. Porcelain GB
Localised in mass
1. Mets
2. Fibrolamellar HCC
3. Adenoma
Sunray spiculation
1. Haemangioma
2. Mets
3. Adenoma
Diffuse increased density - Haemochromatosis
54
What are the differentials for generalised hypoechoic liver on US
Acute hepatitis
Diffuse malignant infiltration
55
What are the differentials for generalised hyper echoic liver on US
Fatty infiltration
Cirrhosis
Hepatitis
Infiltration/deposition - malignant, TB, sarcoidosis
56
What are the differentials for focal hyper echoic liver on US
Mets
Haemangioma
Adneoma
FNH
Focal fatty infiltration
Debris within lesion
HCC
57
What are the differentials for focal hypoechoic US liver
Mets
Lymphoma
HCC
Cysts - benign, Hydatid
Abscess
Haematoma
Cavernous haemangioma
58
What are the differentials for periperotal hyper echoic change on US Liver
1. Air in biliary tree.
2. Schistosomiasis.
3. Cholecystitis.
4. Recurrent pyogenic cholangitis (oriental).
5. Periportal fibrosis.
59
What are the differentials for peri portal hypoechogenicity or hypo attenuation
Hepatic causes
1. Acute hepatitis/cholangitis.
2. Liver cirrhosis.
3. Abscess.
4. Tumour causing secondary lymphatic obstruction.
5. Orthotopic liver transplant rejection.
6. Trauma.
7. AIDS cholangiopathy.
Extrahepatic causes
1. Raised central venous pressure/cardiac failure.
2. Hypoproteinaemia.
3. Bacteraemia.
4. Periportal lymphadenopathy.
5. Acute cholecystitis.
6. Acute pancreatitis.
7. Inflammatory bowel disease.
60
What are the differentials for focal hyper enhancing lesion on CT liver (Arterial)
HCC
Haemangioma
FNH
Adenoma
Mets
61
What are the differentials for focal PV hyper enhancing lesion on CT liver
Haemangioma
HCC
Venous collaterals
62
What are the differentials for hyper enhancing lesion on equilibrium phase CT liver
Haemangioma
Cholangiocarcinoma
Solitary fibrous tumour
Treated mets
63
What are the differentials for focal hyaperdense lesion on CT liver pre-contrast
Calcification - Mets, Primary tumour, Infective lesion
Acute haemorrhage
64
What are the differentials for focal hyaperdense lesion on CT liver post contrast
Hypervascular mass - Mets, Adenoma, FNH
Arterioportal shunt in hepatoma
65
What are the differentials for generalised low attenuation pre-IV contrast
Fatty infiltration
Malignant infiltration
Budd Chiari
Amyloid
66
What are the differentials for generalised increase in attenuation pre-IV contrast
Haemochromatosis
Haemosiderosis
Iron overload
Glycogen storage disease
Amiodarone
67
What are the differentials for focal high T1 signal lesion on MR Liver
Fat
Blood
Proteinacious material
Melanoma mets
Chemical - Gad
Artefact
68
What are the differentials for ringed hepatic lesions on MR liver
Capsule of primary liver tumour
Metastases
Subacute haematoma
Hydatid cyst
Amoebic abscess
69
What are the differentials for liver lesions with central scar
FNH
Haemangioma
HCC - Fibrolamellar
Cholangiocarcinoma
Hepatic adenoma
Mets
70
What are the differentials for liver lesions with capsular retraction
Mets
HCC
Cholangiocarcinoma
Cirrhosis
Post trauma
Inflammatory pseudotumour
71
What are the differentials for splenomegaly
Huge spleen
1. Chronic myeloid leukaemia.
2. Myelofibrosis.
3. Malaria.
4. Visceral leishmaniasis
5. Gaucher’s disease.
6. Lymphoma*.
Moderately large spleen
1. All of the above.
2. Storage diseases.
3. Haemolytic anaemias.
4. Portal hypertension.
5. Leukaemias.
Slightly large spleen
1. All of the above.
2. Infections
(a) Viral – infectious hepatitis, infectious mononucleosis.
(b) Bacterial – septicaemia, brucellosis, typhoid and tuberculosis.
(c) Rickettsial – typhus.
(d) Fungal – histoplasmosis.
3. Sarcoidosis*.
4. Amyloidosis.
5. Rheumatoid arthritis (Felty’s syndrome)*.
6. Systemic lupus erythematosus*.
72
What are the differentials for splenic calcification
Curvilinear
1. Splenic artery atherosclerosis – including splenic artery
aneurysm.
2. Cyst – any long-standing cyst, including hydatid or post-traumatic.
Multiple small nodular
1. Phleboliths – may have small central lucencies.
2. Haemangioma – phleboliths.
3. Tuberculosis.
4. Histoplasmosis.
5. Brucellosis.
6. Sickle-cell anaemia*.
Diffuse homogeneous or finely granular
1. Sickle-cell anaemia*.
2. Pneumocystis jiroveci (previously Pneumocystis carinii)
Solitary > 1 cm
1. Healed infarct or haematoma.
2. Healed abscess.
3. Tuberculosis.
73
What are the differentials for solid splenic lesion
. Lymphoma.
2. Metastases – especially melanoma, lung and breast.
3. Langerhans’ cell histiocytosis.
4. Hamartoma.
5. Haemangioma
6. Sarcoid.
74
What are the differentials for cystic splenic lesion
1. False cyst (80%) – usually past history of trauma.
2. Congenital cyst.
3. Abscess (pyogenic).
4. TB.
5. Echinococcus infection.
6. Epidermoid cyst.
75
What are the differentials for pancreatic calcification
Alcoholic pancreatitis
Pseudocyst
Hyperparathyroidism
Cystic fibrosis
Kwashiorkor
Hereditary pancreatitis
Tumours
76
What are the differentials for cystic pancreatic lesion
Pseudocyst
Serous cyst adenoma
Mucinous cystic neoplasm
Intraductal papillary mucinous neoplasm
Solid pseudo papillary neoplasm
True cyst
Cystic metastases
Pancreatic abscess
77
What are the differentials for solid pancreatic mass
Adenocarcinoma
Focal pancreatitis
Metastases
Islet cell tumour - Insulinoma, Gastrinoma, Glucagonoma
78
What are the imaging findings for crohns disease
Small bowel
Terminal ileum most common site
Asymmetrical involvement and skip lesions (Mesenteric border)
Apthoid ulcers
Fissure ulcers
Blunting, thickening or distortion of the valvulae conniventes
Cobblestone pattern - Longitudinal and transverse fissure ulcers bounding intact mucosa, bulging oedematous mucosal folds
Separation of bowel loops
Strictures
Pseudosacculation
MRI - T2 high signal, early enhancement, slow or absent motion and restricted diffusion
Colon
Asymmetrical involvement and skip lesions, may involve rectum
Apthoid ulcers
Cobblestone pattern
Strictures
Pseudosacculation
Inflammatory pseudopolyps
Thickened, narrowed or ulcerated IC valve
Complications
Fistulation
Perforation
Toxic megacolon
Lymphoma
79
What are the imaging findings of cushings syndrome
1. Growth retardation in children.
2. Osteoporosis.
3. Pathological fractures which show excessive callus formation
during healing; vertebral end-plate fractures, in particular, show
prominent bone condensation.
4. Avascular necrosis of bone.
5. Increased incidence of infection
–
including osteomyelitis and
septic arthritis (the knee is affected most frequently).
6. Hypertension.
7. Water retention resulting in oedema.
80
What are the imaging findings of cystic fibrosis
Thoracic findings
1. Peribronchial thickening.
2. Bronchial dilatation.
3. Mucus plugging
4. Air-trapping
5. Cystic changes
–
unusual in early disease. Not true cysts, but
represent either areas of localized emphysema or cystic
bronchiectasis.
6. Pulmonary hypertension.
7. Hilar enlargement
–
may be due to lymphadenopathy, which is
common, or pulmonary arterial dilatation.
Gastrointestinal findings
1. Meconium ileus: in 10%. Distal intestinal obstruction (meconium
ileus equivalent) may occur in later life.
2. Rectal prolapse.
Hepatobiliary/pancreatic
1. Pancreatic changes and exocrine insufficiency. Pancreas may
demonstrate various abnormalities
(a) Fatty replacement
–
may appear enlarged with lobulations
and septations, or atrophic with partial fatty replacement.
(b) Features of chronic pancreatitis
–
calcifications, atrophy, cyst
formation.
(c) Pancreatic fibrosis
–
low signal on T1W and T2W.
2. Liver disease
(a) Hepatomegaly.
(b) Fatty liver, periportal echogenicity, cirrhosis and portal
hypertension.
(c) Gallstones, biliary obstruction.
Skeletal
1. Retarded skeletal maturation.
2. Clubbing and hypertrophic osteoarthropthy.
Head and neck
1. Chronic sinusitis.
2. Nasal polyps.
3. Mucocoeles.
81
What are the differentials for Enhancing liver lesion
Medical families all hate hospitals
Metastasis (Hypervascular)
Focal nodular hyperplasia (FNH)
Adenoma
Haemangioma
HCC
82
What are the differentials for Air in the biliary tree
Grovelling surgeons expect immediate CT scans
Gallstone ileus
Surgery (Biliary enteric)
ERCP
Infection (Emphysematous cholecystitis)
Chronic pancreatitis
Sphincterotomy
83
What are the differentials for terminal ileal mass/stricutre
TLC
TB
Lymphoma
Crohns disease
84
What are the differentials for colitis
INR
Inflammatory (UC/Crohns), Infective (Pseudomembranous colitis), Ischaemic
Neoplastic (Lymphoma, Neutropenic)
Radiation
85
What are the differentials for solid mesenteric/peritoneal mass
Look closely for metastatic spread
Lymphoma
Carcinoid
Fibromatosis (Desmoid)
Metastases
Sclerosing mesenteritis/Sarcoma
86
What are the differentials for renal papillary necrosis
ADIOS
Analgesics (NSAIDS, Alcohol)
Diabetes
Infection
Obstruction
Sickle cell disease
87
What are the differentials for nephrocalcinosis
Medics hate renal calculi
Medullary sponge kidney
Hyperparathyroidism (Primary), Hyperoxaluria
Renal tubular acidosis
Calcium excess (Sarcoid, vitamin D excess, immobilisation)
88
What are the imaging findings of MEN 1
1. Parathyroid adenomas
–
hyperparathyroidism (90%).
2. Pancreatic islet cell tumours (60%)
(a) Gastrinomas (60%)
–
usually slow-growing: → Zollinger–
Ellison syndrome.
(b) Insulinomas
–
symptoms of hypoglycaemia.
(c) VIPomas
–
secreting vasoactive intestinal peptide → explosive,
watery diarrhoea with hypokalaemia and achlorhydria.
(d) Glucagonomas
–
produce a syndrome of diabetes mellitus,
necrolytic migratory erythema, anaemia, weight loss and
thromboembolic complications.
3. Pituitary adenoma (5%)
–
hormone-secreting and non-secreting.
4. Thyroid adenoma.
5. Adrenal cortical adenoma (40%).
6. Carcinoid tumour (3–4%)
–
originate in foregut (affecting thymus,
bronchus, stomach and duodenum).
7. Multiple facial angiofibromas (85%)
89
What are the imaging findings of MEN IIA
1. Medullary carcinoma of the thyroid (100%).
2. Phaeochromocytoma (50%); bilateral in 50%.
3. Hyperparathyroidism (10%)
90
What are the imaging findings of MEN IIB
1. Marfanoid appearance (100%).
2. Multiple mucosal neuromas (100%).
3. Medullary carcinoma of the thyroid (100%).
4. Phaeochromocytoma (50%).
91
What are the imaging findings of ulcerative colitis
1. Disease colon affected in continuity with symmetrical involvement of the wall
2. Thumbprinting due to mucosal oedema
3. Mural thickening
4. Blunting of austral folds progresses to a narrowed, shortened and tubular colon
5. Widened retrorectal space
6. Inflammatory pseudopolyps
7. Patulous ileocaecal valve with reflux ileitis (Dilated terminal ileum)
92
What are the differentials for a hyper dense liver
Iron deposition
Amiodarone therapy
Glycogen storage disease
Gold therapy
93
What are the differentials for a nodular liver contour
Cirrhosis
Treated metastases
Budd Chiari syndrome
Schistosomiasis
Confluent hepatic fibrosis
94
What are the differentials for a solitary hypodense hypo vascular liver mass
Hepatic cyst
Solitary metastases
Hepatic abscess
Peripheral cholangiocarcinoma
Biliary cyst adenoma
95
What are the differentials for multiple hypo attenuating hepatic lesions
Hepatic cysts
Metastatic disease
Multiple hepatic abscesses
Cholangiocarcinoma
96
What are the differentials for a RUQ cystic mass in a child
Choledochal anomaly
Pancreatic pseudocyst
GI Duplication cyst/diverticulum
Ovarian cystic lesion
Mesenteric cyst
97
What are the differentials for oesophageal dilatation
Achalasia
Scleroderma
Eosophageal/gastric carcinoma
Oesophagitis with stricture
Post surgical changes (Vagotomy)
98
What are the differentials for a solid pancreatic mass
Pancreatic adenocarcinoma
Islet cell tumour
Solid and papillary epithelial neoplasm (SPEN)
Lymphoma
Metastases
99
What are the differentials for linitis plastica
Gastric carcinoma
Metastatic disease (Breast & Lung)
Lymphoma
Crohns disease
100
What are the differentials for a caecal mass
Appendicitis/Appendiceal abscess
Caecal/Appendiceal carcinoma
Mucocele of the appendix
Lymphoma
Adnexal mass
101
What are the differentials for a mesenteric mass
Metastatic disease
Carcinoid tumour
Desmoid/fibrosing mesenteritis
Reactive lymphadenopathy
Abdominal mesothelioma
102
What are the differentials for small bowel wall thickening
Crohns disease
Lymphoma
Bowel wall oedema
Small bowel haemorrhage
Metastases
Whipple disease
103
What are the differentials for a cystic pancreatic lesion
Pancreatic pseudocyst
Mucinous cyst adenoma
Serous cyst adenoma
IPMN
SPEN
104
What are the differentials for a liver mass with a central scar
Haemangioma
Focal nodular hyperplasia
Hepatocellular carcinoma
Hepatic adenoma
Hypervascular metastases
105
What are the differentials for intrahepatic biliary ductal strictures
Primary sclerosing cholangitis
Ascending cholangitis
AIDS cholangiopathy
Neoplasm (Mets/Cholangiocarcinoma)
106
What are the differentials for an echogenic liver mass
Haemangioma
Focal fatty infiltration
HCC
Metastases
Hepatic adenoma
107
What are the differentials for a starry sky liver
Acute hepatitis
Hepatic congestion
Infiltrating neoplasm
Biliary or portal venous gas
108
What are the differentials for hepatomegaly
Neoplastic - Mets, Hepatoma, Lymphoma
Raised venous pressure - CHF, Constrictive pericarditis, Budd Chiari
Degenerative - Cirrhosis, Fatty infiltration
Myeloproliferative disorders - Polycthemia, Myelofibrosis
Infective - Hepatitis, Abscess, Hydatid
Storage disorders - Amyloid, Haemochromatosis, Gauchers
Congenital - Riedels lobe, Polycystic disease
FRCR 2B
flashcards
Decks in class (18)
# Cards
-
Neuro + Head & Neck583
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Paediatrics470
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Cardiothoracics & Vascular566
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GU + Gynae + Breast435
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Gastrointestinal427
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MSK COPY484
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Paeds cases193
-
MSK Cases231
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Cardiovascular & IR Cases365
-
Neuro & H+N Cases307
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Gynae + Breast + GU Cases347
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GI & Nuclear Medicine cases270
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Chest & Cardiac Differentials160
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Paeds Differentials116
-
GI Differentials108
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MSK Differentials213
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Neuro & Spine Differentials141
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GU, Breast & Gynae Differentials127
