PACES - Images

Question 1

What do the labels show?

What is the underlying pathology

Answer 1

osteoarthritis

Question 2

T1W MRI appearance

Answer 2

fat - bright

fluid - dark

1 thing is bright

most anatomical image

Question 3

T2 weighted MRI appearance

Answer 3

Fat bright

fluid bright

2 things are bright - used more commonly

Question 4

bone on MRI vs CT

Answer 4

MRI - dark

CT - bright

Question 5

CT appearance of tissues

Answer 5

• air - dark
• coagulated blood - bright
• bone - very bright

Question 6

What are the features and pathology depicted

Answer 6

rheumatoid arthritis

features on x-ray (LESS)

• loss of joint space,
• erosions,
• soft tissue swelling,
• subluxation & deformity

also may see deformity + deviations e.g. ulnar deviation

Question 7

What are the features and pathology depicted

Answer 7

rheumatoid arthritis

features on x-ray (LESS)

• loss of joint space,
• erosions,
• soft tissue swelling,
• subluxation & deformity

also may see deformity + deviations e.g. ulnar deviation

Question 8

What is adequate inspiration for CXR?

Answer 8

6 anterior ribs

Question 9

What are differentials for cardiomegaly on CXR?

Answer 9

Heart failure Dilated cardiomyopathy Pericardial effusion Only assess on PA

Question 10

how to determine roughly what lobe is affected on CXR?

Answer 10

• above horizontal fissure - R upper lobe
• heart border obstructed - R middle lobe
• R costophrenic - R lower lobe

Question 11

infective causes of cavitating lesion on CXR

Answer 11

TB, S. Aureus, Klebsiella

Question 12

type of imaging

what is shown

Answer 12

ERCP - Endoscopic Retrograde Cholangiopancreatography + cholangiogram

• side viewing scope is used
• ampulla of vater is cannulated + dye injected → cholangiogram
• shows multiple gallstones in the CBD
  
  • bile duct very dilated, normally approximately to age of pt in decades/10 in mm once over 30s
• this can be a diagnostic and therapeutic investigation

Question 13

normal bile duct diameter - rough guide

Answer 13

over the age of 30s

expect to be age in decades/10 as mm value

i.e. 40 → 4mm

Question 14

what is the pathology here?

type of imaging modality

Answer 14

SBO obstruction

AXR

Question 15

DSA vs CT angiogram

Answer 15

digital subtraction angiogram - x-rays of dye in vessels during interventional procedure e.g. stenting

CT angiogram - contrast given and CT done so can scroll through like slices

Question 16

type of imaging

pathology

Answer 16

AXR

sigmoid volvulus

• coffee bean

Question 17

modality of imaging

pathology

Answer 17

AXR

• PSEUDOOBSTRUCTION
  
  • distension of the whole large bowel and rectum
  • air in the rectum
  • air all the way from R colon to the rectum
  • presents like LBO
  • not mechanical obstruction

Question 18

what are the features of AS on x-ray? (spine)

Answer 18

• subchondral erosions
• diffuse syndesmophytes → bamboo spine
• sclerosis
• squaring of the lumbar vertebrae
• sacroiliac joint narrowing (wider in early disease)
  
  • end stage may be narrow line or not visible

Question 19

what is shown here?

Answer 19

hiatus hernia

sliding (fundus displaced above the diaphragm)

Question 20

diagnosis

Answer 20

diverticulosis