1
Q
DDx for pneumatosis intestinalis
A
- bowel necrosis
- most important and life threatening
- mucosal disruption
- peptic ulcer dz
- endoscopy
- enteric tubes
- trauma
- child abuse
- UC or Crohn’s disease
- increased mucosal permeability - often associated with immunosuppression
- AIDS
- organ transplantation
- chemotherapy
- steroid
- graft vs host dz
- pulmonary conditions - air from disrupted alveoli dissect along the bronchopulmonary interstitium and retroperiteoneum along the visceral vesels to the bowel wall
- COPD
- asthma
- mechanical ventilation
- ptx
- pneumediastinum
2
Q
Cystic pneumatosis
vs
Linear pneumatosis
A
- cystic pneumatosis -
- well-defined blebs or grapelike clusters of spherical air collections in the subserosal region
- usually benign
- these air cysts may rupture and result in benign pneumoperitoneum
- linear pneumatosis -
- streaks of gas within and parallel to the bowel wall
- maybe benign or ischemic causes
3
Q
Sigmoid volvulus
vs
Cecal volvulus
A
- sigmoid volvulus
- point towards LLQ
- proximal colon and small bowel are dilated
- cecal volvulus
- point towards RLQ
- proximal small bowel dilated
- distal colon collapsed
- vs cecal bascule - folding rather than a twisitng of a mobile cecum
4
Q
Courses of pelvic muscles
iliopsoas
piriformis
pelvic diaphragm
A
- Iliopsoas
- psoas m. joins the iliacus m.
- lesser trochanter
- Piriformis
- anterior sacrum to
- greater trochanter
- Pelvic diaphragm
- anterior - levator ani
- posterior - coccygeus
5
Q
Level of aortic bifurcation
Level of iliac artery bifurcation
A
- Aorta bifurcates into common iliac arteries at the level of iliac crest
- Common iliac arteries bifurcates at the level of pelvic brim - marked on CT by the transition b/t the convex sacral promontory and the concave sacral cavity
6
Q
Denonvillier’s fascia
A
tough barrier b/t the prostate and rectum
preventing spread of disease from one organ to the other
7
Q
Cervical malignancies
A
- 85% - squamous carcinoma
- 15% - adenocarcinoma
- low attenuation or isoattenuating compared to normal cervix - reduced vascularity, necrosis or ulceration
- II-b - invasion of the parametrium - no longer surgical candidate
8
Q
Endometrial malignancy
A
Hematogenous spread to lung, bone, liver, and brain is much more common with endometrial cancer than cervical cancer
9
Q
In adnexal torsion, the uterus is usually deviated to the affected side
A
In adnexal torsion, the uterus is usually deviated to the affected side
10
Q
Trough sign
A
Vertical lucency
indicates an impaction from posterior shoulder dislocation
11
Q
When disc material migrates from the parent disc, it is termed a “sequestered” or “free fragment”
:
A
When disc material migrates from the parent disc, it is termed a “sequestered” or “free fragment”
12
Q
By noting the density differences b/t the “mass” and the thecal sac
A
By noting the density differences b/t the “mass” and the thecal sac
- if “mass” is denser than thecal sac - it is a bulged disc or sequestered disc
- if “mass” is isodense as the thecal sac - it is a Tarlov cyst/perineural cyst or conjoint nerve root
13
Q
Types of spinal stenosis
A
Types of spinal stenosis
- central canal stenosis
- lateral recess stenosis
- neuroforaminal stenosis
14
Q
Central canal stenosis
A
- most useful CT criteria for diagnosing central canal stenosis - obliteration of epidural fat & flattening of the thecal sac
- most common cause of central canal stenosis - fact degenerative disease
- other causes
- hypertrophy of ligamentum flavum - actually “buckling”
- paget’s disease
- DISH with ossification of the posterior longitudinal ligament
15
Q
Neuroforaminal stenosis
A
Causes of neuroforaminal stenosis
- degenerative joint disease
- osteophytes arising from the vertebral body or the facet
- disc protrusion
- postop scar
16
Q
DDx of diseae entities that have sequestrum
A
DDx of diseae entities that have sequestrum
- osteomyelitis
- EG
- desmoid tumor
- malignant fibrous histiocytoma
17
Q
Ortner Syndrome
Cardiovocal hoarseness
A
- In this syndrome, the LRLN is injured as it loops around the aorta at the aortopulmonary window and along the outer side of the ligamentum arteriosum due to compression or traction caused by changes in the anatomy of the heart or great vessels.
- The left vagus nerve gives rise to the LRLN at the level of the aortic arch, which supplies muscles of the left larynx except the cricothyroid muscle (supplied by the superior laryngeal nerve).
- In isolation, laryngeal findings cannot differentiate RLN palsy from high vagal lesions; however, coincident pharyngeal constrictor atrophy and ballooning of the pharyngeal wall suggest pharyngeal plexus injury due to brain stem or central vagal nerve lesions. Moreover, coincident palsies/atrophy of the trapezius and sternomastoid muscles indicate associated spinal accessory nerve injury with involvement at the jugular foramen or high carotid sheath (above the level of the posterior belly of the digastric muscle).
- Evaluation of the heart, aorta, and supra-aortic thoracic vessels to rule out compression or traction along the thoracic course of RLNs should be part of screening for possible underlying causes of RLN paralysis.
18
Q
“out of proportion TO…”
A
“Out of proportion TO…”
19
Q
Fracture of the lateral talar process
“snowboarder fracture”
A
- often missed - anterolateral ankle pain related to such a fracture often mimics that of an anterior talofibular ligament sprain. Unfortunately, there is a high likelihood of developing osteoarthritis following lateral talar fractures, thus reinforcing the need for a correct diagnosis and optimal management.
- the lateral process is often identified inferior to the tip of the fibula. Any lucency, as in this index case, should prompt the diagnosis. Detailed evaluation of a well-positioned lateral radiograph with regard to the the angle of Gissane should demonstrate a well-defined smooth “V” shape of the lateral process.
- CT should be suggested for further evaluation if radiographic findings are equivocal, as well as to define the full extent of the fracture.
- lateral process fracture staging system (Hawkins) is:
Type I: Nonarticular chip fracture
Type II: Intra-articular, single fracture line
Type III: Intra-articular, comminuted
20
Q
Normal and abnormal ankle xrays
A
Lateral talar process fracture
21
Q
Gissane’s angle
A
Gissane’s angle
22
Q
A
Left PICA stroke
ALWAYS look at the cerebellar hemispheres!
REMEMBER:
Cerebellar stroke - symptoms are IPSILATERAL!!!
Fibers have already crossed over!
23
Q
When describing perianal abscess, it is important to differentiate b/t
intra-sphincteric
vs
extra-sphincteric
abscess
A
When describing perianal abscess, it is important to differentiate b/t
intra-sphincteric
vs
extra-sphincteric
abscess
24
Q
Cause of post aneurysm coiling headache?
A
- RARE - delayed rupture of the aneurysm, which may have been ruptured partially during the coiling process
- COMMON - thrombosis of the aneurysm inciting an inflammatory response
25
The RLN arises from the vagal trunk in the thorax. On the left, the RLN arises at the level of the aortic arch; it crosses the aortic arch and hooks around the ligamentum arteriosum. On the right side, the RLN hooks around the first part of the subclavian artery, then ascends in the groove between the trachea and the esophagus. Because of its longer thoracic course, LRLN palsy is more common than right RLN palsy. The left RLN comes into close contact with left lung apex, aorta, pulmonary artery, ligamentum arteriosum, trachea, esophagus, and mediastinal lymph nodes and accordingly is vulnerable to compression or traction by pathological conditions of any of these structures.
The RLN arises from the vagal trunk in the thorax. On the left, the RLN arises at the level of the aortic arch; it crosses the aortic arch and hooks around the ligamentum arteriosum. On the right side, the RLN hooks around the first part of the subclavian artery, then ascends in the groove between the trachea and the esophagus. Because of its longer thoracic course, LRLN palsy is more common than right RLN palsy. The left RLN comes into close contact with left lung apex, aorta, pulmonary artery, ligamentum arteriosum, trachea, esophagus, and mediastinal lymph nodes and accordingly is vulnerable to compression or traction by pathological conditions of any of these structures.
26
The right and left RLNs supply all the muscles of the larynx except the cricothyroid muscle as well as sensory supply to the larynx below the VCs and the upper part of trachea (supplied by the superior laryngeal nerve).
The right and left RLNs supply all the muscles of the larynx except the cricothyroid muscle as well as sensory supply to the larynx below the VCs and the upper part of trachea (supplied by the superior laryngeal nerve - also a branch of the vagus nerve).
27
Left atrial, aortic, or pulmonary artery enlargement is encountered in various congenital heart diseases and can result in compression of the LRLN.
Aneurysms of different etiologies, direct injury in ductal ligation, or transcatheter closure of patent ductus arteriosus or upon repair of aneurysms are all associated with risk of LRLN palsy. Primary and secondary pulmonary hypertension, with enlargement of the pulmonary artery (as in our case) are also reported to cause LRLN palsy. Some patients with arteriosclerotic heart diseases can suddenly suffer LRLN paralysis due to rapid onset of left ventricular failure with sudden pulmonary hypertension with acute dilatation of the pulmonary vessels. This phenomenon has been termed dynamic dilation.
28
CT findings of VC paralysis include decreased volume of the thyroarytenoid and posterior cricoarytenoid muscles due to denervation atrophy, anteromedial rotation of the arytenoid cartilage, dilation of the ipsilateral laryngeal ventricle, pyriform sinus and vallecula, and thinning and medialization of the ipsilateral aryepiglottic fold. On coronal images, pointing of the VC and flattening of the subglottic angle are seen.
CT findings of VC paralysis include decreased volume of the thyroarytenoid and posterior cricoarytenoid muscles due to denervation atrophy, anteromedial rotation of the arytenoid cartilage, dilation of the ipsilateral laryngeal ventricle, pyriform sinus and vallecula, and thinning and medialization of the ipsilateral aryepiglottic fold. On coronal images, pointing of the VC and flattening of the subglottic angle are seen.
29
Acute Disseminated Encephalomyelitis
ADEM
* ADEM is an autoimmune demyelination disorder
* occurs 5 - 14 days after a viral illness or vaccination
* peak age 3-5 y/o
* The classic appearance is multifocal T2 and FLAIR hyperintensities in the brain and spinal cord (esp in the dorsal white matter) with multifocal neurologic deficits.
* The appearance of ADEM is often identical to multiple sclerosis, although ADEM is a monophasic self-limiting disorder.
* Steroids and/or plasmapheresis is the treatment of choice.
30
Pleural mets secondary to thymoma
"Drop mets"
Dry - no associated pleural effusion
31
Credo
Credo
A statement of the beliefs or aims that guide someone's actions: "he announced his credo in his first editorial".
32
Carpal boss
* bony protuberance at the dorsal base of the 2nd and 3rd metacarpals
* may be a result of a congenital ossicle (os styloideum), or traumatic, or degenerative osteophyte formation
* symptoms: pain and mass along dorsal wrist
33
Elastofibroma dorsi
* benign, fibroelastic soft tissue tumor
* possibly a pseudotumor, reactive in nature, due to mechanical friction of scapula against the ribs
* classically found in the infrascapular region, deep to the serratus anterior and latissimus dorsi musculature
* 60% bilateral
* F:M = 5:1, mean age 65 y/o
* often asymtomatic - incidentally found on CT
* may cause moderate pain and clicking, snappy, clunking of scapula with movement
* surgical resection if symptomatic
* no malignant transformation
* CT
* poorly defined soft tissue mass in the infrascapular or subcapsular region attenuation similar to that of adjacent skeletal muscle
* may have internal septations or scattered areas of fat attenuation
* atypical features such as bone destruction or intense contrast enhancement should raise the suspicion of tumor of a different cause - sarcoma, metastasis
34
DDx for intradural extramedullary tumors
* nerve sheath tumors - neurofibroma, schwannoma
* meningiomas
* other:
* primary: ependymomas, epidermoid tumors, paragangliomas, lipomas, plasmacytomas, and chloromas
* mets
35
Lymphangiomatosis
vs
Lymphangiomyomatosis
vs
Lymphangioma
vs
Lymphangiectasis
* lymphangiomatosis
* similar to lymphangiectasis - dilated lymphatic structures
* lymphangiomyomatosis
* middle aged women, thin walled cysts, PTX, tuberous sclerosis
* lymphangioma
* aka cystic hygroma
* lymphangiectasis
* dilated lymphatic structures
36
Pulmonary lymphangiomatosis
* smooth diffuse interlobular septal thickening
* diffuse effacement of mediastinal fat
* pleural and pericardial effusions
* mild mediastinal lymphadenopathy
37
Systemic lymphangiomatosis
Infiltrating mesenteric and retroperitoneal fluid density
* multifocal proliferation of lymphatic vessels
* clinical presentation depends on anatomic site and extension of involvment
* anorexia
* pain
* hepatosplenomegaly
* ascites
* resp distress
38
Emmy
vs
Academy
vs
Tony
vs
Grammy
* Emmy - TV
* Academy - film
* Tony - theatre
* Grammy - music
39
DDx of calcification in the lungs:
Pulmonary ossification
vs
Metastatic pulmonary calcification
vs
Chronic granulomatous disease
* pulmonary ossification
* dendriform pulmonary ossification
* true metaplasia of pulmonary fibroblasts into osteoblasts in response to chronic insult
* nodular pulmonary ossification
* due to repetitive alveolar hemorrhage
* metastatic pulmonary calcification
* chronic renal insufficiency
* elevated serum calcium
* chronic granulomatous dz
* silicosis
* amyloidosis
40
Dendriform pulmonary ossification
* rare, \< 100 reported cases
* arborizing pattern of calcific reticular opacities and interstitial thickening, most prominent in peripheral lung bases
* demogrpahics: elderly males with co-existing chronic interstitial lung disease
* due to true metaplasia of pulmonary fibroblasts into osteoblasts
* not associated with bad prognosis
41
Arcuate line
* a horizontal line that demarcates the lower limit of the posterior layer of the rectus sheath
* located at about 1/3 of the distance b/t umbilicus and pubic crest
* above the arcuate line - rectus abdominis is surrounded by an anterior and posterior layer of rectus sheath
* below the arcuate line - all 3 muscle layers make up the rectus sheath anterior to the rectus abdominis
* rectus sheath hematoma can be free to cross the midline
42
haven
a place of safety or refuge
haven
a place of safety or refuge
43
DDx for multiple focal hypoechoic splenic lesions
* abscesses
* metastases (esp melanoma)
* lymphoma
* sarcoid
* infarct - if wedge shaped and extends to periphery
44
normal kidney size
9-12 cm
45
epidermoid
vs
dermoid cyst
epidermoid cyst
shows restricted diffusion!
46
Solitary lytic lesion of the skull
DDx
* common
* anatomical variants: vascular channels, venous lakes, arachnoid granulations
* surgical defects: burr hole
* metatasis: breast, lung, prostate most common
* less common
* epidermoid cyst - restricted DWI
* LCH/EG - bevel edges (inner table involved \> out table)
* plasmacytoma
* Paget disease - osteoporosis circumscripta
* hemangioma - lytic diploic space lesion, well-circumscribed, "spoke-wheel" or "reticulated" pattern, strong enhancement post contrast
* dermoid cyst - fat density
* leptomeningoceal cyst - "growing fracture", late complication of skull # with dural laceration
* osteomyelitis - complication of trauma, sinusitis, mastoiditis; "pott puffy tumor" - subperiosteal abscess of the frontal bone
* rare
* encephalocele
* neurosarcoidosis
* aggressive fibromatosis
* sinus pericranii
47
* centered in the diploic space
* expansile
* well-defined margins
* spoke-wheel, reticulated appearance
* avid enhancement
48
Do not diagnose uterine AVF unless the
peak systolic velocity exceeds...?
PSV \> 160cm/sec!!
together with low resistance diastolic flow
49
Stenson's duct
vs
Wharton's duct
* Stenson's duct - parotid duct
* Wharton's duct - submandibular dut
50
Definition of burst fracture
Involving both anterior and middle columns
51
"Microdisc"
Microdisc
Microscopic disc surgery - scraping off herniated disc portions
52
Sacralization of the right aspect of L5
with pseudoarticulation with S1
53
Radiographic findings of pneumonia
can lag behind clinical findings
Radiographic findings of pneumonia
can lag behind clinical findings
54
Post-transplantation lymphoproliferative disorder
PTLD
* occur in post-transplant as a consequence of immunosuppressive drugs
* a spectrum of histologic findings - from benign lymphoid hyperplaisa --\> malignant lymphoma
* most cases: B cell proliferation
* causes multifactoral
* EBV infection is associated with most cases of PTLD
* risk factors for PTLD
* EBV infection
* age
* type of organ transplant
* immunosuppression regimen
* PTLD is typically aggressive - if untreated, can progress to disseminated malignancy
55
Increased phasicity and pulsatility
of the hepatic veins and portal veins
Right heart failure
or
Tricuspid regurgitation
56
SAH/IVH can redistribute to the contralateral side
SAH/IVH can redistribute to the contralateral side
57
Radiation dose to the fetus on a head CT is close to 0
a head CT is estimated at \<0.01 rad
background radiation during the entire gestation period is estimated at 0.23 rad
Radiation dose to the fetus on a head CT is close to 0
a head CT is estimated at \<0.01 rad
background radiation during the entire gestation period is estimated at 0.23 rad
58
Always look at interpeduncular cistern for acute SAH!!!
Always look at interpeduncular cistern for acute SAH!!!
59
Gated study for
cardiac or thoracic aorta examination
Always better!
* lower dose
* better quality
60
CO --\> globus pallidus
Methanol --\> putamen
CG
MP
CO --\> globus pallidus
Methanol --\> putamen
CG
MP
61
Wernicke's encephalopathy
* CT - usually normal
* MR - T2 hyperintensity in:
* medial thalami
* tectal plate
* periductal grey
* mammary bodies
62
Progression of ankylosing spondylitis in spine
1. squaring of the anterosuperior vertebral body margins
2. corner erosions
3. sclerosis in repair phase
4. shiny corners
63
What type of vertebral fracture do AS pts get?
Chalk stick fracture
64
DDx for
multiple intradural extramedullary spinal lesions
* neoplastic
* neurofibromatosis
* schwanomma
* neurofibroma
* meningioma
* mets
* drop mets from ependymoma/medulloblastoma/astrocytoma
* other mets - lymphoma/breast/lung
* infectious/inflammatory
* arachnoiditis
* sarcoid
* TB
* GBS
65
Tracheal stenosis
* 90% iatrogenic - secondary to intubation or tracheostomy
* normal tracheal dimension
* men 25mm
* women 21mm
* most often occur in proximal cervical (subglottic) trachea
*
66
Normal endometrial thickness
* pre-menopausal pt
* \< 15mm
* post-menopausal pt
* no bleeding \< 11mm
* bleeding \< 5mm
67
Hepatic veno-occlusive disease is a known complication of bone marrow transplant
Hepatic veno-occlusive disease is a known complication of bone marrow transplant
68
Hyperextension teardrop fractures typically involve the anterior inferior endplate (particularly of C2).
Flexion teardrop fractures involve the anterior superior endplate.
Hyperextension teardrop fractures typically involve the anterior inferior endplate (particularly of C2).
Flexion teardrop fractures involve the anterior superior endplate.
69
"low level internal echoes" in the fluid
complicated by infection or hemorrhage
"low level internal echoes" in the fluid
complicated by infection or hemorrhage
70
CXR in a seizure patient
* r/o aspiration
* r/o should dislocation
71
Fournier gangrene
vs
Peyronie's disease
* Fournier gangrene - necrotizing infection of the perineum
* Peyronie's disease - fibrosis +/- calcification of the tunica albuginea - painful and/or curved penis on erection (most commonly affecting the dorsal side)
72
Penile blood supply
* internal pudendal artery divides into
* common penile artery
* dorsal penile
* bulbourethral
* cavernosal
* perineal arteries
73
Types of priapism
Priapism - persistent complete or partial erection for \> 4 hours in the absence of sexual stimulation
* Ischemic priapsim
* veno-occlusive, low-flow, painful
* more common
* rigidity of the corpora cavernosa with little arterial flow
* often caused by ED drugs and sickle cell pts
* urologic emergency
* Rx: coporal aspiration of blood and injection of phenylephrine; surgery
* Nonischemic priapsim
* arterial, high-flow, painless
* less common
* results from unregulated arterial inflow into the lacunar spaces of the penile cavernosa
* most common cause is injury to the *_cavernosal artery_* resulting from blunt trauma (straddle injury during sexual intercourse)
* *_not_* a urologic emergency
* Rx: observation; doppler-guided compression of the injured artery; IR - embolization
74
Gastric arterial supply
* celiac trunk - left gastric
* common hepatic - right gastric
* splenic artery - short gastric
* right and left gastroepiploic artery
75
Parathyroid glands usually deep to the thyroid gland
on US
Parathyroid glands usually deep to the thyroid gland
on US
76
3 planes of ultrasound examination of fetal brain
* trans-ventricular
* trans-cerebellar
* trans-thalamic
77
U/S findings associated with agenesis of corpus collosum
ACC
* absence of the cavum septum pellucidum
* colpocephaly
* high-riding 3rd ventricle
* widening of the inter-hemispheric fissure
* race car configuration parallel lateral ventricles
78
Isolated ACC is rare
ACC is often associated with what anomalies?
* lissencephaly
* schizencephaly
* periventricular nodular heterotopia
* polymicrogyria
79
"Mucocele of the appendix"
* F:M \> 4:1
* 0.3% prevalence
* 3 histological types
* focal or diffuse hyperplasia
* mucinous cystadenoma
* most common
* benign
* 20% rupture --\> pseudomyxoma peritonei
* mucinous cystadenocarcinoma
* much less common
* greater risk of rupture
80
Bubbly or lytic bone lesions
FEGNOMASHIC
* fibrous dysplasia
* enchondroma, EG
* GCT
* non-ossifying fibroma/NOF
* osteoblastoma
* metastasis, myeloma
* aneurysmal bone cyst
* solitary bone cyst/UBC
* hyperparathyroidism - brown tumor, hemangioma
* infection
* chondroblastoma, chondromyxoid fibroid
Bubbly or lytic bone lesions
FEGNOMASHIC
* fibrous dysplasia
* enchondroma, EG
* GCT
* non-ossifying fibroma/NOF
* osteoblastoma
* metastasis, myeloma
* aneurysmal bone cyst
* solitary bone cyst/UBC
* hyperparathyroidism - brown tumor, hemangioma
* infection
* chondroblastoma, chondromyxoid fibroid
81
Multiple lytic lesions
FEEMHI
Multiple lytic lesions - FEEMHI
* fibrous dysplasia
* enchondromas, EG
* metastasis, myeloma
* hyperparathyroidism - brown tumor, hemangiomas
* infection
82
Lytic epiphyseal lesions
CCIG
Lytic epiphyseal lesions - CCIG
* chondroblastoma
* GCT
* infection
* geode
83
Lytic lesions in \< 30 y/o
* chondroblastoma
* NOF
* ABC
* UBC
* EG
* infection
Lytic lesions in \< 30 y/o
* chondroblastoma
* NOF
* ABC
* UBC
* EG
* infection
84
Dense Bones
Regular Sex Makes Occasional Perversions Much More Pleasurable And Fantastic
Dense Bones
Regular Sex Makes Occasional Perversions Much More Pleasurable And Fantastic
* Renal osteodystrophy
* Sickle cell disease
* Myelofibrosis
* Osteopetrosis
* Pyknodysostosis
* Mastocytosis
* Mets - breast and prostate (5 bees lick pollen - brain (medulloblastoma), bronchogenic, bone, bowel, bladder), lymphoma, prostate)
* Paget's disease
* Athletes
* Fluorosis
85
High-riding shoulder
DDx
High-riding shoulder
* RA
* CPPD
* trauma
* rotator cuff tear
86
Widened tear drop in the hip
DDx
Widened tear drop in the hip
* infection
* trauma
* AVN
* PVNS
* synovial osteochondromatosis
87
Permeative lesion in a child
DDx
Permeative lesion in a child
* Ewing's sarcoma
* infection
* EG
88
Cortical holes
Pseudopermeative lesion
DDx
Cortical holes
Pseudopermeative lesion
DDx
* Osteoporosis
* Radiation
* Hemangiomas
89
CPPD-associated disorders
CPPD-associated disorders
* primary hyperparathyroidism
* gout
* hemochromatosis
90
Dense base of the skull
DDx
Dense base of the skull
DDx
* fibrous dysplasia
* Engelmann's disease
* Von Bochem's disease
* Paget's disease
* meningioma
* pyknodysostosis
* osteopetrosis
91
Geodes
DDx
Geodes
DDx
* CPPD
* degenerative OA
* RA
* AVN
92
Bony Sequestration
DDx
Bony Sequestration DDx
* Infection
* EG
* Osteoid osteoma
* fibrosarcoma
* lymphoma
93
Arthropathy based on distribution in the hands and wrists
Distal
vs
Proximal
Arthropathy based on distribution in the hands and wrists
* Distal
* psoriasis
* Reiter's syndrome
* OA
* Proximal
* RA
* CPPD
94
Joints that exhibit erosions with OA
Joints that exhibit erosions with OA
* TMJ
* AC joint
* SI joint
* symphysis pubis
95
Rib lesions DDx
FAME
Rib lesions DDx
FAME
* fibrous dysplasia
* ABC
* mets and myeloma
* EG and enchondroma
96
AUTOMATICS that must be mentioned in every case
\< 30 y/o
\> 30 y/o
AUTOMATICS that must be mentioned in every case
* \< 30 y/o - infection, EG
* \> 30 y/o - infection, Mets/myeloma
97
Pyknodysostosis
Pyknodysostosis
* autosomal recessive bone dysplasia
* osteosclerosis
* short stature
98
Normal kidney size
11 +/- 2 cm
9 - 13 cm
99
Gallbladder sludge
* echogenic, layering, mobile
* non-shadowing
* echogenicity is due to crystals - cholesterol and calcium bilirubinate
* DDx
* pus
* blood
* associated with
* pregnancy
* fasting
* TPN
* rapid weight loss
* critical illness
100
Approximately 10% RCC may be echogenic enough to mimic the appearance of AML
Approximately 10% RCC may be echogenic enough to mimic the appearance of AML
* can order CT or MR for confirmation
* features suggestive of RCC - cystic elements; hypoechoic halo; calcifications
* features suggestive of AML - posterior acoustic shadowing
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