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97 Cards in this Set
- Front
- Back
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Deep Sulcus Sign
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- Occurs in pneumothorax
- When lying supine, air goes to highest part in thorax --> deep sulcus. |
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Aunt Minnie's Sign
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Collapsed Lung - look at lateral
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Obscured heart outlines
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Pneumonia/involvement of right middle lobe or left upper lobe/lingula. Lower lobes do not obscure heart outlines.
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Pneumomediastinum
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Can be 2/2 small pleural bleb (spontaneous resolution), esophageal tear, pneumothorax, high inspiratory/expiratory pressures in asthma/COPD
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Aortic Dissection
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Type A - Ascending (requires surgery)
Type B - Descending |
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D-Dimer
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- Detects fibrinogen products
- Used most often for PE ddx - Very sensitive (negative result excludes PE) - Best in "healthy" outpatient patients |
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V/Q Scan
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- Used to dx PE
- Performed by injecting technetium labeled macroaggregated albumin particles intravenously - these 'stick' in the smaller pulmonary capillaries and remain there for several hours until phagocytosed. Distribution of the particles provides us with a perfusion map of the lungs. |
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Colonic Edema
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- "Thumbprinting" sign
- When colon wall thickened, protrudes into bowel. - IBD |
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"Apple Core" Lesion
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Seen in patients with colon carcinoma
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SBO + Ileus
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Gallstones
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Kidney Stones
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Non-contrast CT scan is the best modality. US better for pregnant patients.
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Gallbladder + Cystic Duct
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Normal cystic duct is 6 mm.
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Pancreas + Surrounding Vasculature
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Appendicitis
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"Tram Tracking"
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Dilated intrahepatic bile duct adjacent/parallel to portal vein branch.
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MRCP
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Magnetic Resonance Cholangiopancreaticogram
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ERCP
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- Endoscopic Retrograde CholangioPancreaticogram
- More therapeutic than diagnostic |
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Ultrasound > CT Scan
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- Cheaper, faster, and can better visualize gallbladder wall thickening and stones within.
- Better for f/u of renal stone. |
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CT Scan > Ultrasound
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- Needed to visualize pancreatitis --> whenever you have painless jaundice.
- Gold standard of kidney stone eval. |
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Acalculus Cholecystitis
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- Inflammation of gallbladder w/o presence of stones.
- Associated with anorexia nervosa. |
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Pancreatitis
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Associated with painless jaundice.
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"Colon cut-off sign"
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Inflammation from the pancreatitis causes inflammation and spasm of the adjacent bowel and may result in a partial pseudoobstruction at the splenic flexure.
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Pancreatic Mass
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Renal Stone
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- On non-contrast CT, gold standard imaging modality.
- Located at the URETEROVESICULAR junction |
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Renal obstruction coronal
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Right hydronephrosis, renal enlargement, and perinephric stranding.
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Renal obstruction transverse
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Right hydronephrosis, renal enlargement, and perinephric stranding.
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Ureterovesicular Junction
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Where ureter inserts into bladder.
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Ureteropelvic Juntion
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Where ureter inserts into renal pelvis
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Ureteral Jets
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Doppler U/S shows urine jets from ureter into bladder bilaterally. Kind of like a cysto.
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Pyelonephritis
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Image taken 8 minutes after contrast injection. Left kidney cleared it all, looks normal. Right, infected kidney retained the contrast and looks swollen. Arrows point to area of patchy/striated nephrogram. This is an UNcomplicated case.
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Emphysematous Pyelonephrosis
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Requires drainage.
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Contrast-Induced Nephropathy
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- Occurs in up to 40% of patients with underlying renal failure (elevated creatinine levels)
- Prophylactic therapies include hella hydration and/or NaHCO3 and/or N-acetylcysteine - Acetylcysteine mechanism of action: scavenges O2-derived free radicals and improves endothelium vasodilatation. - Treat with supportive therapy |
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Renovascular Hypertension
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- Caused by increased renin release.
- More renin released because kidneys need higher forward pressure. - Kidneys often need higher forward pressure 2/2 renal artery stenosis. ie a vicious cycle. |
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Renal Artery Stenosis
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Diagnosed with angiogram
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Hematuria
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- Glomerular: with proteinuria = problem with the neprhron.
- Extraglomerular (isolated hematuria): without proteinuria = malignancy, stones, trauma, infection, meds. |
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Renal Cyst U/S
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Renal Cyst CT
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Simple Renal Cyst on U/S
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- Anechoic (black)
- Round/oval - Increased through transmission - Smooth walls, no septations - No internal vascularity |
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Renal Cell Carcinoma
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- Classic Triad: flank pain, hematuria, fnalk mass
- Surgery is main treatment |
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Pelvic Trauma X-Ray
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Chest Trauma CT
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- Right lung normal.
- Left lung anterior = "ground glass" appearing contusion - Left lung posterior = atelectasis and effusion |
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Abdominal Trauma CT
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Stars = hematomas
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Free abdominal gas
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Duodenal Leak
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Bladder Rupture
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Yellow arrow shows rupture. Red arrows shows where urine leaked into abdomen.
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Head CT w/o Contrast
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Primary and 1st modality used for head trauma.
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Epidural Hemorrhage
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- Do NOT cross skull bone suture lines
- Arterial in origin (middle meningeal) - Patients lose consciousness, have lucid interval, then rapid decompensation. |
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Subdural Hemorrhage
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- Occur b/w dura and arachnoid.
- Due to tearing of bridging cerebral veins - Crescent shaped - Do NOT cross flax |
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Subarachnoid Hemorrhage
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- Tearing of cerebral vessels
- Rupture of aneurysm or trauma or AVM - Lumbar puncture will show elevated opening pressure, elevated RBC count, and xanthochromia (pink tint) |
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Clay Shoveler's Fracture
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- Avulsion of spinous process 2/2 pulling from trapezius muscle.
- Treatment = pain meds and phys. therapy |
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Decompensation 2/2 Brain Bleed Tx
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- In epidural hemorrhage, you can get cerebral herniation and rebleed
- In subarachnoid, you can get vasospasm |
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Brain Herniation 1
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- Red arrows point to subdural collection
- Yellow star shows compressed RIGHT lateral ventricle - Blue line is midline and shift from - Green star shows dilated occipital horn of LEFT lateral ventricle |
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Brain Herniation 2
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Suprasellar Cistern (in red) should be black/liquid... filled with brain.
Suprasellar cistern is where the cavernous sinus is? |
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Brain Herniation Overview
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Diffuse Axonal Injury
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White matter damage
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Acute Subdural Hemorrhage
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- < 3 days, generally hyperdense.
- Subacute (3 days-3 weeks) are isodense - Chronic ( > 3 weeks) are hypodense |
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CT Angiography
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Diagnosis and evaluation of aneurysms and subarachnoid hemorrhage.
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Lumbar Puncture
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Should always follow a negative non-contrast CT scan in the setting of increased ICP headache.
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Aneurysm Incidence
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- Anterior Communicating (30%)
- Posterior Communicating (25%) - Middle Meningeal (20%) |
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Subarachnoid Hemorrhage 2/2 ruptured aneurysm
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Progressive Multifocal Leukoencephalopathy (PML)
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- Caused by JC Virus
- CD4 < 100 - Rapid demyelinating disease |
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Neurocysticercosis
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- No edema in imaging
- Infection from eggs of Taenia solum (pork tapeworm) - Eggs must be ingested independently of the actual tapeworm - infection by the latter only causes abdominal problems. |
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Toxoplasmosis General
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- Reactivation of Latent Disease
- Prophylactic treatment once CD4 < 100 |
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Toxoplasmosis Imaging
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- Multiple lesions
- Abundant edema - Hyperintense center w/ T2 imaging - Involvement of deep gray matter (Basal Ganglia) |
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Primary CNL Lymphoma
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- Solitary lesion
- Subependymal (by ventricles) enhancement - Encasement of ventricles - Hypointense center w/ T2 imaging |
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Pyogenic Absecess
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- Appears bright on diffusion weighted imaging
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Cerebral Mets
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- Plenty of edema
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Intussusception
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- Currant Jelly stools (stool mixed with mucous and blood).
- Paroxysms of pain - Vertically oriented mass - Treat and see with AIR ENEMA |
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Upper GI Series
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Fluoroscopic study that uses radio-opaque contrast to look at the entire GI tract.
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Mid-Gut Volvulus
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RSV
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- Causes hyperinflation and perivascular markings
- Perivascular markings 2/2 bronchial wall thickening and edema. - Hyperinflation caused by peripheral air trapping when central airways collapse 2/2 edema. |
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Torus (Buckle) Fracture
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- 2/2 compressie force
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Joint Effusion in Child
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- Most common cause is transient synovitis
- Also consider septic arthritis |
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Metaphyseal Corner Fracture (Bucket-Handle Fracture)
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- Happens with shaking/grabbing
- Pathognomonic for child abuse - Other child abuse fractures: posterior ribs, humeral head dislocation, Type V salter harris fracture (crush fracture) |
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Developmental Dysplasia of the Hip
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- Shallow acetabular development
- Predisposition to Subluxation and dislocation of hip - Ultrasound is best in 2 month olds because not enough calcifications yet for radiograph. |
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Necrotizing Enterocolitis
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- Seen in premature infants
- Gas gets trapped under submucosal layers of intestines and causes necrosis to mucosal layers |
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Epiglottitis
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- Caused by HIB (Haemophilus influenzae type B)
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Croup
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- Steeple Sign
- Subglottis infection |
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Air Bronchogram
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Visualizing the airways when the entire lung is consolidated 2/2 pneumo
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Rheumatoid Arthritis
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- Stiff joints in the morning
- MCP and PIP joint involvement - Swan neck and boutonniere deformities |
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Dual-energy X-ray Absorptiometry (DEXA) Scan
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- Osteoporosis screening
- Can be used in osteopenia, too (precursor to osteoporosis). - T-score > -1 = normal. - T-score < -2.5 = osteoporosis |
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Fibroadenoma
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MCC of breast mass in women < 30
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Hysterosalpingogram
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Fill uterus with contrast, let it pour through tubes. Will show you the contours of the uterus as well as the patency of the fallopian tubes.
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Sonohysterogram
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Fill uterus with saline and you can evaluate uterus for thickening... but you cannot see tube patency.
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Breast Mass
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- First do ultrasound.
- If cystic, you're good. If not clear, do ultrasound guided core biopsy of mass. - If biopsy positive, do MRI to see if any other focal lesions present. |
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Tamoxifen
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- Anti estrogen receptor
- Increases risk of endometrial cancer and endometrial hyperplasia |
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Ankle anatomy
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Injured Ankle
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Fracture Adjectives
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Knee Injury 1
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Knee Injury 2
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- Lipohemarthrosis (mixture of fat and blood within joint capsule 2/2 trauma)
- Intraarticular frature --> fat and blood released from marrow space |
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MRI Normal Knee
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Femoral Neck Insufficiency Fracture
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Right Wrist Fracture
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Hill-Sachs Fracture
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- During dislocation, happens when humeral head hits the glenoid
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Elbow Injury
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