Radiology | Master Of Medicine

Category Archives: Radiology

Frequently asked Xray views.

Supra orbital fissure – Caldwell view

Recurrent shoulder dislocation -Strikers view

Sella tursica -Lateral view

Scaphoid -Oblique view

Patella- skyline view

Pneumothorax -PA view in full expiration

Types of renal calculi and their properties.

Calcium Oxalate Calculus

  1. Most common renal calculi
  2. Hard and small

Phosphate calculus

  1. Smooth, white and solitary.
  2. Triple phosphate calculus-Calcium Ammonium magnesium phosphate/struvite calculus.
  3. Staghorn calculus- When they fill all or most of renal pelvis.
  4. Seen in alkaline urine especially with proteus infection.

Uric acid and urate calculus.

  1. Radioluscent.
  2. Form in acidic urine
  3. Most responsive to lithotripsy.

Cystein calculi

  1. Uncommon,seen in cystinuria.
  2. Appear inacidic urine.
  3. Extremely hard, resistant to ESWL.

Xanthine calculi

  1. Radioluscent
  2. Secondary to congenital deficiency of xanthine oxidase.

Indinavir calculi

  1. Radioluscent.
  2. Due to Indinavir use in 6% patients who use it.

Silicate stones

  1. Rare
  2. Associated with long term use of antacids containing silica

Triamterene stones

  1. Radioluscent, rare.
  2. Associated with antihyypertensive medications containing triamterene.

X ray appearences in heart diseases.

Imaging of the chest is not only valuable in respiratory disorders, but it also  gives valuable insights into specific disease conditions of heart. Given below are specific appearances that heart diseases make on an X ray film.

  1. Coeur en Sabot /Boot shaped heart –  Tetralogy of Fallot
  2. Pear/Money bag/purse –   Pericardial Effusion
  3. Box shaped heart –   Ebstein’s anomaly
  4. Egg on side –    TGA
  5. Snowman/figure of 8 –   TAPVC
  6. Scimtar sign –    TAPVC.
  7. Wide Vascular Pedicle – Corrected TOGV
  8. Sitting Duck shaped Heart- Persistant Truncus Arteriosus
  9. Flask shaped Heart/Leather bottle with Pulm. Oligemia- Pericardial Effusion
  10. Snowman/Figure of 8/ Cottage leaf of Bread heart- TAPVC
  11. Shaggy Heart – Pertusis
  12. Figure of 3 (CXR)/Reversed E sign(Ba swallow) –   Coarctation of Aorta
  13. Hilar Dance sign(Fluoroscopy) –   ASD
  14. Egg in cup – Constrictive pericarditis.

Find more characteristic findings in masterofmedicine among revision topics

Barium study findings in various gastrointestinal diseases.

Barium swallow findings

  1. Bird beak appearance – Achalasia cardia
  2. Rat tail appearance – Achalasia cardia
  3. Corkscrew esophagus – Diffuse esophageal spasm
  4. Curling esophagus – Diffuse esophageal spasm
  5. Nut crackers esophagus – Diffuse esophageal spasm

Barium meal findings

  1. String sign - Congenital hypertrophic pyloric stenosis
  2. Thumb print appearance – Ischaemic colitis
  3. Inverted 3 sign of Frosberg – Ca head of pancreas
  4. Widening of C loop of duodenum/antral pad sign- Ca head of pancreas

Barium enema findings

Ileocaecal TB and incompetant ileocaecal valve

  1. Pulled up caecum
  2. Obtuse ileocaecal angle
  3. Filling defect

Carcinoma Colon

  1. Apple core deformity
  2. Irregular filling defect

Ulcerative Colitis

  1. Lead pipe appearance
  2. Loss of haustrations

Crohn’s disease

  1. String sign of Kantor
  2. Raspberry thorn ulcers

Colonic polyps

  1. Smooth irregular filling defects

Hirschsprung disease

  1. Dilated proximal zone with narrow distal zone of coning

Diverticulosis of colon

  1. Saw tooth appearance
  2. Champagne glass sign

Ischemic colitis

  1. Thumb print appearance

Intussusception

  1. Coiled spring appearance
  2. Claw sign

Volvulus

  1. Bird beak sign
  2. Ace of spades

Precautions to be taken against nuclear radiation exposure.

The news about potential nuclear disaster from nuclear rod meltdown at Fukushima nuclear plant in Japan in itself is capable of producing symptoms in susceptible patients. Since radiation exposure is unpreventable ,if occurring in our locality, most people are worried about the hazards of potential nuclear radiation exposure. Taking this fear factor into account there are people who enjoys spreading around rumours and making people even more worried.

The fear of radiation exposure from the Japanese Nuclear power plant is blown out of propotion, especially since the nuclear power plant in Japan is a modern facility and capable of withstanding earthquakes and have excellent containment facilities. I need not talk about all those, as those as purely technical parts and better taken care of by experts in the field.

What are the effects of Radiation exposure on human body?

You may have seen patients on radiation therapy, their appearance tells us a story about the hazards of radiation exposure. Nausea, Vomiting, hair loss, Skin changes, dehydration are usual symptoms.

Exposure of higher doses of ionizing radiation can lead to:

  • Thyroid dysfunction
  • Reduced lymphocyte count,increases susceptibility to infections
  • Destruction of bone marrow cells,leukemias
  • Direct effects on blood vessels  and heart,cause hearfailure
  • Reproductive tract will be affected leading to sterility in some cases
  • Intestinal bleeding,diarrhoea, dehydration

Read more about effects of  nuclear radiation

How can we prevent hazards of radiation exposure?

As always said, prevention is better than cure. Avoid travel to Japan as advised by US and most of the European countries.

I.Potassium Iodide tablets

Thyroid is one of the organs which is affected earliest by radiation exposure. The logic behind using Potassium Iodide tablets is that it saturates iodine stores in thyroid with natural iodine, thus preventing the accumulation of radioactive iodine in the thyroid. This is more of harm than good, because Iodine is an inhibitor of thyroid gland and decreases the formation of thyroid hormones and lead to thyroid failure. So use of  Potassium iodide indiscriminately should be avoided, only regions which are surrounding the nuclear plant and having high levels of exposure should use these tablets.

II.Avoid contact with objects exposed to radiation

Avoid contact with airplanes which have been on rescue missions, clothes worn etc.

III.Shielding

Lead shielding is ideal in preventing rays with maximum energy(gamma rays) from striking the body. This is why Xray rooms have Lead shielding. Since lead shielding is not  feasible in nuclear disasters , any shielding, let it be clothes, walls, buildings etc can help you from getting high doses of radiation. So it will be better to stay inside a building, wearing thick clothes rather than venturing out into open space with/without clothes.

Precautions against medical radiation exposure

  1. Increase the distance between you and the source of radiation.
  2. Decrease the time of exposure.
  3. Stand behind the lead shield
  4. Avoid the use of Xrays/CT scans during pregnancy unless absolutely indicated

Also read:

Potassium iodide won’t protect you from nuclear reactor radioactive isotopes

How to lessen effects of radiation exposure via wonderhowto

Radiosensitive tumours

Highly radiosensitive

Wilm’s Tumour
Ewing Sarcoma
lymphoma
Multiple Myeloma
Seminoma/Dysgerminoma

Limited sensitivity

squamous and basal cell carcinomas of the skin
carcinomas of the mouth, including the tongue and lip
carcinomas of the accessory sinuses
carcinoma of the bladder
carcinoma of the larynx

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