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How to look for it on the scan
405 diagnoses, each written the way you would teach it at the console: how to acquire the study, the manoeuvre, what confirms it, what licenses you to exclude it, and the classic misread. 268 reference values sit beside them, each with the caveat that keeps it from being misused.
Start herethe three pages to read first in every section
Acute and on-call
Abdomen and pelvis
Cardiac and vascular
Chest
Neuro and head & neck
Musculoskeletal
- Acute appendicitisFind the appendix first and prove it is the appendix; only then judge diameter, compressibility and the fat around it.USG · CT · MRI · 3 values · 4 papers
- Acute cholecystitisCalculi plus a thick wall is not the diagnosis — a SONOGRAPHIC Murphy sign elicited with the probe on the gallbladder is what makes it acute.USG · 5 values · 4 papers
- Acute epididymo-orchitis — and the torsion it must not beAn enlarged, hyperaemic epididymis (head first) with or without a hyperaemic testis — judged against the other side at the same colour settings, and only after torsion has been positively excluded.USG
- Acute epiglottitis (supraglottitis)A swollen epiglottis and aryepiglottic folds threaten the airway; the lateral neck radiograph shows the thumb sign, but a patient in distress goes to a secured airway first — imaging must never delay it.X-ray · CT
- Acute limb ischaemia on CT angiographyA cold, painful limb: the CT angiogram shows where the vessel stops, whether it is embolic (sharp meniscus, normal vessels elsewhere) or thrombotic (on a background of atheroma), and the run-off below — the vascular surgeon plans embolectomy or lysis from it.CT
- Acute mesenteric ischaemiaBiphasic CTA: find the cause in the vessels (SMA embolus or thrombosis, SMV thrombosis, low flow), then judge the bowel — wall enhancement, pneumatosis and portal venous gas — because dead bowel changes the operation.CT · 3 values · 5 papers
- Acute pancreatitisThe diagnosis is usually clinical and biochemical. The imaging questions are the CAUSE, the NECROSIS and the COMPLICATIONS — and timing decides what you can answer.CT · MRI · 3 values · 4 papers
- Aortic dissectionFind the intimal flap, then answer the three questions that decide the operation: where it starts, how far it goes, and what is malperfused.CT · 2 values · 5 papers
- Aortic intramural haematoma and penetrating ulcer — the non-classic acute aortic syndromesA crescentic, high-attenuation thickening of the aortic wall on the non-contrast series that does not enhance and has no flap (IMH), or contrast outpouching through calcified intima (PAU) — classified by Stanford type like dissection.CT
- Bowel obstructionProve obstruction, then find the TRANSITION POINT, then decide whether the bowel is compromised. All three, in that order.CT · X-ray · 2 values · 4 papers
- Deep vein thrombosisThe test is COMPRESSION, not colour. A vein that fully collapses under the probe has no clot in it.USG · 1 value · 4 papers
- Early ischaemic stroke on non-contrast CTThe first job is to exclude haemorrhage. The second is to find early ischaemic change, which needs a narrow stroke window, not the standard one.CT · 1 value · 5 papers
- Ectopic pregnancyThe question is not "is there an adnexal mass" — it is "is there a definite INTRAUTERINE pregnancy", and a pseudosac is not one.USG · 5 values · 5 papers
- Emphysematous pyelonephritis and pyelitisGas in the renal parenchyma of a diabetic, septic patient — CT separates parenchymal destruction (emphysematous pyelonephritis) from gas limited to the collecting system (emphysematous pyelitis), because the first may need nephrectomy.CT
- Fournier gangrene of the perineumNecrotising fasciitis of the perineum and scrotum: gas in the scrotal wall and perineal fascia spreading to the abdominal wall — CT maps the extent and finds the source (perianal abscess, urethral injury) for debridement.CT · USG
- Free intraperitoneal gasOn a radiograph you need the right film and enough time upright; on CT you need a lung window, and that is where small volumes live.X-ray · CT · 3 papers
- Gallstone ileusRigler triad — small bowel obstruction, pneumobilia and an ectopic gallstone — seen together on CT; the fistula (usually cholecystoduodenal) and a second stone determine the operation.CT · X-ray
- Haemorrhagic ovarian cyst — the lace pattern, and when it has rupturedA cyst with a reticular "lace" or retracting-clot pattern and no internal colour flow is a haemorrhagic corpus luteum; echogenic free fluid in the pelvis and Morison pouch means it has ruptured.USG
- Ischaemic colitisSegmental colonic wall thickening in a watershed territory (splenic flexure, rectosigmoid) in an older patient with pain and bloody stool — CT separates non-occlusive colitis from transmural infarction that needs surgery.CT
- Joint effusion in the irritable childUltrasound answers one question — is there an effusion — and it cannot tell you whether it is infected. Say both things.USG · 1 value · 2 papers
- Metastatic spinal cord compressionImage the WHOLE spine, find every level, and state the highest level with cord signal change — the clinical level is often wrong.MRI · 2 values · 4 papers
- Necrotising soft-tissue infectionGas dissecting along fascial planes is the specific sign; fluid and non-enhancing deep fascia are the sensitive ones. Surgery is not delayed for imaging — CT maps the extent for the debridement.CT
- Obstructing ureteric calculusFind the stone, then prove it is obstructing, then say the two things the urologist acts on: size and position.CT · USG · 2 values · 4 papers
- Orbital cellulitis and its complicationsThe septum divides a harmless preseptal cellulitis from a sight- and life-threatening postseptal one; imaging answers whether infection is behind the septum, whether there is a subperiosteal or orbital abscess, and whether it has reached the cavernous sinus.CT · MRI
- Ovarian torsionThe diagnosis is the pedicle and the ovarian morphology — not the flow. Preserved arterial flow does NOT exclude torsion.USG · 4 values · 4 papers
- Perforated peptic ulcer as the source of free gasFree gas says a viscus has perforated; the site is read from where the gas and fluid concentrate — gas at the falciform ligament and around the duodenum, a wall defect in the anterior duodenal bulb or gastric antrum — and it decides the operation.CT · X-ray
- Pituitary apoplexySudden headache, visual loss or ophthalmoplegia with a sellar mass: haemorrhage or infarction inside a (usually undiagnosed) macroadenoma — MRI shows blood products, chiasm compression and cavernous sinus involvement.MRI · CT
- Placental abruption on ultrasoundPremature separation of the placenta: ultrasound finds a retroplacental, marginal or subchorionic haematoma in a minority — so a normal scan does NOT exclude abruption; the diagnosis stays clinical.USG
- PneumothoraxFind the visceral pleural line with no lung markings beyond it — and on a supine film, look at the base, not the apex.X-ray · CT · USG · 1 value · 5 papers
- Posterior reversible encephalopathy syndrome (PRES)Vasogenic oedema in the parieto-occipital subcortical white matter in a patient with severe hypertension, eclampsia, renal failure or immunosuppression — recognise the pattern, the atypical variants and the complications (haemorrhage, restricted diffusion).MRI · CT
- Pulmonary embolism on CTPAJudge the contrast bolus before you judge the arteries, then work centrally to peripherally, then look at the right heart.CT · 4 values · 4 papers
- Ruptured or leaking abdominal aortic aneurysmIn a known or suspected AAA with pain or shock, the question is blood outside the wall: retroperitoneal haematoma beside the sac, active extravasation, and the signs of impending rupture — then the neck anatomy the vascular surgeon needs for EVAR.CT
- Sigmoid or caecal volvulusA hugely dilated loop of colon with the other colon collapsed: which loop, where it points and whether there is a whirl at its base decide sigmoid versus caecal volvulus — and ischaemia or perforation decides surgery versus endoscopic decompression.X-ray · CT
- Spinal epidural abscessBack pain, fever and a neurological deficit: MRI of the WHOLE spine with contrast shows the enhancing epidural collection, its craniocaudal extent, cord compression and the source — discitis, facet joint or psoas.MRI
- Spontaneous oesophageal perforation (Boerhaave)Vomiting, chest pain and surgical emphysema: CT shows pneumomediastinum and a left-sided effusion centred on the distal oesophagus, and oral contrast shows the leak — the site and the side decide the thoracic surgery.CT · Fluoroscopy
- Spontaneous retroperitoneal haemorrhageAn anticoagulated patient with falling haemoglobin and flank pain: CT finds the haematoma, its compartment, the hematocrit level, active extravasation and the source — iliopsoas, rectus sheath, renal or adrenal — which decides embolisation.CT
- Subarachnoid haemorrhageBlood in the CSF spaces is subtle and dependent — search the basal cisterns, the sulci, the sylvian fissures and the occipital horns deliberately.CT · 1 value · 4 papers
- Testicular torsionA time-critical clinical diagnosis. Image only if it will not delay surgery, and look at the cord, not just the flow.USG · 3 values · 4 papers
- The cause of acute cholangitisCholangitis is a clinical diagnosis (fever, jaundice, raised inflammatory markers); imaging proves biliary dilatation, finds the level and cause of obstruction, and looks for the complication that changes management — a liver abscess or portal vein thrombosis.USG · CT · MRI
- Toxic megacolon — the calibre, the wall and the perforationA transverse colon over 6 cm with loss of haustra and nodular, thinned wall in a systemically unwell patient with colitis — reported with the maximal diameter and a direct search for free gas.X-ray · CT
- Acetabular fractureClassify by Judet–Letournel from the columns and walls on CT and 3D, then measure what the surgeon acts on: the articular gap and step-off in the weight-bearing dome, marginal impaction, intra-articular fragments and femoral head position.CT · 3 papers
- Acute traumatic spinal cord injury on MRIMRI shows what CT cannot: cord oedema length, cord haemorrhage (the worst prognostic sign), ongoing compression by disc or haematoma, and ligamentous disruption — the report grades and localises it for surgery and prognosis.MRI
- Adult elbow fractures and the terrible triadIn an adult, a displaced fat pad means a fracture — usually the radial head. Then look for the combination that destabilises the elbow: dislocation with radial head and coronoid fractures (the terrible triad).X-ray · CT · 3 values · 5 papers
- Ankle fracture and mortise injuryRead the ankle as a ring around the talus: find every malleolar fracture, then measure the mortise — medial clear space, tibiofibular clear space and overlap — because a widened mortise makes a simple-looking fibular fracture unstable.X-ray · CT · 5 values · 4 papers
- Arterial injury in an injured limbAfter penetrating injury, knee dislocation or a displaced fracture near an artery, CT angiography shows occlusion, active extravasation, pseudoaneurysm, intimal flap or arteriovenous fistula — and the minor injuries that can be watched.CT
- Bladder and urethral injuryA passively filled bladder on a trauma CT cannot exclude rupture: fill it retrogradely (CT cystography) and classify the leak as intraperitoneal or extraperitoneal; if the urethra may be injured, prove it is intact before a catheter goes in.CT · Fluoroscopy · 1 value · 4 papers
- Blunt cerebrovascular injuryCTA of the neck in a screened patient: follow each carotid and vertebral artery from origin to skull base and grade what you find by the Biffl (Denver) scale — the grade decides antithrombotic therapy or intervention.CT · 4 papers
- Blunt thoracic aortic injuryLook at the aortic isthmus on the arterial phase in every trauma CT: an intimal flap, a contour bulge or a pseudoaneurysm there is the injury that kills at the scene or days later.CT · 3 values · 4 papers
- Bowel and mesenteric injuryThe injury CT misses most: look for a bowel wall defect, extraluminal gas, a mesenteric haematoma or active mesenteric bleeding, and unexplained free fluid — each of which, without a solid organ injury to explain it, must be said out loud.CT · 4 papers
- Calcaneal fractureFall from height: measure Böhler's angle on the lateral radiograph, then classify the posterior facet on the coronal CT (Sanders) — and look at the lumbar spine and the other foot.X-ray · CT · 3 values · 3 papers
- Cardiac and pericardial injuryHaemopericardium is the finding that matters: on FAST and CT, look for pericardial fluid of blood attenuation and the signs of tamponade, and in penetrating trauma follow the track to the heart.CT · USG · 1 value · 3 papers
- Cervical spine injuryCT from the occiput to the upper thoracic spine, read as lines, joints and columns: the craniocervical junction, the four alignment lines, every facet joint, and the soft tissues — then decide whether MRI is needed for the ligaments and cord.CT · MRI · X-ray · 13 values · 4 papers
- Chest wall, pleural and lung injuryCount the fractured ribs and find the flail segment, then look for the pneumothorax the radiograph missed, measure the haemothorax, and separate contusion from laceration.CT · X-ray · 6 values · 4 papers
- Craniocervical (atlanto-occipital) dissociationA devastating ligamentous injury easily missed on CT: measure the basion–dens interval and the condyle–C1 interval, look for prevertebral swelling and the subarachnoid blood at the craniocervical junction — and get MRI of the ligaments.CT · MRI
- Diaphragmatic ruptureRead both hemidiaphragms on coronal and sagittal reformats: a discontinuity, a collar of herniated viscus, or bowel lying against the posterior ribs with no diaphragm between is the diagnosis that is missed on axial slices.CT · 1 value · 4 papers
- Facial and orbital fracturesRead the face as buttresses and name the pattern — Le Fort, zygomaticomaxillary complex, orbital blow-out, naso-orbito-ethmoid, mandible — then say what the fracture does to the orbit and the bite.CT · 3 values · 5 papers
- Globe injury and retrobulbar haemorrhageOn the trauma CT, read the orbits on a soft-tissue window: globe contour and volume, lens position, intraocular gas or foreign body, and retrobulbar haematoma with tenting of the posterior globe — the orbital compartment syndrome.CT · 3 values · 5 papers
- Imaging the injured child — selective CT and the differences from adultsChildren need selective, dose-conscious imaging: decision rules for the head (PECARN) and cervical spine, CT abdomen only when indicated, and awareness of the paediatric patterns — solid organ injury managed non-operatively, SCIWORA, and injuries that suggest abuse.CT · USG
- Knee dislocation and popliteal artery injuryA knee dislocation often reduces before imaging. Suspect it from the injury pattern (multiple ligaments, fibular head, Segond, tibial spine), and treat the popliteal artery as injured until CTA or an arterial assessment says otherwise.X-ray · CT · MRI · 1 value · 5 papers
- Lisfranc (tarsometatarsal) injuryCheck two alignments on every foot radiograph — the medial second metatarsal against the middle cuneiform, the medial fourth against the cuboid — and the gap between the first and second metatarsal bases. The injury that is missed is subtle and ligamentous.X-ray · CT · MRI · 1 value · 4 papers
- Liver injuryGrade the laceration and haematoma by AAST 2018, find the vascular injury across the phases, and trace every laceration to the hepatic veins, the IVC and the porta — the juxtahepatic venous injury is the one that kills.CT · 3 values · 5 papers
- Measuring a distal radius fractureDescribe the fracture and give the four radiographic parameters — radial inclination, radial height, palmar/dorsal tilt and ulnar variance — plus articular step-off; then look at the scaphoid, the scapholunate interval and the DRUJ.X-ray · CT · 3 values · 4 papers
- Measuring a femoral or tibial shaft fractureDescribe it the way it will be fixed: location, pattern, fragment count, then the six numbers — displacement, angulation, rotation, shortening, gap and joint extension — each measured in a defined way and in two planes.X-ray · CT · 1 value · 3 papers
- Paediatric elbow fractureThree lines and two fat pads on the lateral and AP radiographs find almost every paediatric elbow fracture: the anterior humeral line, the radiocapitellar line, and the ossification centres in their CRITOE order.X-ray · 10 values · 4 papers
- Pancreatic and duodenal injuryThe injury that looks trivial on the first CT: find the laceration across the pancreatic neck and ask whether it crosses the main duct; separate a duodenal wall haematoma from a perforation.CT · MRI · 2 values · 4 papers
- Pelvic ring disruptionThe pelvis is a ring: find the anterior and the posterior injury, name the force pattern (lateral compression, anteroposterior compression, vertical shear), and look for the arterial bleeding and the bladder and urethral injury that travel with it.CT · X-ray · 1 value · 4 papers
- Performing FAST and eFASTFour abdominal windows and two thoracic ones, each answering one question — free fluid, pericardial fluid, pneumothorax. A positive FAST in an unstable patient changes the next step; a negative FAST excludes nothing.USG · 2 values · 3 papers
- Perilunate dislocation and scapholunate injuryOn the lateral wrist film, follow the radius–lunate–capitate column: they must stack like cups. A capitate sitting off the lunate (perilunate) or a lunate tipped out of the radius (lunate dislocation) is missed in a large share of first presentations.X-ray · CT · MRI · 3 values · 4 papers
- Physeal (growth plate) fractureName the Salter–Harris type by what the fracture line crosses — physis, metaphysis, epiphysis — because the type predicts growth disturbance; compare the physeal width with the other side when the film looks normal.X-ray · CT · MRI · 2 values · 4 papers
- Proximal femoral (hip) fractureName the site — intracapsular (femoral neck) or extracapsular (intertrochanteric, subtrochanteric) — and whether a neck fracture is displaced: that single distinction decides fixation versus replacement. When the radiograph is normal and the patient cannot bear weight, MRI.X-ray · CT · MRI · 1 value · 5 papers
- Reading a penetrating torso injuryReconstruct the TRAJECTORY first — entry, exit or projectile, and the organs in line between them — then look at every structure on that path, because the injury is wherever the track went, not where the blood is.CT · 4 papers
- Renal injuryGrade the laceration by AAST 2018 on the nephrographic phase, then use the delayed excretory phase to prove or exclude a collecting system or ureteropelvic injury — the one question a single-phase CT cannot answer.CT · 3 values · 5 papers
- Scaphoid fractureA normal radiograph does not exclude it. Say that plainly, because the missed scaphoid fracture is the classic avascular necrosis.X-ray · CT · MRI · 1 value · 3 papers
- Separating active bleeding from contained vascular injuryAcross the arterial, portal venous and delayed phases: active extravasation GROWS and changes shape; a pseudoaneurysm or AV fistula stays the same size and washes out with the blood pool. The difference changes the grade, the urgency and the treatment.CT · 1 value · 5 papers
- Shoulder dislocation and proximal humeral fractureTwo views in orthogonal planes, always — a posterior dislocation hides on a single AP. Then count the parts of a proximal humeral fracture by Neer and measure the greater tuberosity displacement and glenoid bone loss.X-ray · CT · 7 values · 4 papers
- Skeletal injury in suspected physical abuseA complete skeletal survey to the published standard, read for the high-specificity fractures (classic metaphyseal lesions, posterior rib fractures), fractures of different ages, and fractures the history does not explain — with head imaging and a follow-up survey at about two weeks.X-ray · CT · MRI · 2 values · 5 papers
- Skull base and temporal bone fracturesThin-section bone-algorithm CT: trace the fracture through the otic capsule, the facial nerve canal, the carotid canal and the venous sinuses — those four decide what happens next.CT · 4 papers
- Splenic injuryGrade the laceration and haematoma by AAST 2018 on the portal venous phase, then decide from the arterial and delayed phases whether there is a vascular injury or active bleeding — that is what moves the grade to IV or V and the patient to angiography.CT · 3 values · 4 papers
- Sternoclavicular and acromioclavicular injuryA posterior sternoclavicular dislocation can compress the great vessels, trachea and oesophagus and is invisible on a standard chest film — CT is the test. At the other end, grade an AC injury by the coracoclavicular distance.X-ray · CT · 3 values · 4 papers
- Talar fractureA talar neck fracture threatens the talar body's blood supply: classify it by Hawkins from the joints it dislocates, and look for the lateral process fracture that is missed as an "ankle sprain".X-ray · CT · 3 papers
- Thoracolumbar spine fractureName the morphology (compression, burst, distraction, translation), prove or disprove posterior ligamentous complex disruption, and measure height loss, kyphosis and canal compromise.CT · MRI · 3 values · 4 papers
- Tibial plateau fractureA lipohaemarthrosis on the lateral knee radiograph means an intra-articular fracture; CT maps the split, the depression and the columns, and gives the step-off and widening numbers the surgeon plans from.X-ray · CT · MRI · 3 papers
- Tracheobronchial and oesophageal injuryPneumomediastinum is the finding; the question is where the air came from. Look at the airway wall, the endotracheal tube cuff, and the oesophagus, and remember the Macklin effect (alveolar rupture) explains most trauma pneumomediastinum.CT · 4 values · 5 papers
- Traumatic intracranial injuryRead the head CT in a fixed order — extra-axial blood, brain, ventricles and cisterns, bone — and measure the three numbers the neurosurgeon acts on: thickness, midline shift and cistern status.CT · 5 values · 5 papers
- Whole-body CT in major trauma — the protocol and the review orderA standard protocol (non-contrast head and cervical spine, arterial chest, portal venous abdomen-pelvis or split-bolus) and a fixed review order — primary survey for the life-threatening findings in minutes, then the tertiary read — so nothing is missed under pressure.CT
- Abdominal tuberculosisLook in four places — the peritoneum (ascites, omental and mesenteric thickening), the nodes (necrotic, matted), the ileocaecal region (thickening, a contracted caecum) and solid organs — and remember Crohn disease and peritoneal carcinomatosis are the mimics.CT · USG · 4 papers
- Abdominal wall or groin hernia — and whether it is in troubleName the hernia by its neck (inguinal, femoral, incisional, spigelian, obturator), measure the neck and the sac, and look for the complications — obstruction, incarceration, strangulation — that make it an emergency.CT · USG
- Acute diverticulitis and its complicationsFind the inflamed diverticulum, then decide complicated or not — abscess (and its size), extraluminal gas far from the colon, fistula, obstruction — because that decides antibiotics, drainage or surgery.CT · USG · 1 value · 4 papers
- Acute pyelonephritis and its complicationsMost pyelonephritis needs no imaging; imaging is for the patient who does not improve, is diabetic, obstructed or septic — to find obstruction, abscess or emphysematous change.CT · USG
- Adrenal adenoma versus myelolipomaA lipid-rich adenoma is intravoxel fat (unenhanced ≤10 HU or opposed-phase drop). A myelolipoma is MACROSCOPIC fat. They are different tests on the same organ.CT · MRI · 3 values · 5 papers
- Adrenal mass that is not an adenoma — carcinoma, phaeochromocytoma, metastasisWhen an adrenal mass fails the adenoma tests (unenhanced ≤ 10 HU, washout, signal drop), size, heterogeneity, growth and the clinical picture separate carcinoma, phaeochromocytoma and metastasis — and biochemistry must come before any biopsy.CT · MRI
- Appendiceal mucocele — mucinous neoplasm until proven otherwiseA distended, fluid-filled appendix over 1.5 cm with a thin or calcified wall and no fat stranding is a mucocele; its danger is rupture and pseudomyxoma peritonei, so the peritoneum is reported every time.CT · USG
- Autoimmune (IgG4-related) pancreatitisA sausage-shaped pancreas with a low-attenuation capsule-like rim and loss of clefts, a duct narrowed without upstream dilatation, and other IgG4 organs involved — the mimic of pancreatic cancer that must not be resected.CT · MRI
- Autosomal dominant polycystic kidney diseaseBilateral enlarged kidneys replaced by cysts: diagnose by age-specific cyst counts, measure total kidney volume (it predicts progression and qualifies for therapy), and look for complications — haemorrhage, infection, stones, and liver cysts.USG · MRI · CT
- Bladder tumour — muscle invasion and VI-RADSMuscle invasion decides cystectomy versus resection: multiparametric MRI scores the likelihood with VI-RADS on T2, DWI and dynamic contrast; CT stages nodes and metastases.MRI · CT · USG
- Budd–Chiari syndromeObstruction of hepatic venous outflow: absent or reversed flow in the hepatic veins, intrahepatic comma-shaped collaterals, a hypertrophied caudate lobe and a mosaic enhancement pattern — find the level (veins, IVC web) for the interventional plan.USG · CT · MRI
- Cholangiocarcinoma and its resectabilityClassify it by site (intrahepatic, perihilar, distal) and growth pattern, then map what the surgeon needs: the longitudinal biliary extent (Bismuth–Corlette), hepatic artery and portal vein involvement, lobar atrophy and nodes.CT · MRI
- Chronic pancreatitis and its complicationsCalcifications, a dilated beaded duct and parenchymal atrophy make the diagnosis; the report adds the complications — pseudocyst, splenic vein thrombosis, pseudoaneurysm, biliary stricture — and whether a mass is hiding in it.CT · MRI
- Cirrhosis and portal hypertensionDescribe the liver (surface nodularity, caudate hypertrophy), then the signs of portal hypertension — spleen size, portal vein flow direction and velocity, collaterals, ascites — and survey for hepatocellular carcinoma.USG · CT · 4 papers
- Classifying a cystic renal mass (Bosniak 2019)Only a renal-mass protocol CT or MRI can apply Bosniak 2019: count and measure septa and walls, look for enhancement in HU (CT) or visually/subtraction (MRI), and find any enhancing nodule — its shape decides class IV.CT · MRI · USG · 3 values · 4 papers
- Colon cancer on CT — local stage and the metastatic surveyStage a colon cancer on CT: the tumour and its T-stage (beyond the wall into fat, adjacent organs), the nodes, the liver and lungs, the peritoneum — and the complications (obstruction, perforation) that decide an emergency operation.CT
- Focal splenic lesionMost incidental splenic lesions are benign (cyst, haemangioma, hamartoma, infarct); the report separates the simple from the one that needs work-up — solid, growing, multiple with systemic features — and names lymphoma, metastasis and abscess when they fit.USG · CT · MRI
- Gallbladder carcinoma — and separating it from wall thickening that is notThree patterns — a mass replacing the gallbladder, focal or diffuse wall thickening, an intraluminal polyp — then liver invasion, duct involvement and nodes; the hardest part is not calling xanthogranulomatous cholecystitis or adenomyomatosis cancer.USG · CT · MRI
- Gastric cancer on CT stagingWith the stomach distended by water, CT shows the wall thickening or mass, how far it goes through the wall, the nodal stations, peritoneal disease and liver metastases — the peritoneum is the one most often missed.CT
- Gastrointestinal stromal tumour (GIST)An exophytic, well-defined submucosal mass of the stomach or small bowel with heterogeneous enhancement, necrosis and no nodes — size, site and mitotic rate decide risk; response to therapy is judged by attenuation, not only size.CT · MRI
- Grading hepatic steatosis — and saying which method measured itFat is graded qualitatively on ultrasound, estimated from unenhanced CT attenuation, and measured on MRI proton-density fat fraction; the report names the method and the number, and looks for focal fat and sparing that mimic lesions.USG · CT · MRI
- Hepatic hydatid disease (cystic echinococcosis)Classify the cyst by the WHO-IWGE ultrasound stage (CE1–CE5) — it decides active versus inactive and treatment — and look for rupture into the biliary tree, which changes management.USG · CT · MRI
- Intratesticular massA solid intratesticular mass in a young man is a germ cell tumour until proven otherwise; ultrasound confirms it is intratesticular, characterises it and looks at the other testis — CT then stages the retroperitoneum.USG
- Liver abscess — pyogenic or amoebicA complex liver collection in a febrile patient: size, loculation and liquefaction decide aspiration or drainage; the cluster sign suggests pyogenic, a single subcapsular abscess in a young man from an endemic area suggests amoebic.USG · CT
- MR enterography for small bowel Crohn diseaseThe clinical question is not "is there disease" but whether it is ACTIVE INFLAMMATION or FIBROSIS — and those have opposite treatments.MRI · 1 value · 4 papers
- Multiparametric MRI of the prostateThe DOMINANT sequence depends on the zone — diffusion in the peripheral zone, T2 in the transition zone — and getting that backwards inverts the score.MRI · 3 values · 4 papers
- Pancreatic neuroendocrine tumourA well-circumscribed, avidly arterial-enhancing pancreatic mass without duct dilatation — then size, the duct, vessels, liver metastases (also arterially enhancing) and the functioning syndrome that sent the patient.CT · MRI
- Perianal fistula on MRI — the Parks class, the internal opening and the collectionsTrace every tract on T2 fat-saturated images from the internal opening (clock position) to the skin, classify it against the sphincters (Parks), and report extensions and abscesses — the surgical map.MRI
- Peritoneal carcinomatosisNodules, plaques and omental caking on the peritoneal surfaces, with ascites — map it region by region (Peritoneal Cancer Index) because the extent, especially in the small bowel mesentery, decides cytoreductive surgery.CT · MRI
- Portal vein thrombosis — bland or tumourEchogenic or filling-defect material in the portal vein: acute vs chronic (cavernous transformation), extent into the SMV and splenic vein, and whether it is tumour thrombus (enhancing, expanding, next to HCC).USG · CT
- Renal angiomyolipomaMacroscopic fat in a renal mass, without calcification, makes angiomyolipoma the leading diagnosis; ultrasound cannot prove that fat.USG · CT · MRI · 2 values · 4 papers
- Renal infarctionFlank pain with no stone: a wedge-shaped, non-enhancing cortical defect with the cortical rim sign, or global non-enhancement — then the cause (embolus from the heart, dissection, thrombosis).CT
- Retroperitoneal fibrosisA periaortic soft-tissue mantle at L4–L5 that encases the aorta and draws the ureters medially — separate idiopathic or IgG4-related fibrosis from lymphoma and malignant fibrosis, and report the ureteric obstruction.CT · MRI
- Solid renal mass — renal cell carcinoma and its stagingA solid enhancing renal mass without macroscopic fat is renal cell carcinoma until proven otherwise; report size, subtype clues, nephrometry for nephron-sparing surgery, renal vein and IVC thrombus, and the staging.CT · MRI
- Ulcerative colitis — extent, severity and complicationsContinuous colitis from the rectum upward with a thickened, stratified wall; the acute report looks for toxic megacolon and perforation, the chronic one for the lead-pipe colon, strictures (cancer until proven otherwise) and PSC.CT · MRI
- Upper-tract urothelial carcinoma on CT urographyHaematuria work-up: a filling defect, wall thickening or a mass in the pelvicalyceal system or ureter on the excretory phase — and multifocality, because urothelial cancer is a field disease.CT
- Working up a focal liver lesionThe question is almost never "is there a lesion" — it is whether this patient has a background liver, and what the lesion does over TIME after contrast.USG · CT · MRI · 8 values · 4 papers
- Working up a pancreatic cystic lesionIs it communicating with the duct (branch-duct IPMN), and does it have worrisome features or high-risk stigmata? Those, not the cyst's name, drive surveillance, EUS or surgery.MRI · CT · 4 values · 5 papers
- Working up obstructive jaundiceThree questions in order: are the ducts dilated, WHERE does the dilatation stop, and what is sitting at that point.USG · CT · MRI · 4 values · 5 papers
- Xanthogranulomatous pyelonephritisAn enlarged, non-functioning kidney with a central staghorn stone and dilated calyces replaced by low-attenuation material (bear-paw sign), spreading into the perinephric space — the chronic infection that mimics tumour.CT
- Abdominal aortic aneurysm and ruptureMeasure the maximum diameter outer wall to outer wall perpendicular to the centreline, then look for rupture (retroperitoneal haematoma) and impending-rupture signs, and give the anatomy an endovascular repair needs.USG · CT · 3 values · 5 papers
- Acute myocarditis — the Lake Louise criteriaOne T2-based marker of oedema plus one T1-based marker of injury (native T1, ECV or non-ischaemic LGE) makes the diagnosis; the LGE is typically subepicardial in the inferolateral wall and does not follow a coronary territory.MRI
- Anomalous coronary artery origin and courseName the origin and course of each coronary artery — the malignant course between the aorta and pulmonary artery (interarterial) with an intramural segment and slit-like ostium is the one linked to sudden death in young athletes.CT · MRI
- Aortic coarctation — native and repairedFind the narrowing at the isthmus beyond the left subclavian artery, measure it against the diaphragmatic aorta, show its significance (collaterals, gradient), and look for the associated lesions — bicuspid aortic valve above all.X-ray · CT · MRI
- Arrhythmogenic cardiomyopathy (ARVC and its left-dominant forms)The CMR criteria are functional: regional RV akinesia, dyskinesia or dyssynchronous contraction PLUS RV dilatation or dysfunction. Fat on its own is not a criterion; LV subepicardial LGE identifies left-dominant disease.MRI
- Assessing myocardial viability with late gadolinium enhancementThe transmural extent of LGE in each segment predicts recovery after revascularisation: < 25% likely to recover, > 50% unlikely — report per segment on the 17-segment model with LV volumes and EF.MRI
- Bicuspid aortic valve and its aortopathyName the valve morphology (fused type, raphe), then measure the aortic root and ascending aorta at standard levels — the dilated ascending aorta, not the valve, is what sets the surgical threshold.CT · MRI
- Cardiac amyloidosis — an infiltrative cardiomyopathyThick walls with a small cavity, diffuse subendocardial or transmural LGE, myocardium that will not null, very high native T1 and ECV — then bone-avid tracer scintigraphy and a light-chain screen to separate ATTR from AL.MRI · Nuclear · 2 values
- Cardiac mass — thrombus, myxoma, metastasis or sarcomaThrombus is the commonest mass and does not enhance; myxoma is a mobile left atrial mass on a stalk from the septum; metastases are far commoner than primary malignancy — CMR tissue characterisation and first-pass perfusion separate them.MRI · CT
- Cardiac sarcoidosisPatchy mid-wall or subepicardial LGE in the basal septum and lateral wall — often crossing the septum to the RV side — on CMR; focal FDG uptake after proper dietary suppression on PET shows activity. Scar tells you where, PET tells you whether it is active.MRI · PET-CT
- Classifying vascular anomalies (ISSVA) — tumour or malformation, fast or slow flowSeparate vascular tumours (infantile haemangioma — grows then involutes) from malformations (present at birth, grow with the child), then slow-flow (venous, lymphatic, capillary) from fast-flow (arteriovenous) — the class decides sclerotherapy, embolisation or observation.USG · MRI
- Coronary artery calcium score — and incidental calcium on routine chest CTAn Agatston score from a gated non-contrast scan, given with the MESA or age/sex percentile and a CAC-DRS category; on a non-gated chest CT, coronary calcium is still reported (none, mild, moderate, severe).CT
- CT before atrial fibrillation ablation — pulmonary vein anatomy and the appendageMap the pulmonary veins (number, ostia, common trunks, early branching), exclude left atrial appendage thrombus on a delayed phase, and note the oesophagus behind the posterior wall.CT
- Endoleak after EVARAfter endovascular aneurysm repair, contrast outside the graft but inside the sac is an endoleak: type I (seal zone) and III (graft defect) need urgent repair; type II (branch backflow) is watched unless the sac grows.CT · USG
- Femoral pseudoaneurysm after catheterisation — the yin-yang and the neckA perivascular sac with swirling bidirectional (yin-yang) colour flow connected by a neck with to-and-fro spectral flow to the femoral artery — measure sac and neck to choose compression, thrombin or surgery.USG
- Fibromuscular dysplasia — the string of beadsAlternating stenoses and dilatations ("string of beads") in the mid and distal renal or internal carotid arteries of a young or middle-aged woman — distinct from ostial atherosclerosis.CT
- Following a repaired tetralogy of Fallot on cardiac MRIThe questions are about the RV: how big (indexed volumes), how well it pumps, how much the pulmonary valve leaks (regurgitant fraction), and whether the outflow tract or branch pulmonary arteries are narrowed — because together they time pulmonary valve replacement.MRI · CT
- Grading internal carotid artery stenosisOn Doppler, grade by the peak systolic velocity and the ICA/CCA ratio together with the grey-scale plaque; on CTA, measure by NASCET — the narrowest lumen against the normal distal ICA.USG · CT · 3 values · 5 papers
- Hypertrophic cardiomyopathy on cardiac MRIMeasure the thickest segment on short-axis cine at end-diastole, find where it is (septal, apical, mid-ventricular), look for LV outflow obstruction and an apical aneurysm, then quantify scar — and rule out the phenocopies before you call it HCM.MRI · 2 values
- Iliac vein compression (May–Thurner)Compression of the left common iliac vein between the right common iliac artery and the spine — reported as percentage narrowing with collaterals, in a patient with left leg swelling or left iliofemoral DVT.CT · USG
- Imaging after the arterial switch for transposition of the great arteriesAfter the arterial switch the pulmonary arteries drape over the aorta (Lecompte); follow-up looks for branch pulmonary artery stenosis, neo-aortic root dilatation and regurgitation, and coronary ostial stenosis.MRI · CT
- Imaging the Fontan circulationIn a single ventricle palliated with a Fontan (total cavopulmonary connection), follow-up looks for conduit and pulmonary artery obstruction or thrombus, collateral flow, ventricular function, and the liver (Fontan-associated liver disease).MRI · CT
- Large-vessel vasculitis — Takayasu arteritis and aortitisSmooth concentric wall thickening of the aorta and its branches with stenoses, occlusions and aneurysms in a young woman (Takayasu) or an older patient (giant cell arteritis) — early wall thickening and enhancement come before stenosis; the report maps every involved branch.CT · MRI
- Left ventricular hypertrabeculation ("non-compaction")Excess trabeculation is common and often benign (athletes, pregnancy, sickle cell); the diagnosis of a cardiomyopathy needs more than a ratio — LV dilatation or dysfunction, LGE, thin compacted myocardium, and family history.MRI
- Left-to-right shunt — ASD, VSD, PAPVR and PDAA shunt is proved by FLOW, not by a hole: measure Qp:Qs with phase contrast, look for the right-heart volume load, then name the defect — and in a sinus venosus defect, find the anomalous pulmonary vein.MRI · CT
- Mapping lower limb venous insufficiency (varicose veins)Standing duplex: find which junctions and trunks reflux (saphenofemoral, saphenopopliteal, the great and small saphenous veins, perforators), measure the reflux time and the diameters, and draw the map the surgeon or interventionist will treat from.USG · 1 paper
- Measuring myocardial and liver iron with T2* MRIIn transfusion-dependent anaemias (thalassaemia major), cardiac T2* below 20 ms indicates myocardial iron and below 10 ms severe loading with heart failure risk; liver R2* or T2* estimates liver iron concentration — the numbers guide chelation.MRI
- Pericardial effusion, tamponade and constrictionSize the effusion, then answer the real question — is it compressing the heart (tamponade) or is the pericardium thick and the filling restricted (constriction)?USG · CT · MRI · 2 values · 5 papers
- Planning TAVI on CTMeasure the aortic annulus in systole (area, perimeter, diameters), the coronary ostial heights, sinus and sinotubular dimensions, valve calcification, and the iliofemoral access calibre — the numbers that choose the valve size and route.CT
- Pulmonary hypertension on CTMeasure the main pulmonary artery against the ascending aorta, look at the right heart, then search for the cause — chronic thromboembolism, lung disease, a shunt or left heart disease — because the cause is the report.CT · 4 papers
- Quantifying valve regurgitation and stenosis on CMRWhen echocardiography is uncertain, CMR measures the regurgitant volume and fraction directly by phase-contrast flow and volumetric difference, and the ventricular volumes that decide surgery timing.MRI
- Reading a coronary CT angiogramConfirm the study is diagnostic, map the coronary anatomy and dominance, grade every stenosis in the segment model, then summarise with CAD-RADS 2.0 — stenosis category plus plaque burden and modifiers.CT · 2 values · 5 papers
- Reading a stress perfusion cardiac MRI — ischaemia and viabilityAn inducible perfusion defect is subendocardial, in a coronary territory, and persists beyond peak myocardial enhancement; the LGE on the same study tells you whether that myocardium is viable.MRI · CT
- Reading an MR angiogramMRA over-reads stenosis by design — turbulence causes signal loss that looks like narrowing, and the technique determines how much.MRI · 5 papers
- Reading late gadolinium enhancement on cardiac MRIWhere the scar sits in the wall is the diagnosis: subendocardial or transmural in a coronary territory is infarction; mid-wall or epicardial, sparing the subendocardium, is non-ischaemic — then match the pattern to the cardiomyopathy.MRI · 2 values · 5 papers
- Reading run-off angiography in peripheral arterial diseaseMap every stenosis and occlusion from the aorta to the feet by segment, with length and degree, reconstitution and the best tibial vessel to the foot — the map the vascular team uses to choose angioplasty or bypass (GLASS/TASC).CT · MRI
- Renal artery stenosisAtherosclerotic stenosis at the ostium in older patients, fibromuscular dysplasia (string of beads, mid-distal) in young women — Doppler measures the peak systolic velocity and renal–aortic ratio, CTA shows the anatomy.USG · CT
- Takotsubo (stress) cardiomyopathy on CMRRegional wall-motion abnormality beyond one coronary territory (apical ballooning most often) with oedema in the same segments and NO infarct-pattern LGE — after unobstructed coronaries — separates Takotsubo from infarction and myocarditis.MRI
- The cause of a dilated left ventricle on cardiac MRIA dilated, poorly contracting LV is the phenotype, not the diagnosis: the LGE pattern separates ischaemic from non-ischaemic, and a mid-wall septal stripe is both a clue and a risk marker.MRI · 2 values
- Thoracic aortic aneurysm — measuring it the same way every timeDiameters perpendicular to the centreline at fixed landmarks, compared with the prior study at the same landmarks — growth rate and absolute size set surveillance and repair.CT
- ARDS — bilateral opacities, dependent consolidation and the complicationsBilateral opacities not fully explained by effusion, collapse or nodules, within a week of an insult (Berlin definition); CT shows a gradient from normal non-dependent lung to dependent consolidation, and imaging tracks barotrauma and line position.X-ray · CT
- Aspiration pneumonia and pneumonitis — gravity decides whereConsolidation in the dependent segments for the position at the time — posterior upper-lobe and superior lower-lobe segments when supine, basal segments when upright — often with centrilobular tree-in-bud and airway debris.X-ray · CT
- Bronchiectasis and its causeCompare each bronchus with its companion artery (bronchoarterial ratio), look for lack of tapering, then map the distribution — upper, lower, central or focal — because the distribution points to the cause.CT · 4 papers
- Cardiogenic pulmonary oedema — the sequence on the chest radiographUpper-lobe diversion, then interstitial oedema (Kerley B lines, peribronchial cuffing, fissural thickening), then alveolar oedema in a bat-wing distribution with effusions — graded in order.X-ray · CT
- Characterising a pleural effusion and empyemaUltrasound sizes and characterises the fluid and guides the needle; CT separates empyema from lung abscess and finds pleural thickening that suggests malignancy.USG · CT · 3 values · 4 papers
- Chronic thromboembolic pulmonary hypertension (CTEPH)Organised chronic clot looks different from acute clot: eccentric wall-adherent thrombus, webs and bands, abrupt narrowing and post-stenotic dilatation, mosaic perfusion and bronchial artery collaterals — findings that mean referral for endarterectomy or angioplasty.CT
- Community-acquired pneumonia and its complicationsFind the consolidation and name its lobe by the borders it silhouettes, then look for what changes management — effusion or empyema, cavitation, and an underlying obstructing lesion.X-ray · CT · 4 papers
- Diffuse alveolar haemorrhageBilateral ground glass and consolidation with centrilobular nodules and, days later, crazy paving — with haemoptysis, a falling haemoglobin and a vasculitis or anticoagulation context; BAL with sequentially bloodier returns confirms it.CT
- Diffuse cystic lung disease — LAM, LCH, BHD, LIPCysts are thin-walled and air-filled (unlike emphysema, which has no wall); their shape and distribution identify the cause — round uniform (LAM), bizarre upper-zone (LCH), basal paramediastinal (Birt–Hogg–Dubé), few perivascular with ground glass (LIP/Sjögren).CT
- Drug-induced lung disease, including checkpoint-inhibitor pneumonitisA new pattern of lung injury that began after a drug — organising pneumonia, NSIP, HP-like, diffuse alveolar damage — in a patient on amiodarone, methotrexate, bleomycin, nitrofurantoin or immune checkpoint inhibitors; the report names the pattern and the time course.CT
- Eosinophilic pneumonias — peripheral and migratoryChronic eosinophilic pneumonia gives peripheral, upper-zone consolidation (the photographic negative of pulmonary oedema); acute eosinophilic pneumonia mimics ARDS with septal thickening and effusions — both confirmed by eosinophils in BAL or blood.CT
- Hypersensitivity pneumonitis — non-fibrotic and fibroticSmall-airway disease is the signature: poorly defined centrilobular nodules and mosaic attenuation with air trapping on expiration; fibrotic HP adds fibrosis without the basal-subpleural predominance of UIP. Then ask for the exposure.CT
- Lines and tubes on the ICU chest radiographFor each device: where the tip is, where it should be, and what complication it has caused — in the order endotracheal tube, central lines, nasogastric tube, chest drains, then the pneumothorax check.X-ray
- Lobar collapse on the chest radiograph — the patterns for each lobeEach lobe collapses in its own direction and leaves its own signature (Golden S, luftsichel, veil-like opacity, sail sign); the job is to name the lobe and then find the cause at the hilum.X-ray · CT
- Lung abscess — and separating it from empyemaA thick-walled cavity with an air–fluid level inside the lung: CT separates it from an empyema (lenticular, split pleura, compresses lung) because an abscess is treated with antibiotics and an empyema with drainage.CT · X-ray
- Lung ultrasound at the bedsideYou are reading ARTEFACTS, not anatomy — A-lines mean air, B-lines mean interstitial fluid, and the pattern is the diagnosis.USG · 3 papers
- Lymphangitic carcinomatosisSmooth or nodular interlobular septal thickening with thickened bronchovascular bundles and preserved lung architecture, often unilateral or asymmetric, in a patient with cancer — separate it from pulmonary oedema, which is smooth, bilateral and resolves.CT
- Malignant pleural disease — mesothelioma and metastasesPleural thickening that is circumferential, nodular, > 1 cm thick, or involves the mediastinal pleura points to malignancy (Leung criteria); the report gives the pattern and extent, and looks for asbestos markers and the primary.CT
- Managing a pulmonary noduleMeasure it properly, type it (solid, part-solid, ground-glass), look for the features that raise or lower suspicion, then apply the right rulebook: Fleischner 2017 for an incidental nodule, Lung-RADS v2022 in a screening programme.CT · 6 values · 5 papers
- Mediastinal mass — compartment first (ITMIG)Place the mass in the prevascular, visceral or paravertebral compartment (ITMIG), then read its content — fat, fluid, calcification, enhancement — which narrows prevascular masses to thymic lesions, lymphoma, germ cell tumours and thyroid.CT · MRI
- Non-tuberculous mycobacterial lung diseaseTwo patterns: nodular bronchiectatic (middle lobe and lingula bronchiectasis with tree-in-bud, often in older women) and fibrocavitary (upper lobe cavities like TB in men with COPD) — separating it from TB matters for treatment and isolation.CT
- Nonspecific interstitial pneumonia (NSIP)Symmetric basal ground-glass and reticulation with traction bronchiectasis and immediate subpleural sparing, little or no honeycombing — the NSIP pattern points to connective tissue disease or hypersensitivity until proven otherwise.CT
- Occupational lung disease — silicosis, coal worker pneumoconiosis, asbestosUpper-zone perilymphatic nodules with eggshell-calcified nodes and progressive massive fibrosis (silicosis), and pleural plaques with basal fibrosis (asbestos) — radiographs are classified by the ILO system; CT characterises and finds cancer and TB.CT · X-ray
- Organising pneumoniaPatchy peripheral and peribronchovascular consolidation that migrates, with a perilobular pattern or a reversed halo (atoll) sign — a pattern with many causes, so name the likely cause and the mimic that must be excluded.CT
- Pneumocystis pneumoniaBilateral, symmetric ground glass that is perihilar or upper-lobe predominant with peripheral sparing, sometimes crazy paving, sometimes thin-walled cysts — in an immunocompromised patient. Nodes, effusion or discrete nodules point elsewhere.X-ray · CT
- Pulmonary arteriovenous malformation — the feeding artery sizeA nodule or serpiginous mass with an enlarged feeding artery and draining vein; the feeding artery diameter (≥ 2–3 mm) decides embolisation, and multiple PAVMs mean hereditary haemorrhagic telangiectasia.CT
- Pulmonary aspergillosis — the whole spectrumName the form by the host: a fungus ball in an old cavity (aspergilloma), progressive cavitation with pleural thickening (chronic pulmonary), central bronchiectasis with high-attenuation mucus (ABPA), or nodules with a halo in a neutropenic patient (angioinvasive).CT
- Pulmonary metastasesMultiple well-defined, round, basal-predominant nodules of different sizes in a patient with cancer — count, measure the target lesions, and describe the variants (cavitating, calcified, haemorrhagic halo, miliary) that point to the primary.CT
- Pulmonary tuberculosis — active or oldDecide whether the disease is ACTIVE (cavitation, tree-in-bud, consolidation, new nodules) or sequelae (fibrosis, calcified granuloma, bronchiectasis), because that is the question the physician is asking.X-ray · CT · 4 papers
- Reading a fibrotic interstitial lung disease patternOn HRCT, place the fibrosis (basal, peripheral, upper, peribronchovascular), name its features (reticulation, traction bronchiectasis, honeycombing), then assign the pattern: UIP, probable UIP, indeterminate, or an alternative diagnosis.CT · 4 papers
- Reading emphysema and airway disease on CT in COPDName the emphysema subtype (centrilobular, panlobular, paraseptal) and severity, the airway wall thickening and air trapping — and the findings that change care: lung cancer, bronchiectasis, pulmonary artery enlargement, and suitability for valve or volume-reduction therapy.CT
- Septic pulmonary emboliMultiple peripheral nodules of different sizes, many cavitating, with feeding vessels — in an IV drug user, a patient with a line or right-sided endocarditis, or Lemierre syndrome — the chest CT should prompt echocardiography and a search for the source.CT
- Small cell lung cancerA central hilar and mediastinal mass (often bulky nodes with a small or invisible primary), SVC compression, and early metastases to liver, adrenals, bone and brain — staged as limited or extensive disease.CT
- Smoking-related interstitial lung diseaseRespiratory bronchiolitis (centrilobular ground-glass nodules, upper zones), desquamative interstitial pneumonia (basal ground-glass with small cysts), Langerhans cell histiocytosis (upper-zone nodules and bizarre cysts) and combined fibrosis and emphysema — patterns that improve after smoking cessation.CT
- Staging lung cancer on CT and PET-CTMeasure the primary and name what it touches (T), map nodes by IASLC station (N), and look for metastases in the adrenals, liver, bone and brain (M) — using the TNM edition your centre reports in.CT · PET-CT · 4 papers
- Subsolid nodules — the adenocarcinoma spectrumPure ground-glass and part-solid nodules follow their own Fleischner rules; the solid component size (on lung window, in mm) decides the category, and slow growth over years is the rule rather than the exception.CT
- Superior sulcus (Pancoast) tumourAn apical lung cancer that invades the chest wall: MRI shows the relation to the brachial plexus (first thoracic root), subclavian vessels, vertebral bodies and neural foramina — the anatomy that decides resectability.MRI · CT
- The trachea and central airwaysFocal or diffuse tracheal narrowing, wall thickening that spares or involves the posterior membrane, and dynamic collapse on expiration: stenosis after intubation, tracheobronchomalacia, relapsing polychondritis, amyloid, granulomatosis with polyangiitis and tumours.CT
- Thoracic sarcoidosisSymmetric hilar and right paratracheal nodes with PERILYMPHATIC nodules (along fissures, subpleural surfaces and bronchovascular bundles) in the upper and mid zones — and, late, upper-lobe fibrosis pulling the hila up and back.X-ray · CT
- Viral pneumonia, including COVID-19Bilateral, peripheral, lower-lobe ground glass with or without consolidation and crazy paving suggests COVID-19 or another viral pneumonia; say how typical the pattern is, and look for what changes management — PE, superinfection and later fibrotic change.X-ray · CT
- Acute invasive fungal sinusitis (mucormycosis)In a diabetic or immunocompromised patient, the earliest sign is not bone destruction but soft tissue beyond the sinus walls — periantral fat stranding, and on MRI a black (non-enhancing) turbinate — then orbital, cavernous sinus and brain extension.CT · MRI
- Acute stroke with MRI and perfusion — core, penumbra and the late windowBeyond the non-contrast CT: the infarct core (DWI or CT perfusion rCBF), the hypoperfused tissue at risk (Tmax), the vessel occlusion on angiography, and the DWI–FLAIR mismatch that dates a wake-up stroke — each answers a thrombectomy or thrombolysis question.MRI · CT
- An intracranial mass — intra-axial or extra-axial, and then what?Decide the compartment first (a CSF cleft, a dural base and buckled grey matter mean extra-axial), then use enhancement, diffusion and perfusion to separate glioma, metastasis, lymphoma and meningioma — and report mass effect before anything else.MRI · CT · 4 papers
- Assessing a parotid massThree questions decide the operation: which lobe, where is the facial nerve, and does the signal behave like a benign tumour or a malignant one.MRI · 1 value · 4 papers
- Assessing a thyroid noduleA risk-stratification exercise with a published lexicon — the features are scored, not described freely, and size only matters after the score.USG · 4 values · 4 papers
- Brain arteriovenous malformationA nidus of vessels with early venous drainage; the Spetzler–Martin grade needs size, eloquence and deep venous drainage — and the report looks for the high-risk features (intranidal aneurysm, venous stenosis, deep drainage) and haemorrhage.MRI · CT
- Brain metastasesCount them on thin post-contrast MRI — the number and size decide stereotactic radiosurgery versus whole-brain radiotherapy — at the grey–white junction and in the posterior fossa, and separate a solitary metastasis from a glioma or abscess.MRI · CT
- Cerebral venous sinus thrombosisThink of it when a headache, seizure or haemorrhage does not fit an arterial territory. Look at the sinuses themselves: a dense sinus on CT, a filling defect on CT venography, and loss of flow void or clot signal on MRI.CT · MRI · 1 value · 3 papers
- Cervical lymph nodes — benign, metastatic, tuberculous or lymphomaName the level, measure the short axis, then the features that matter more than size: loss of the fatty hilum, rounded shape, necrosis, cystic change, calcification, peripheral vascularity and extranodal extension.USG · CT
- Chiari I malformation and syringomyeliaMeasure tonsillar descent below the foramen magnum, assess crowding and CSF flow, and find the syrinx — then look for the causes of a syrinx other than Chiari (tumour, trauma, tethered cord).MRI
- CNS tuberculosis — meningitis, tuberculomas and their complicationsBasal meningeal enhancement with hydrocephalus and infarcts in the basal ganglia is tuberculous meningitis; T2-dark ring lesions are tuberculomas; the report grades hydrocephalus and infarcts because they drive outcome.MRI · CT
- Deep neck space infectionTwo questions that outrank the diagnosis: is the AIRWAY threatened, and has it reached the mediastinum or a vessel.CT · 1 value · 4 papers
- Demyelination that is not MS — NMOSD and MOGADLong optic neuritis, longitudinally extensive myelitis and area postrema lesions point away from MS towards aquaporin-4 NMOSD or MOG antibody disease — the treatment differs and some MS drugs worsen NMOSD.MRI
- Diffuse glioma in the WHO 2021 (CNS5) eraImaging cannot give the molecular diagnosis but can predict it: the T2–FLAIR mismatch sign suggests IDH-mutant astrocytoma, calcification and frontal cortical location suggest oligodendroglioma, necrosis and a thick enhancing rim suggest glioblastoma — and the report maps eloquent cortex for surgery.MRI
- Herpes simplex encephalitisAsymmetric bilateral limbic involvement — medial temporal lobes, insula, cingulate — with restricted diffusion and later haemorrhage, sparing the basal ganglia; the report should prompt aciclovir now, not after the PCR.MRI · CT
- Hydrocephalus — obstructive or communicating, and is it acute?Tell hydrocephalus from atrophy (dilated temporal horns and a small, sharp callosal angle versus widened sulci), find the level of obstruction by which ventricles are large, and look for signs that it is acute — transependymal oedema and effaced sulci.CT · MRI · USG · 4 papers
- Idiopathic intracranial hypertension — the supporting signs and the venous sinusesFlattened posterior globes, distended optic nerve sheaths, a partially empty sella and transverse sinus stenosis support raised pressure; MR venography excludes the sinus thrombosis that mimics it.MRI
- Intracranial aneurysm and describing it for treatmentFind the aneurysm on CT or MR angiography, then describe what the neuro-interventionalist needs: location, size, neck width, dome-to-neck ratio, branches from the neck, irregularity (blebs) — the features that decide coiling, clipping or surveillance.CT · MRI
- Meningioma — and what to report for the surgeonAn extra-axial, dural-based, avidly enhancing mass with a CSF cleft and dural tail; the report adds venous sinus invasion, hyperostosis, brain oedema and the features that suggest a higher grade.MRI · CT
- Mesial temporal sclerosis in epilepsyOn an epilepsy-protocol MRI, a small hippocampus with bright T2/FLAIR signal and loss of internal architecture — plus the secondary signs (fornix, mammillary body, temporal horn) — identifies a surgical target.MRI
- Middle ear cholesteatomaA non-dependent soft-tissue mass in the attic (Prussak space) eroding the scutum and ossicles on CT, and restricting on non-EPI diffusion MRI — the MRI is what separates cholesteatoma from granulation tissue after surgery.CT · MRI
- Moyamoya vasculopathyProgressive stenosis of the distal ICAs and proximal ACA/MCA with a basal collateral network — ivy sign on FLAIR, watershed infarcts — in a child with TIAs or an adult with haemorrhage.MRI · CT
- Myelitis — separating the causes by patternA T2-bright cord lesion with or without enhancement: its length, axial position and enhancement pattern separate MS, NMOSD, MOGAD, infection, sarcoid, spinal cord infarct and dural fistula — and a compressive cause must be excluded first.MRI
- Neonatal hypoxic-ischaemic injury on MRIThe PATTERN depends on the severity and the maturity of the brain, and the TIMING of the scan changes what diffusion shows.MRI · 3 papers
- Neurocysticercosis — and staging itA cyst with a scolex (vesicular), a ring-enhancing lesion with oedema (colloidal), a nodular enhancing lesion (granular) or a calcified dot (nodular calcified): the stage decides antiparasitic treatment; intraventricular and subarachnoid forms decide surgery.MRI · CT
- Orbital mass — compartment firstPlace the lesion in its compartment (globe, optic nerve sheath, intraconal, extraconal, lacrimal gland), then its behaviour: cavernous venous malformation, schwannoma, lymphoma, optic nerve glioma or meningioma, lacrimal tumours and metastases each have a home.MRI · CT
- Pituitary adenomaDynamic contrast MRI of the sella: a microadenoma enhances LATER than the normal gland; a macroadenoma is measured and its reach is named — optic chiasm, cavernous sinus (Knosp grade), sphenoid sinus — because that decides surgery.MRI · 3 papers
- Primary CNS lymphomaA periventricular or deep grey matter mass that is T2-dark, restricts on diffusion and enhances homogeneously — suggest it before biopsy, because steroids can make it vanish and the biopsy non-diagnostic.MRI
- Reading atrophy patterns in suspected dementiaRate the atrophy that matters — medial temporal (MTA), posterior (Koedam), frontal and anterior temporal — score small-vessel disease (Fazekas) and microbleeds, and exclude the treatable (NPH, tumour, subdural): structural MRI supports, it does not diagnose, the dementia subtype.MRI
- Reading sinus CT before endoscopic sinus surgeryStage the disease (Lund–Mackay), map the drainage pathways (ostiomeatal unit, frontal recess, sphenoethmoidal recess), and flag the anatomical danger points — Keros depth, lamina papyracea, Onodi cell, dehiscent optic nerve or ICA — for the surgeon.CT
- Sialolithiasis and obstructive sialadenitisA calculus in the submandibular (Wharton) or parotid (Stensen) duct with upstream ductal dilatation — the stone's position along the duct and its size decide endoscopic, transoral or gland surgery.USG · CT
- Staging laryngeal cancerStage by subsite (supraglottic, glottic, subglottic) and the spaces that change the T-stage: pre-epiglottic and paraglottic fat, thyroid cartilage (inner vs outer cortex), and extralaryngeal spread — then the nodes.CT · MRI
- Staging nasopharyngeal carcinomaMRI stages it: the fossa of Rosenmüller origin, parapharyngeal and skull base extension, perineural spread through the foramina to the cavernous sinus, and the retropharyngeal and cervical nodes that are almost always involved.MRI · CT
- Staging oral cavity cancerDepth of invasion (DOI) now sets the T-stage for oral tongue and floor of mouth, alongside mandibular invasion, extrinsic muscle and neurovascular involvement — and the nodes, where extranodal extension changes N-stage.MRI · CT
- The ring-enhancing brain lesionDiffusion is the discriminator: an abscess restricts CENTRALLY, a necrotic tumour does not.MRI · 4 papers
- Thyroid eye disease — and the threatened optic nerveEnlarged extraocular muscle bellies sparing the tendons (inferior and medial first), increased orbital fat and proptosis; the report must say whether the orbital apex is crowded, because compressive optic neuropathy needs urgent decompression.CT · MRI
- Vestibular schwannoma — the internal auditory canal and the cerebellopontine angleAn enhancing mass centred on the internal auditory canal (IAC), extending into the cerebellopontine angle as an "ice-cream cone" — measured in its largest CPA dimension and staged by its relation to the brainstem.MRI
- Wernicke encephalopathy and other toxic-metabolic patternsSymmetric T2/FLAIR and DWI signal in the medial thalami, mammillary bodies, periaqueductal grey and tectal plate in a malnourished or alcoholic patient — thiamine is given on suspicion, the MRI supports it.MRI
- Working up spontaneous intracerebral haemorrhageMeasure the haematoma and its mass effect, then find the cause: its location (deep → hypertensive; lobar in the elderly → amyloid), the spot sign on CTA, and the signs of an underlying lesion or venous thrombosis.CT · MRI · 2 values · 4 papers
- Working up white-matter T2/FLAIR hyperintensitiesLocation, shape and the company they keep decide it: periventricular ovoid lesions perpendicular to the ventricles, juxtacortical, infratentorial and spinal cord lesions point to demyelination; small punctate deep lesions in an older vascular patient point to small-vessel disease.MRI · 2 values · 5 papers
- A breast lump in pregnancy or lactation — ultrasound first, and do not dismiss itEvery palpable lump in pregnancy or lactation gets a targeted ultrasound; a solid mass that is not a classic galactocele or lactating adenoma is biopsied — pregnancy-associated breast cancer is often diagnosed late.USG · Mammography
- AdenomyosisEndometrium in the myometrium: an asymmetric globular uterus, a thickened, irregular junctional zone, myometrial cysts and fan-shaped shadowing — MUSA features on ultrasound, junctional zone thickness on MRI.USG · MRI
- Assessing a breast massA lexicon-driven risk assessment where the CONCORDANCE between imaging, examination and pathology decides the outcome — not any single study.USG · Mammography · MRI · 2 values · 4 papers
- Axillary lymph nodes on ultrasound — cortex, hilum and the biopsy targetA normal node has a thin, uniform hypoechoic cortex and a fatty hilum; eccentric cortical thickening over 3 mm, a lost hilum or a round shape are the features that earn a needle.USG
- Breast implant rupture and implant-associated complicationsName the implant type and position, then look for intracapsular rupture (linguine sign), extracapsular silicone, and the late seroma or mass that can mean breast implant-associated anaplastic large cell lymphoma.MRI · USG
- Caesarean scar niche (isthmocele)A triangular anechoic defect in the anterior lower segment at the caesarean scar — report its depth, width, length and, most importantly, the residual myometrial thickness above it.USG
- Caesarean scar pregnancyA gestational sac implanted in the niche of a previous caesarean scar, with thin myometrium between sac and bladder and peritrophoblastic flow — distinguish it from a low intrauterine sac or a miscarriage in progress, because it leads to accreta or rupture.USG
- Characterising an adnexal massEstablish the ORGAN of origin first, then apply a risk-stratification lexicon — and menopausal status changes the meaning of everything.USG · CT · MRI · 5 values · 5 papers
- Characterising an ovarian dermoidA Rokitansky nodule, fat-fluid level or sebum that suppresses on fat-saturated MRI characterises a mature cystic teratoma — once the mass has been shown to be ovarian.USG · CT · MRI · 1 value · 3 papers
- Congenital diaphragmatic hernia — side, liver position and lung sizeStomach or bowel beside the heart with mediastinal shift; the prognosis is in the observed/expected lung-to-head ratio (O/E LHR) and whether the liver is up in the chest.USG · MRI
- Describing breast calcifications with BI-RADSSeparate typically benign calcifications from suspicious ones by morphology (amorphous, coarse heterogeneous, fine pleomorphic, fine linear branching) and distribution (grouped, linear, segmental) — the combination sets the BI-RADS category and the biopsy.Mammography
- Diagnosing early pregnancy failureTransvaginal measurements decide: crown–rump length without a heartbeat, or mean sac diameter without an embryo, at the diagnostic thresholds. Below them the finding is "suspicious" and needs a repeat scan — never a diagnosis.USG · 6 values · 4 papers
- Fetal growth restriction — size, Doppler and timingFGR is defined by size AND function (Delphi consensus): an EFW or AC below the 3rd centile, or below the 10th with abnormal Doppler; the umbilical artery, MCA, cerebroplacental ratio, uterine arteries and ductus venosus stage it — early versus late FGR behave differently.USG
- Fetal MRI of the brainA second-line problem-solver after an equivocal ultrasound — and it must be read against GESTATIONAL AGE, because the normal brain changes weekly.MRI · 1 value · 3 papers
- Fetal urinary tract dilation — the UTD classificationMeasure the anteroposterior renal pelvic diameter on a transverse view and add calyceal dilation, parenchymal thickness and appearance, ureter, bladder and liquor — the UTD A1/A2-3 grade sets postnatal follow-up.USG
- Fetal ventriculomegalyMeasure the atrium of the lateral ventricle correctly (≥ 10 mm is ventriculomegaly), then search for its cause — spina bifida, aqueduct stenosis, callosal agenesis, infection, haemorrhage — because isolated mild ventriculomegaly and associated ventriculomegaly have very different outcomes.USG · MRI
- Gestational trophoblastic disease (molar pregnancy)A complete mole in the first trimester is often only an enlarged cavity with cystic placental change and very high hCG; a partial mole has a fetus with a focally cystic placenta — imaging suggests, histology confirms, and hCG follow-up detects persistent disease.USG
- Hysterosalpingography — tubal patency and the cavityFill the cavity slowly, then watch each tube fill and spill freely into the peritoneum; name the site of any block (proximal, distal with hydrosalpinx) and any cavity filling defect or contour abnormality.Fluoroscopy
- Low-lying placenta, placenta praevia and vasa praeviaMeasure the distance from the placental edge to the internal os on a transvaginal scan: covering the os is praevia, within 20 mm is low-lying; and look with colour Doppler for fetal vessels running over the os (vasa praevia).USG
- Male breast lump — gynaecomastia or cancerMost male breast lumps are gynaecomastia (subareolar, symmetric, fan- or flame-shaped); an eccentric, irregular mass is cancer until proven otherwise — mammography and ultrasound together separate them.Mammography · USG
- Mapping endometriosis — endometriomas and deep diseaseFind the endometriomas (T1 bright, T2 shading), then map deep infiltrating disease compartment by compartment — the uterosacral ligaments, torus, rectosigmoid, bladder, ureters — because the map decides the operation.MRI · USG · 4 papers
- Mapping uterine fibroids (FIGO leiomyoma classification)Count, size and FIGO-classify each fibroid — submucosal (0–2), intramural (3–4), subserosal (5–7), other (8) — because the class decides hysteroscopic, laparoscopic or embolisation treatment; and look for the features that are not a typical fibroid.USG · MRI
- Mastitis and breast abscess — drainable or not, and not a cancerA complex, fluid-predominant collection with an echogenic rim and peripheral hyperaemia in an inflamed breast — measure it for aspiration, and follow it to resolution because inflammatory cancer can look the same.USG
- Measuring cervical length for preterm birth riskTransvaginal cervical length measured to a strict technique — empty bladder, sagittal view of the whole canal, no pressure, three measurements, shortest valid — below ~25 mm before 24 weeks identifies women who benefit from progesterone or cerclage.USG
- Müllerian duct anomalies — the fundal contour decidesSeptate vs bicornuate is decided on the external fundal contour in the true coronal plane of the uterus: an indentation of the fundus means bicornuate; a flat or convex fundus with an internal septum means septate (hysteroscopically treatable).USG · MRI
- Open spina bifida — the cranial signs find itThe lemon sign (frontal scalloping) and banana sign (cerebellum wrapped around the brainstem) in the cranial views lead to the spinal lesion; the level of the defect is what counselling needs.USG
- Pelvic inflammatory disease and tubo-ovarian abscessPID is clinical; imaging is for the patient who looks unwell or has a mass — to find the thick-walled, fluid-filled tube (cogwheel), the tubo-ovarian complex or abscess, and the size that decides drainage.USG · CT
- Placenta accreta spectrumIn a woman with a previous caesarean and a low anterior placenta, look at the placenta–myometrium–bladder interface: lacunae, loss of the clear zone, myometrial thinning, bladder wall interruption and bridging vessels.USG · MRI · 2 values · 5 papers
- Polycystic ovarian morphology — counting follicles properlyFollicle number per ovary (FNPO) of 20 or more on a transvaginal scan with a high-frequency probe, or an ovarian volume of 10 mL or more — one criterion of three for PCOS, never the diagnosis on its own.USG
- Postmenopausal bleeding — the endometrial thickness and when it is not enoughA double-layer endometrial thickness of 4 mm or less in a postmenopausal woman with bleeding has a very low risk of cancer; above that, or when the endometrium cannot be seen well, sampling or hysteroscopy follows.USG
- Reading breast MRI — background, masses, non-mass enhancement and kineticsDescribe fibroglandular tissue and background parenchymal enhancement, then each lesion as a focus, mass or non-mass enhancement with its kinetic curve and diffusion — for high-risk screening, extent of disease, and implant or occult-primary questions.MRI
- Reading the uterus on MRI — adenomyosis, fibroids and the junctional zoneThe JUNCTIONAL ZONE is the measurement that carries the diagnosis, and it is a T2 finding.MRI · 3 values · 4 papers
- Retained products of conceptionAfter delivery or miscarriage: an echogenic endometrial mass with colour Doppler flow into it is retained products; avascular fluid and clot are not — and a hypervascular myometrial lesion may be an enhanced myometrial vascularity or AVM that must not be curetted blindly.USG
- Staging cervical cancer on MRI (FIGO 2018)On high-resolution T2 perpendicular to the cervix, measure the tumour, look for parametrial invasion (the dark stromal ring broken), then vagina, pelvic side wall, bladder and rectum, and nodes — FIGO 2018 lets imaging assign the stage.MRI · 4 papers
- Staging endometrial cancer on MRIThe questions are depth of myometrial invasion (< or ≥ 50%), cervical stromal invasion, extension beyond the uterus and pelvic or para-aortic nodes — each changes the FIGO stage and the extent of surgery.MRI
- Staging ovarian cancer on CT — the map for cytoreductionA CT that describes where the disease is in the sites that make complete cytoreduction difficult: the root of the small bowel mesentery, porta hepatis, lesser sac, diaphragm, and supradiaphragmatic nodes — not only "peritoneal disease present".CT
- The 11–14 week scan — dating, nuchal translucency and early anatomyMeasure crown–rump length to date, nuchal translucency to FMF standards for screening, and survey the early anatomy — skull, brain, heart, abdominal wall, limbs — where many major anomalies are already visible.USG
- The fetal heart at the anomaly scan — five axial viewsScreen the fetal heart with five transverse planes — situs, four-chamber, left and right outflow tracts, three-vessel and three-vessel-trachea — because most major congenital heart disease is missed on the four-chamber view alone.USG
- The second-trimester anomaly scanA protocol-driven survey where completeness is the product — the views are prescribed, and what you did not see must be reported.USG · 4 values · 2 papers
- Twin pregnancy — chorionicity and the complications it predictsChorionicity is set in the first trimester (lambda vs T sign) and decides surveillance: monochorionic twins need two-weekly scans from 16 weeks for twin–twin transfusion (Quintero stage), selective FGR and TAPS.USG
- A child with an abdominal mass — Wilms tumour or neuroblastoma?Find the organ of origin first (claw sign of the kidney, or displacement from outside it), then the discriminators — calcification, vessel encasement versus displacement, crossing the midline — and stage the spread.USG · CT · MRI · 4 papers
- A child with right iliac fossa pain — mesenteric adenitis and the other mimicsWhen the appendix is normal or not seen, name what IS there: enlarged mesenteric nodes with ileal wall thickening (mesenteric adenitis), an ileocolic intussusception, an ovarian cause, or a Meckel diverticulum — and say whether the appendix was fully seen.USG · 2 papers
- Abusive head trauma in an infantSubdural haematomas of different ages or over the convexities and interhemispheric fissure, with hypoxic-ischaemic injury, bridging vein thrombosis and retinal haemorrhages, without an adequate history — the report describes, dates cautiously and triggers the safeguarding pathway and skeletal survey.CT · MRI
- Biliary atresia in a jaundiced infantConjugated jaundice beyond two weeks: the triangular cord sign, an absent or small irregular gallbladder and hepatic subcapsular flow on ultrasound, and no bowel excretion on hepatobiliary scintigraphy point to biliary atresia — surgery (Kasai) before 60 days improves outcome.USG · Nuclear
- Choledochal cyst (Todani classification)Cystic dilatation of the bile ducts: classify it (Todani I–V), show the anomalous pancreaticobiliary junction on MRCP, and look for stones, pancreatitis and — in adults — malignancy.USG · MRI
- Congenital lung malformations — CPAM, sequestration, CLE, bronchogenic cystName the malformation from its content and blood supply: cystic lung (CPAM), a systemic artery from the aorta (sequestration), a hyperinflated lobe (congenital lobar emphysema), a fluid cyst beside the airway (bronchogenic) — CT angiography answers the surgical question.CT · X-ray
- CraniosynostosisAn abnormal head shape: positional plagiocephaly (parallelogram) versus a fused suture — low-dose 3D CT shows which sutures are closed (sagittal, metopic, coronal, lambdoid) and the syndromic pattern.CT · X-ray
- Germinal matrix and intraventricular haemorrhage in the preterm neonateEchogenic haemorrhage at the caudothalamic groove on cranial ultrasound, graded by extension into the ventricles, ventricular dilatation and parenchymal (periventricular venous) infarction.USG
- Haematuria in a child after minor trauma — the kidney that was already abnormalDisproportionate haematuria after minor trauma often reveals a pre-existing renal abnormality — PUJ obstruction, Wilms tumour, horseshoe kidney — so the scan reports the underlying kidney, not only the injury.USG · CT
- Hepatoblastoma and PRETEXT stagingA large liver mass in a child under 3 with very high alpha-fetoprotein: PRETEXT counts the involved sections and the annotation factors (vessels, extrahepatic disease, multifocality, rupture) that decide resectability or transplant.USG · CT · MRI
- Hirschsprung disease on a contrast enemaIn a neonate with delayed meconium or distal obstruction, the contrast enema finds the transition zone and the rectosigmoid ratio — the diagnosis is made on rectal biopsy, but the enema tells the surgeon where the aganglionic segment ends.Fluoroscopy · X-ray · 3 papers
- Hydronephrosis in an infant — PUJ obstruction or reflux?Measure the renal pelvis in the transverse plane and grade the calyces, look at the ureter and bladder, then decide between pelviureteric junction obstruction (ureter not seen) and vesicoureteric reflux or a lower obstruction (ureter dilated) — the next test differs.USG · Fluoroscopy · 4 papers
- Hypertrophic pyloric stenosisFind the pylorus to the right of the gastric antrum, measure the single muscle wall and the channel length on a true longitudinal view, and watch it for several minutes — a channel that opens and lets fluid through is not stenosis.USG · 4 values · 4 papers
- Imaging a child after a urinary tract infection — reflux and scarringUltrasound looks for obstruction and structural anomalies; the micturating cystourethrogram grades vesicoureteric reflux (I–V); DMSA shows scarring — who needs which depends on age and the type of infection (NICE/AAP pathways).USG · Fluoroscopy · Nuclear
- Inhaled foreign body in a childMost inhaled objects are not radio-opaque: the sign is air trapping — a hyperlucent lung that stays inflated on expiration or on the dependent decubitus view — and a normal radiograph does not exclude it; bronchoscopy does.X-ray · CT
- IntussusceptionA target on transverse and a pseudokidney on longitudinal — then decide whether it is ileocolic (needs reduction) or transient small bowel (does not).USG · 1 value · 4 papers
- Juvenile idiopathic arthritis — synovitis, the growth plate and erosionsSynovial thickening and effusion with Doppler signal (ultrasound) or synovial enhancement (MRI) in a child with persistent arthritis; the child's cartilage is thick and unossified, so erosions and growth disturbance are judged against age norms.USG · MRI
- Langerhans cell histiocytosis of boneA punched-out lytic lesion without sclerotic rim — bevelled edges in the skull, vertebra plana in the spine — in a child; the skeletal survey or whole-body MRI decides single vs multisystem disease.X-ray · CT · MRI
- Legg–Calvé–Perthes diseaseIdiopathic avascular necrosis of the femoral head in a young child: a small, dense, then fragmented epiphysis with a subchondral crescent — the lateral pillar and head-at-risk signs predict outcome; MRI shows it before the radiograph.X-ray · MRI
- Malrotation and midgut volvulusBilious vomiting in a neonate is a surgical emergency until proven otherwise. The upper GI contrast study decides: the duodenojejunal flexure must lie left of the left pedicle at the level of the duodenal bulb. Ultrasound adds the whirlpool sign and the SMA/SMV relationship.Fluoroscopy · USG · 3 values · 5 papers
- Meckel diverticulum — bleeding, obstruction and inflammationIn painless rectal bleeding in a child, a focus of pertechnetate uptake in the right lower quadrant appearing with the gastric uptake and persisting is ectopic gastric mucosa in a Meckel diverticulum; in obstruction or diverticulitis, CT shows a blind-ending pouch off the ileum.Nuclear · CT
- Multicystic dysplastic kidney vs hydronephrosisNon-communicating cysts of varying size with no identifiable renal pelvis or normal parenchyma is MCDK; cysts that connect to a central dilated pelvis are hydronephrosis — the distinction decides surgery.USG
- Necrotising enterocolitisPneumatosis and portal venous gas are the specific signs; a fixed loop across serial films is the one that is easy to dismiss.X-ray · USG · 2 values · 4 papers
- Neonatal bowel obstruction — high or low decides the next studyCount the gas-filled loops: a double bubble or few loops means high obstruction (upper GI contrast, exclude malrotation); many dilated loops means low obstruction (contrast enema — Hirschsprung, meconium ileus, small left colon, atresia).X-ray · Fluoroscopy
- Neuroblastoma and its image-defined risk factorsAn adrenal or paraspinal mass with calcification that encases vessels and may enter the spinal canal; staging uses image-defined risk factors (IDRFs) — encasement, invasion, intraspinal extension — and MIBG shows the metastases.CT · MRI · Nuclear
- Oesophageal atresia and tracheo-oesophageal fistulaA nasogastric tube coiled in a blind upper pouch on the chest radiograph; gas in the stomach means a distal fistula (the common type), a gasless abdomen means pure atresia — then look for VACTERL anomalies.X-ray
- Osteomyelitis and septic arthritis in childrenThe radiograph is normal for 10–14 days; MRI shows marrow oedema, subperiosteal abscess and physeal involvement early, and ultrasound finds the joint effusion to aspirate — the report says where the pus is.X-ray · MRI · USG
- Paediatric neck masses — position tells you most of itMidline and moving with tongue protrusion is a thyroglossal duct cyst; along the anterior border of sternocleidomastoid is a branchial cleft cyst; posterior triangle and trans-spatial is a lymphatic malformation — and most lumps are reactive nodes.USG
- Periventricular leukomalacia — the white matter of the preterm brainPeriventricular echogenicity that persists beyond 7 days or evolves into cysts (cystic PVL) on serial cranial ultrasound; MRI at term-equivalent age shows the full extent of white matter injury.USG · MRI
- Pneumonia in a child — round pneumonia, viral pattern and the complicationsLobar or round consolidation favours bacterial infection; bilateral perihilar peribronchial thickening with hyperinflation favours viral; the imaging job is mostly the complications — effusion, empyema, necrosis.X-ray · USG
- Posterior fossa tumour in a childSeparate the big three by location, diffusion and behaviour: medulloblastoma (midline vermis, restricts), pilocytic astrocytoma (cyst with an enhancing nodule, no restriction), ependymoma (fourth ventricle, squeezes through the foramina) — then image the whole neuraxis for drop metastases.MRI · CT
- Posterior urethral valvesA boy with a thick-walled bladder, bilateral hydroureteronephrosis and a dilated posterior urethra (keyhole sign antenatally) — the voiding MCUG shows the valve and the dilated posterior urethra, and ultrasound shows the renal damage.USG · Fluoroscopy
- Reading the neonatal chest radiograph in respiratory distressLung volume and pattern separate the causes: low volume with granular opacity (surfactant deficiency), high volume with streaky perihilar opacity and fissural fluid (transient tachypnoea), patchy asymmetric opacity with hyperinflation (meconium aspiration) — and the lines, tubes and air leaks come first.X-ray
- Retinoblastoma — calcified intraocular mass in a young childA calcified intraocular mass in a child with leukocoria is retinoblastoma until proven otherwise; MRI (not CT) stages optic nerve, choroid and extraocular spread and looks for the pineal tumour of trilateral disease.USG · MRI
- Rickets — the metaphysis at the fastest-growing physisWidened physes with frayed, cupped, splayed metaphyses at the wrist and knee, plus a rachitic rosary and bowing; healing shows as a dense zone of provisional calcification returning.X-ray
- Skeletal dysplasia — the skeletal survey and the segmentsRead a skeletal survey by segment: which part of the limb is short (rhizomelic, mesomelic, acromelic), which part of the bone (epiphysis, metaphysis, diaphysis, spine), and the skull and pelvis — then match the pattern.X-ray
- Slipped capital femoral epiphysis (SCFE)An adolescent with hip or knee pain: the epiphysis slips posteriorly and inferiorly — the frog-leg lateral view shows it first; Klein line and the metaphyseal blanch sign on the AP catch the rest, and the other hip must be checked.X-ray
- Toddler's fracture and other occult fractures of walking childrenA subtle oblique or spiral lucency in the distal tibial diaphysis of a limping 1–3-year-old, often seen on only one view — add an internal oblique view, and if still negative, treat and repeat at 7–10 days.X-ray
- Ultrasound for developmental dysplasia of the hipGet the standard coronal plane first (straight iliac line, triradiate cartilage, labrum) — every Graf angle measured off-plane is wrong. Then measure the alpha angle and femoral head coverage, and stress for instability.USG · X-ray · 4 values · 4 papers
- Wilms tumour (nephroblastoma)A large renal mass in a young child that arises from the kidney (claw sign), displaces rather than encases vessels, and may extend into the renal vein and IVC — report the contralateral kidney, the venous extent and the lungs.USG · CT · MRI
- Adhesive capsulitis (frozen shoulder)Thickening of the coracohumeral ligament and the capsule in the axillary recess with obliteration of the fat under the coracoid (rotator interval) — supporting a clinical diagnosis of painful loss of external rotation.MRI · USG
- Ankle ligament injury — lateral complex, syndesmosis, deltoidAn inversion sprain tears the ATFL, then the CFL; a high sprain tears the syndesmosis; the report adds the osteochondral lesion of the talus and the peroneal tendons that explain persistent pain.MRI · USG
- Anterior shoulder instability — labrum and bone lossAfter an anterior dislocation: the anteroinferior labral tear (Bankart and variants), the Hill–Sachs lesion, and — what decides the operation — the amount of glenoid bone loss and whether the Hill–Sachs is on- or off-track.MRI · CT
- Avascular necrosis of the femoral headMRI finds it before the radiograph: a serpiginous subchondral band with the double-line sign on T2 — then measure the extent of the head involved and look for subchondral collapse, because collapse decides joint-preserving versus replacement surgery.MRI · X-ray · 3 papers
- Bone metastases — lytic, sclerotic, mixed, and the fracture riskReport the number and distribution of lesions, their character (lytic, sclerotic, mixed), and the ones that threaten: cortical destruction in weight-bearing long bones, spinal instability (SINS) and epidural cord compression.CT · MRI
- Calcific tendinopathy of the shoulder — the phase of the depositHydroxyapatite deposits in the rotator cuff (supraspinatus most often): hard, shadowing deposits are formative; soft, non-shadowing ones are resorptive and painful — the phase decides barbotage.USG · X-ray
- Carpal tunnel syndrome on ultrasound — the median nerve areaAn enlarged median nerve cross-sectional area at the tunnel inlet (pisiform level) — commonly above 10–12 mm² (verify local threshold) — with flattening under the retinaculum, and a search for a space-occupying cause.USG
- Cartilage tumour — enchondroma or chondrosarcomaRings-and-arcs chondroid matrix identifies a cartilage tumour; the questions are deep endosteal scalloping (> two-thirds of cortical thickness), cortical breach, periosteal reaction, soft-tissue mass and pain — the features of chondrosarcoma rather than enchondroma.X-ray · MRI · CT
- Degenerative cervical myelopathy — canal, cord and signalReport the level, the cause (disc-osteophyte, ligamentum flavum, OPLL), the degree of canal stenosis with cord compression, and cord signal change on T2 — the surgical indication.MRI
- Ewing sarcoma — permeative bone and a large soft tissue massA permeative, moth-eaten lesion of a diaphysis or flat bone with lamellated (onion-skin) or spiculated periosteal reaction and a soft tissue mass larger than the bone destruction suggests — in a child or young adult.X-ray · MRI
- Femoroacetabular impingement and the hip labrumCam (a bump at the head–neck junction), pincer (acetabular overcoverage) or both: the radiograph measures the angles, MR arthrography shows the labral tear and the cartilage delamination that decide arthroscopy versus arthroplasty.X-ray · MRI
- Fibrous dysplasia — the ground-glass matrixAn expansile intramedullary lesion with a homogeneous ground-glass matrix, a well-defined sclerotic rim (rind) and no periosteal reaction — a "leave-me-alone" lesion in most cases.X-ray · CT
- Giant cell tumour of boneAn eccentric, lytic, subarticular lesion with a narrow non-sclerotic zone of transition in a skeletally mature patient — around the knee and distal radius — the report adds cortical breach, articular surface and pathological fracture.X-ray · MRI
- Gout and calcium pyrophosphate diseaseGout: punched-out erosions with overhanging edges and tophi, the double-contour sign on ultrasound, urate coloured on dual-energy CT; CPPD: chondrocalcinosis of the menisci and TFCC and the SLAC wrist pattern.X-ray · USG · CT
- Grading a muscle injury in the athleteName the muscle, the site (myofascial, myotendinous, intratendinous) and the extent — the British Athletics Muscle Injury Classification grades it, and intratendinous (c) injuries take longest to return to play.MRI · USG
- Is this bone lesion aggressive?The radiograph answers it: the zone of transition, the periosteal reaction and cortical destruction tell you how fast the lesion is growing. Age and location then narrow the differential; MRI stages it.X-ray · MRI · 5 papers
- Lateral patellar dislocation and its risk factorsAfter a transient lateral dislocation the bone bruises (medial patella, lateral femoral condyle) and MPFL tear make the diagnosis; the report then measures the anatomical risk factors — trochlear dysplasia, patella alta, TT–TG distance — that decide stabilisation surgery.MRI
- Lipoma versus well-differentiated liposarcomaPure fat with thin septa is a lipoma; thick septa, nodular non-fat and enhancement are the features that force MRI and histology, because imaging cannot reliably exclude an atypical lipomatous tumour.USG · CT · MRI · 1 value · 4 papers
- Lumbar spinal stenosis — central, lateral recess and foraminalGrade each of the three zones at each level on axial T2 — central canal (Schizas or similar), lateral recess, foramen — and name the structures causing it; the level and zone match the patient's claudication or radiculopathy.MRI
- Morton neuroma — the third web spaceA hypoechoic (ultrasound) or low-signal (MRI) spindle-shaped mass in the intermetatarsal space, most often the third, at or just distal to the metatarsal heads, reproducing pain on compression.USG · MRI
- Myeloma bone diseaseWhole-body low-dose CT has replaced the skeletal survey: count lytic lesions ≥ 5 mm, look for fractures at risk and extramedullary disease; whole-body MRI finds focal marrow lesions (> 1 lesion ≥ 5 mm) that define disease needing treatment.CT · MRI
- Osteoarthritis on the radiograph — which compartment and how much joint spaceAsymmetric joint space narrowing with osteophytes, subchondral sclerosis and cysts, reported by compartment and graded (Kellgren–Lawrence) on a weight-bearing view — the grade and the compartment decide injection, osteotomy or arthroplasty.X-ray
- Osteoid osteoma — find the nidusA small (< 2 cm) lucent nidus, often with central mineralisation, surrounded by dense reactive sclerosis — CT with thin sections finds the nidus that the sclerosis hides, and guides ablation.CT · X-ray
- Osteomyelitis in the diabetic footRadiographs are late; MRI decides. Osteomyelitis is low T1 marrow signal CONFLUENT with a medullary pattern, contiguous with an ulcer or sinus tract — oedema alone, or a neuropathic joint, is not osteomyelitis.X-ray · MRI · 5 papers
- Osteoporotic vertebral fracture — report it, grade it, and ask whether it is benignA vertebral height loss of 20% or more is a fracture (Genant grade 1–3) and must be named in the report — including incidentally on a chest or abdominal CT; MRI separates acute from old and benign from malignant collapse.X-ray · CT · MRI
- Osteosarcoma and Ewing sarcoma — the aggressive bone tumours of the youngAn aggressive metaphyseal lesion with osteoid matrix and sunburst periosteal reaction (osteosarcoma) or a permeative diaphyseal lesion with a large soft-tissue mass (Ewing): the radiograph suggests it, whole-bone MRI stages the marrow extent and skip lesions before biopsy.X-ray · MRI
- Paget disease of bone — enlarged, coarse, and starting at one endBone enlargement with coarsened trabeculae and cortical thickening, starting at one end of a long bone and advancing with a blade-of-grass lytic front; in the skull, osteoporosis circumscripta then cotton-wool sclerosis.X-ray · CT
- Painful hip or knee replacementCompare with the previous radiograph: loosening (progressive lucency ≥ 2 mm), osteolysis from particle disease, periprosthetic fracture, component malposition, dislocation — and for metal-on-metal hips, the pseudotumour on MARS MRI.X-ray · CT · MRI
- Reading a lumbar spine MRI for disc herniation and nerve compressionUse one nomenclature (bulge, protrusion, extrusion, sequestration), place the herniation in its zone, and name the nerve root it touches — because the root, not the disc, explains the symptoms.MRI · 2 papers
- Reading the knee — meniscus and cruciate ligamentsA meniscal tear is signal REACHING AN ARTICULAR SURFACE on two consecutive images — and the root and ramp are where tears are missed.MRI · 2 values · 4 papers
- Rheumatoid arthritis — erosions, synovitis and the cervical spineSymmetric small-joint disease with periarticular osteopenia, uniform joint space loss and marginal erosions; ultrasound and MRI show synovitis and erosions years before the radiograph — and atlantoaxial instability must be looked for before anaesthesia.X-ray · USG · MRI
- Sacroiliitis in axial spondyloarthritisOn MRI, active sacroiliitis is subchondral bone marrow oedema on STIR in the typical location; structural damage is erosions, sclerosis, fat metaplasia and ankylosis on T1 — report both, because both enter the classification.MRI · X-ray · 4 papers
- Shoulder ultrasound for the rotator cuffOperator-dependent and position-dependent — anisotropy is the artefact that manufactures tears, and dynamic assessment is what ultrasound adds.USG · 1 value · 4 papers
- Soft-tissue mass that could be a sarcomaAny soft-tissue mass that is deep to the fascia, larger than 5 cm, growing or painful needs MRI before biopsy — the report gives the compartment, size, relation to the neurovascular bundle and bone, and the features that a lipoma would not have.MRI · USG
- Spondylodiscitis — tuberculous or pyogenicContrast MRI of the whole spine: find the infected disc and endplates, then the collections and the canal — and read the pattern that separates tuberculosis (disc relatively spared, large paraspinal abscess, skip lesions) from pyogenic infection.MRI · CT · 4 papers
- Spondylolysis — the pars interarticularisA defect of the pars interarticularis (usually L5), with or without spondylolisthesis; in adolescents, MRI shows the stress reaction before a fracture line, and CT shows whether the defect is established or healing.CT · MRI · X-ray
- Stress fractures — fatigue and insufficiencyThe radiograph is normal early; MRI grades the injury from periosteal oedema to a fracture line — and the high-risk sites (femoral neck tension side, anterior tibial cortex, navicular, fifth metatarsal base) need a different plan.X-ray · MRI
- The Achilles tendon — tendinopathy and ruptureMidportion versus insertional tendinopathy, and for a rupture the gap in cm (resting and in plantarflexion) with the site — the numbers that decide conservative functional treatment versus repair.USG · MRI
- The elbow — epicondylitis, distal biceps and collateral ligamentsCommon extensor tendinopathy (tennis elbow) and its partial tears, distal biceps rupture with the retraction that decides repair, and the ulnar collateral ligament in the throwing athlete.MRI · USG
- The TFCC and wrist ligamentsUlnar-sided wrist pain: classify TFCC tears (Palmer traumatic 1 vs degenerative 2), check the ulnar variance and ulnocarpal abutment, and look at the scapholunate and lunotriquetral ligaments whose tears lead to carpal instability.MRI
- Acute GI bleeding — CT angiography, then targeted embolisationContrast extravasation on the arterial phase that grows and changes shape on the portal venous phase localises the bleed; the CTA map sends the catheter to the right artery.CT · Fluoroscopy
- An observation in a cirrhotic liver — applying LI-RADSIn a patient at risk, measure the observation and look for the major features — arterial-phase hyperenhancement, washout, an enhancing capsule, threshold growth — then assign the LI-RADS category of the version in use.CT · MRI · USG · 4 papers
- Anastomotic leak after bowel surgeryExtraluminal contrast or gas at the anastomosis, or a perianastomotic collection containing gas, 5–10 days after surgery — separated from the expected post-operative free gas and fluid by its location, growth and contrast.CT · Fluoroscopy
- Assessing HCC after locoregional therapy — LI-RADS treatment responseAfter TACE, ablation or radioembolisation, viable tumour is arterial-phase hyperenhancement, washout or enhancement like pre-treatment in or along the treated lesion; LR-TR viable / non-viable / equivocal — and mRECIST measures the viable part.CT · MRI
- Assessing response to immunotherapy — pseudoprogression and immune-related adverse eventsCheckpoint inhibitors can make tumours look bigger before they shrink (pseudoprogression) — iRECIST requires confirmation of progression — and cause immune-related adverse events (pneumonitis, colitis, hypophysitis, thyroiditis, sarcoid-like nodes) that the report must name.CT · PET-CT
- Assessing treatment response on PET-CTCompare like with like — same scanner, same uptake time, same criteria — and know which scoring system the tumour type uses.PET-CT · 4 values · 4 papers
- Breast MRI after neoadjuvant chemotherapyMeasure residual enhancement in the same way as baseline, describe its pattern (concentric shrinkage vs fragmentation), and state whether the clip is inside residual disease — the surgeon needs extent, not a category.MRI
- Checking central lines, ports and their complicationsName every line and its tip position (cavoatrial junction for most central lines), look for pneumothorax after insertion, malposition into the wrong vein, catheter fracture or pinch-off, fibrin sheath and thrombosis.X-ray · CT
- EVAR planning — the neck, the iliacs and the accessMeasure the infrarenal neck (diameter, length, angulation, thrombus, calcification), the aneurysm, and the iliac and femoral arteries on centreline reformats — these decide whether an endograft can seal and be delivered.CT
- Fluoroscopy during biliary drainageContrast injection into an obstructed system is itself a risk — opacify sparingly, decompress first, and read the level from the filling pattern.Fluoroscopy · 1 value · 4 papers
- Haemodialysis fistula — maturation and dysfunction on DopplerA mature fistula follows the "rule of 6s" (≥ 6 mm diameter, ≤ 6 mm deep, ≥ 600 mL/min flow); dysfunction is a stenosis with a peak velocity ratio of about 2–3 or more, most often at the juxta-anastomotic segment.USG
- Haemoptysis — CT angiography and bronchial artery embolisationCTA localises the bleeding side and lobe, maps enlarged bronchial and non-bronchial systemic arteries, and names the cause (bronchiectasis, TB, aspergilloma, cancer) — the map that makes embolisation quicker and safer.CT · Fluoroscopy
- Imaging before and after uterine artery embolisation for fibroidsBefore UAE: fibroid map, enhancement (non-enhancing fibroids respond poorly), pedunculated subserosal or submucosal fibroids at risk, adenomyosis, and alternatives; after UAE: infarction percentage, expulsion and complications.MRI
- Imaging for vertebroplasty and kyphoplasty — which fracture, and what went wrongBefore augmentation, STIR oedema identifies the painful acute fracture; posterior wall retropulsion and pedicle integrity decide safety; after, cement leakage into the canal, foramina, veins or lungs is the complication to report.MRI · CT
- IVC filter — position and complicationsReport the filter type and position relative to the renal veins, then tilt, strut penetration through the IVC wall into adjacent organs, fracture and embolised fragments, and caval thrombosis — the findings that decide retrieval.CT · X-ray
- Liver metastases — detection, characterisation and resectabilityMost are hypovascular and best seen in the portal venous phase; hypervascular ones (neuroendocrine, renal, melanoma, thyroid) need an arterial phase; MRI with DWI and hepatobiliary contrast finds the small ones that change resection plans.CT · MRI
- Local staging of rectal cancer on MRIFour numbers decide the treatment: distance from the anal verge, T stage, mesorectal fascia clearance, and extramural venous invasion.MRI · 1 value · 5 papers
- Metastases of unknown primary — a structured searchLet the metastatic pattern and histology direct the search: squamous neck nodes to the head and neck mucosa, liver metastases to the gut and pancreas, bone to prostate, breast, lung, kidney and thyroid — then biopsy the safest site that answers the question.CT · PET-CT
- Neutropenic enterocolitis (typhlitis)Circumferential wall thickening of the caecum and ascending colon (± terminal ileum) with pericolic stranding in a neutropenic patient on chemotherapy — reported with wall thickness and a direct search for pneumatosis and perforation.CT · USG
- Oesophageal cancer stagingCT stages local invasion (aorta, airway, pericardium) and nodes and metastases; PET-CT finds distant disease that makes the patient unresectable; endoscopic ultrasound gives the T stage.CT · PET-CT
- Percutaneous nephrostomy — the posterior calyx and Brödel linePuncture a posterior lower- or mid-pole calyx under ultrasound, along the relatively avascular plane (Brödel line), then confirm with contrast before the guidewire and catheter — never the renal pelvis directly.USG · Fluoroscopy
- Planning an image-guided biopsyChoose the modality that shows the target best, pick the shortest safe path that avoids vessels, bowel, pleura where possible and major nerves, and write down the pre-procedure checks — coagulation, the indication and the tissue the pathologist needs.CT · USG · 4 papers
- Planning an image-guided drainageThe question is not "is there a collection" — it is whether there is a SAFE WINDOW, and whether the contents will actually come out of a drain.USG · CT · 1 value · 3 papers
- Portal vein embolisation — the future liver remnantMeasure the future liver remnant (FLR) volume as a percentage of the total functional liver on CT volumetry before and 3–6 weeks after portal vein embolisation; hypertrophy and the kinetic growth rate decide whether major hepatectomy can proceed.CT
- Radiation pneumonitis and fibrosis — confined to the fieldGround glass and consolidation 1–6 months after thoracic radiotherapy, conforming to the treatment field rather than to anatomical lobes; fibrosis follows with volume loss and traction bronchiectasis — a new mass within it is recurrence until proven otherwise.CT
- Radioembolisation (Y-90) — the planning angiogram and the shuntThe work-up maps the arteries, coils or avoids vessels to the gut, and uses a Tc-99m MAA scan to measure the lung shunt fraction and exclude extrahepatic deposition before the dose is calculated.Nuclear · CT
- Radiologically inserted gastrostomy (RIG)Distend the stomach with air, confirm no colon or liver lies in the path, fix the stomach with T-fasteners, then puncture and place the tube under fluoroscopy — with a contrast check before the first feed if in doubt.Fluoroscopy · CT
- Reading a bone scanIt images OSTEOBLASTIC RESPONSE, not tumour — so a purely lytic deposit can be invisible, and a healing fracture can look identical to a metastasis.Nuclear · 1 value · 3 papers
- Reading FDG PET-CT without falling for its pitfallsFDG measures glucose use, not cancer: brown fat, muscle, bowel, infection, granulomas, fractures, post-radiotherapy and post-surgical change, and marrow stimulation after G-CSF all take it up; low-grade and mucinous tumours may not.PET-CT
- Reading PSMA PET-CT in prostate cancerPSMA PET finds nodal and bone disease earlier than CT and bone scan, at staging of high-risk disease and at biochemical recurrence; report with PROMISE / E-PSMA (miTNM) and know the physiological uptake and the non-prostate PSMA-avid lesions that mimic metastases.PET-CT
- Reading radioiodine whole-body scans after thyroid cancer surgeryPost-ablation and diagnostic I-131 or I-123 scans show thyroid remnant, nodal and distant (lung, bone) iodine-avid disease — and a list of physiological and contamination foci that must not be called metastases.Nuclear
- Reading somatostatin-receptor PET (DOTATATE) in neuroendocrine tumoursSomatostatin-receptor PET stages well-differentiated NETs, finds the primary, and selects patients for PRRT (Krenning score) — know the physiological uptake (uncinate process, adrenals, pituitary, spleen) and the accessory spleen.PET-CT
- RECIST 1.1 in practice — choosing and measuring target lesionsChoose up to five measurable target lesions (two per organ) at baseline, measure the same lesions the same way at every time point — longest diameter for lesions, short axis for nodes — and sum them; new lesions mean progression whatever the sum.CT
- Staging a pancreatic head mass for resectabilityThe report is a surgical document: the degree of circumferential contact with named vessels decides the operation.CT · 4 values · 5 papers
- Staging and response in lymphoma (Lugano, Deauville)Stage with FDG PET-CT by the Lugano classification (nodal regions above and below the diaphragm, extranodal sites, bulk), then assess response with the Deauville five-point scale against the mediastinum and liver.PET-CT · CT · 4 papers
- Superior vena cava obstructionA narrowed or occluded SVC with chest wall and mediastinal collaterals; name the cause (tumour, nodes, thrombus around a line) and the extent (brachiocephalic veins, azygos) because stenting depends on it.CT
- The neck after treatment for cancer — NI-RADSCompare the post-treatment neck with the first post-treatment baseline (about 12 weeks after therapy): expected changes are symmetric and non-mass-like; a new or enlarging enhancing mass, or focal FDG uptake, is scored by NI-RADS and acted on.CT · PET-CT
- Thermal ablation of liver and kidney tumours — the ablation zone and its marginAn adequate ablation zone covers the tumour with a 5–10 mm margin; on the first follow-up it is a non-enhancing zone larger than the tumour, and nodular enhancement at its edge is residual or recurrent disease.CT · MRI
- TIPS — planning and Doppler surveillanceBefore TIPS, confirm portal and hepatic vein patency and anatomy; after it, Doppler shows flow toward the heart through the stent with velocities in the expected range and reversed flow in the portal branches — a change from baseline flags dysfunction.USG · CT
- Transarterial chemoembolisation — planning the arterial mapBefore TACE, map the hepatic arterial anatomy (replaced and accessory arteries), the tumour feeders and extrahepatic supply, and confirm portal vein patency and liver function eligibility.CT · Fluoroscopy