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Develop a habit of trusting your instincts. If you are short of time or are confused about the specific name of a fracture or a radiological sign, then it is appropriate to write a brief description of the abnormality instead of writing a wrong name. Most abnormalities in the examination will be relatively easy to diagnose. Most of the films will have a single significant abnormality.

Even if there are more than one, it will be part of a single diagnosis e. If not, then write the most clinically significant one e. In rare cases where you find two pathologies like pneumothorax and a lung mass, or osteoporosis and a vertebral wedge compression fracture, or pneumomediastinum with a rib fracture and you are confused, then it is appropriate to write all important pathologies. Systematic and consistent approach is a must to be successful in rapid reporting component of the examination.

Apply a uniform technique when attempting mock tests so you can judge your reporting style and know if you are over calling or under calling the abnormality. In case of a fracture extending into an adjoining joint, mentioning intra-articular extension is important to secure a full mark.

FRCR teaching & learning

In skeletal radiographs, always look for soft tissue swelling which may point to an underlying bone fracture. Similarly, foreign bodies and soft-tissue gas may also serve as pointers to significant adjoining abnormality. Always check and trace the outline of each bone in a radiograph with attention. Prosthetic valve, laminectomy, calcified hilar lymph nodes, fused vertebrae, splenomegaly, soft tissue calcification except for vascular calcification, severe osteoarthritis, basal ganglia calcification in child etc.

Basal ganglia calcification in adult, calcified lymph nodes in abdomen etc. In knee, shoulder and skull x-ray films, always look for fat-fluid level. Registered users of MedMantra. You may print the checklists on one sheet of paper front and back and always keep with you while practicing rapid reporting packets. Hello, Guest! Log in Register. Remember me. Please visit often to know about the latest developments.

Downloaded from: Points to Remember In the rapid reporting component of the examination, there is no margin of error. You are now being logged in using your Facebook credentials. Film 6 Normal right elbow. Film 7 Osteochondritis dissecans of the left medial femoral condyle and an avulsion fracture of the medial collateral ligament. Tip: A common location of osteochondritis dissecans is the lateral aspect of the medial femoral condyle subarticular surface; it can also affect the weight-bearing surfaces of the lateral femoral condyle, tibia and patella.

The latter can be seen clearly in a magnified view: Film 9 Lytic lesion of the right iliac blade. This lesion destroying the blade is more easily demonstrated on the pelvic X-ray: Tip: Remember to look at the rest of the film. It is hard to see what is not there! The right iliac bone is destroyed. The differential diagnosis is a primary bone lesion or metastatic 32 deposit. There is evidence of thumbprinting.

The differential diagnosis for thumbprinting includes ulcerative, pseudomembranous and ischaemic colitis. Film I I Left pneumothorax. Film 1 2 Normal right wrist. Film 13 Medial dislocation of the left patella. Film 14 Right supracondylar fracture. Film 1 5 Right paratracheal lymphadenopathy. The right paratracheal lymph nodes can be seen in the corresponding CT slice: Tip: The differential diagnosis is lymphoma, sarcoidosis,TB and metastases.

Tip: This is a defect of the posterior lateral humeral head that occurs with anterior dislocation of the shoulder and is caused by contact between the posterior humeral head and the anterior inferior glenoid rim. Film 1 7 Normal left foot with multicentric os peroneum accessory ossicle.

Film 18 Air in right orbit: Eyebrow' sign. Tip: This appearance is due to air from a sinus entering the orbit, indicating a blow-out fracture, i. Film 1 9 Avulsion fracture of left fibular epiphysis. Film 20 Linear radiopaque foreign body in the oesophagus. Film 21 Left occipital skull fracture. Film 22 Right lunate dislocation. Tip: On the lateral view, the lunate is anteriorly rotated and displaced, and on the dorsovolar view, it has a triangular configuration.

Film 23 Enchondroma: third metacarpal, right hand. Tip: The radiographic signs are expansion of the cortex without cortical break, and no periosteal reaction or soft tissue component. There is abnormal bony texture with expansion of the ribs anteriorly. Tip: Look for costal osteomas expanded posterior aspect of ribs with thinned cortices. Film 26 Pneumoperitoneum. Tip: The radiographic signs are outline of the falciform ligament, a triangular collection of gas in Morrison's pouch and Rigler's sign air outlining both sides of the bowel wall.

Film 27 Myossitis ossificans of left iliopsoas muscle. Ossification is seen projected over the left femoral head, within the left psoas muscle and also the right psoas muscle. The ossification is distinguished from malignant causes e. Look at the alignment on the normal foot radiograph; i. Film 30 Sclerotic metastases. Tip: These metastases are most commonly from prostate cancer in adult males and breast cancer in adult females. They can also arise from brain, bronchial, bowel and bladder tumours and from lymphomas.

They occur frequently in the vertebrae and pelvis. Tip: The azygos fissure 0.

FRCR 2B rapid-reporting | Radiology Reference Article |

Film 2 Avulsion fracture of the right anterior inferior iliac spine. Tip: This is the site of insertion of the rectus femoris muscle. Film 3 Film 5 Blount's disease of the left medial tibial condyle. Tip: This is avascular necrosis of the medial tibial condyle, which is enlarged and deformed. There is beaking of the medial proximal metaphysis. Film 4 Hiatus hernia. Tip: Look for the air-fluid level behind the heart. Normal paediatric right elbow. Film 6 Right-sided aortic arch with linear atelectasis seen in the right lower zone.

The corresponding CT scan shows a right-sided aortic arch: Tip: The left-sided aortic knuckle is absent. This variant occurs in 0. Tip: There is avascular necrosis of the 2nd metatarsal head. There is flattening, increased density and cystic lesions within the metatarsal head.

Film 8 Left upper lobe mass. A left upper lobe mass is clearly seen on the frontal view. Film 9 Bennett's fracture of the left thumb. Tip: This is an intra-articular fracture of the base of the 1st metacarpal. Film 10 Pancoast's tumour with left first rib destruction. Tip: Pancoast's tumour is usually a squamous cell lung tumour.

Although this case is a radiograph of the cervical spine, and therefore primarily centred on the cervical vertebrae, both apices and I st ribs are included on this view and therefore must be included as part of the review. Film I I Pneumomediastinum. Tip: On this radiograph, the signs are subcutaneous emphysema in the neck tissues and streaky lucencies of air in the mediastinum. Film 1 2 Left ureteric stone seen adjacent to the left L4 transverse process. Film 1 3 Left impacted fracture of the neck of the femur.

Film 14 Fracture of left patella. Practice Paper 2: Answers Film 1 5 Right bronchogenic cyst in the subcarinal region. The CT appearance of this cystic lesion is as follows: Tip: These cysts are spherical, well-defined and smooth-walled. Two-thirds are intrapulmonary and occur in the medial third of the lower lobes. Other chief differential diagnoses to consider are oesophageal duplication and neuroenteric cysts. Film 16 Right Colles' fracture. Film 1 7 Emphysematous cholecystitis. Tip: There is air in the gallbladder wall, indicating ischaemia and infection with gas-producing organisms diabetics are predisposed to this condition.

Differential diagnoses include enteric fistula and an air-containing periduodenal abcess.

FRCR 2B training - session 7- Dr. Amr Saadawy (in ENGLISH)

Film 18 Jones' fracture of the left 5th metatarsal. Tip: This is positioned in the diaphysis above the tuberosity of the 5th metatarsal. Non-union is a common complication. Film 19 Large right-sided pleural effusion with mediastinal shift. Film 20 Burst fracture of L3 vertebral body. Tip: On this film, the radiographic signs are loss of vertebral body height and interpedicular widening. Practice Paper 2: Answers Film 21 Avulsion fracture of the volar plate of the distal phalanx of the left thumb.

Film 22 Normal left foot with os trigonum. Film 23 Osgood-Schlatter disease of the left knee.

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Tip: There is fragmentation of the tibial tuberosity and associated soft tissue swelling. Film 24 Right olecranon fracture. Film 25 Fracture of the lamina of the C2 vertebral body. Film 26 Greenstick fracture of the right distal radius.

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Film 27 'Open book' pelvic fracture. Tip: This is an unstable pelvic fracture with disruption of the pelvic ring due to diastasis widening of the symphysis pubis and left sacro-iliac joint. Film 28 Osteopetrosis. Tip: On this film, the radiographic signs are generalized sclerosis with transverse metaphyseal bands and linear lucencies from fractures due to minor trauma brittle bones. Film 29 Fracture of the anterior process of the left calcaneum.

Film 30 Bilateral hilar lymphadenopathy. Tip: Differential diagnoses for this appearance include sarcoid, lymphoma,TB, histoplasmosis and silicosis.

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Tip: This is a multicystic expansile lesion causing thinning of the cortex with internal septations. It is usually eccentric, but the fibula is a small bone and therefore appears central. Differential diagnoses to consider are simple bone cyst and non-ossifying fibroma. Film 2 Situs inversus. Note the left-sided marker with outline of the liver in the left upper outer quadrant. The patient also has dextrocardia. Film 3 Right lower lobe consolidation. Film 4 Fracture of middle phalanx of left thumb Film 5 Bilateral apical fibrosis due to radiation therapy. Surgical clips can be seen at the site of thyroid surgery for thyroid carcinoma.

Film 6 Right clavicular fracture. Film 7 Radiopaque densities seen within the left side of the pelvis suggestive of teeth, in keeping with a dermoid cyst. Tip: A dermoid cyst is an ovarian teratoma containing tissues derived from only ectoderm hair, teeth, fat. Tip: This is a comminuted fracture of the ring of C I unstable. Both articular pillars of C I are offset laterally versus those of C2 on an open-mouth view. Film 10 Left perilunate dislocation. Tip: This is two to three times more common than lunate dislocation.

Film I I Left mandibular fracture. Film 1 2 Normal right ankle with vascular calcification. Film 1 3 Calcified left ventricular aneurysm. Film 14 Left base of 5th metatarsal fracture. Tip: This was an ankle X-ray, but remember to look at the rest of the bones. Film 1 5 Left posterior mediastinal mass.

The corresponding CT scan shows a large cystic lesion in the posterior mediastinum: Tip: The differential diagnoses are neurogenic tumour, vascular mass,foregut cyst and extramedullary haematopoeisis. This case was a foregut cyst. Practice Paper 3: Answers Film 16 Normal chest. Film 1 7 Left hydropneumothorax with surgical emphysema. Film 1 8 Spiral fracture of right tibia. Film 19 Right middle lobe consolidation. Film 20 Normal abdomen. Film 21 Slipped right capital femoral epiphysis. Tip: There is posteromedial displacement of the femoral head. The line of Klein a line drawn along the superior edge of the femoral neck fails to intersect the femoral head.

The epiphysis appears smaller due to posterior slippage. Post your question. Safe and Secure Payments. Easy returns.

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