Case of the Week 8 Created on June 05, 2023 Case of the Week 5 June 2023 1 / 2 What is the diagnosis? Gallbladder mucocele Liver abscess Emphysematous cholecystitis Acute acalculous cholecystitis 2 / 2 Which of the following is a false statement regarding emphysematous cholecystitis? Vascular compromise of the cystic artery is thought to play a significant role in causing emphysematous cholecystitis. Women are affected twice as commonly as men. It is a surgical emergency and treatment is emergent surgical intervention. CT is considered the most sensitive and specific imaging modality for identifying gas within the gallbladder lumen or wall. Your score is The average score is 63% LinkedIn Facebook Twitter 0% Restart quiz Previous week cases 16 Created on May 29, 2023 Case of the Week 29 May 2023 1 / 2 What is the diagnosis? Sinding-Larsen-Johansson disease Osgood-Schlatter disease Jumper’s knee Infrapatellar bursitis 2 / 2 Which of these is not an MRI finding of Osgood-Schlatter disease? Thickening and edema of the distal patellar tendon Bone marrow edema at the tibial tuberosity Prepatellar bursitis Deep infrapatellar bursitis Your score is The average score is 59% LinkedIn Facebook Twitter 0% Restart quiz 28 Created on May 22, 2023 Case of the Week 22 May 2023 1 / 2 What is the finding seen in the given CT images Pancreatic pseudocyst Gastric outlet obstruction with pneumatosis of gastric wall Toxic megacolon with pneumatosis coli Bezoar 2 / 2 Causes of gastric wall pneumatosis may include Ingestion of corrosives Gastric outlet obstruction Gastric volvulus All of the above Your score is The average score is 88% LinkedIn Facebook Twitter 0% Restart quiz 23 Created on May 15, 2023 Case of the Week 15 May 2023 1 / 2 The maxillofacial CT scan demonstrates Orbital floor blowout fracture Lamina papyracea blowout fracture Tripod fracture Hemosinus 2 / 2 Complications of this injury may include Extraocular muscle entrapment Enopthalmos Hypoglobus All of the above Your score is The average score is 76% LinkedIn Facebook Twitter 0% Restart quiz 25 Created on May 08, 2023 Case of the Week 8 May 2023 1 / 2 In the above given frontal and lateral wrist radiograph, identify the fracture Normal radiograph. No fracture identified. Torus fracture involving distal radial metaphysis. Greenstick fracture involving the distal radial metaphysis. Salter Harris type V involving the distal radial epiphysis. 2 / 2 Which among the following is true regarding above depicted fracture. Also known as buckle fractures, are incomplete fractures of shaft of long bones better characterized by bulging of the cortex. They result from trabecular compression due to an axial loading forces along the long axis of the bone. Usually seen in children, frequently involving the distal radial metaphysis. All of the above Your score is The average score is 62% LinkedIn Facebook Twitter 0% Restart quiz 23 Created on April 24, 2023 Case of the Week 24 April 2023 1 / 2 What is the complete diagnosis? Occlusion of the right common carotid artery Occlusion of the right internal carotid artery Occlusion of the right vertebral artery Segmental occlusion of both vertebral arteries 2 / 2 Which of these is false about the vertebral artery? PICA is a paired artery originating from V4 segment of the vertebral artery Most common cause of vertebral artery thrombosis is vertebral artery dissection Vertebral artery dissection is encountered in older patients than internal carotid artery dissection Rotational vertebral artery occlusion syndrome (bow hunter's syndrome) is a rare form of vertebrobasilar insufficiency secondary to dynamic compression of the usually dominant vertebral artery. Your score is The average score is 48% LinkedIn Facebook Twitter 0% Restart quiz 37 Created on April 17, 2023 Case of the Week 17 April 2023 1 / 2 What is the diagnosis? Non-ketotic hyperglycaemic hemichorea (NHH)/ hemichorea - hemiballismus syndrome Hypertensive hemorrhages Basal ganglia calcifications Tuberous sclerosis. 2 / 2 Which of these is false about non-ketotic hyperglycaemic hemichorea Non-ketotic hyperglycaemic hemichorea is always bilateral CT brain initially is normal, but later can demonstrate hyperdensity in the Caudate nuclei and Putamen. MRI brain is the diagnostic modality of choice Findings tend to be contralateral to the body side affected by hemiballistic, hemichoreic movements. Symptoms and imaging findings resolve upon normalization of glucose levels. Your score is The average score is 58% LinkedIn Facebook Twitter 0% Restart quiz 47 Created on April 10, 2023 Case of the Week 10 April 2023 1 / 2 What is the diagnosis? Pneumatosis intestinalis Emphysematous cholecystitis. Hepatic abscess. Pneumatosis coli. 2 / 2 What is the major complication leading to a high mortality rate? Pancreatitis Pericholecystic abscess. Perforation Cystic duct obstruction Your score is The average score is 78% LinkedIn Facebook Twitter 0% Restart quiz 47 Created on April 03, 2023 Case of the Week 03 April 2023 1 / 2 What is the diagnosis? Aspiration pneumonia Aspiration pneumonia secondary to esophageal dilatation esophageal dilatation secondary to neoplasm at the GE junction and aspiration pneumonia Impacted food bolus at the gastroesophageal junction with esophageal obstruction and aspiration pneumonia 2 / 2 Which of these is FALSE about impacted food bolus? Cannot be identified at all on plain radiograph Depending on the ingested content, the bolus may be visible on plain radiograph. CT helps in identifying the site of impaction and complications Treatment less invasive than endoscopy includes effervescent crystals, carbonated drinks, glucagon and muscle relaxant. Your score is The average score is 52% LinkedIn Facebook Twitter 0% Restart quiz 33 Created on March 27, 2023 Case of the Week 27 March 2023 1 / 2 What is the vascular abnormality seen in above images? Aortic aneurysm Aberrant right subclavian artery Aberrant left subclavian artery Double aortic arch 2 / 2 What is the most common course of aberrant right subclavian artery? Retro tracheal Pre tracheal Retro esophageal Retro sternal Your score is The average score is 58% LinkedIn Facebook Twitter 0% Restart quiz 34 Created on March 20, 2023 Case of the Week 20 March 2023 1 / 2 What is the diagnosis? small bowel obstruction,due to adhesions small bowel obstruction, due to volvulus small bowel obstruction, due to internal hernia small bowel obstruction, due to jejunojejunal intussusception 2 / 2 Which of these is false about intussusception? Intussusception without a lead point tends to be transient. An intussusception without a lead point does not generally cause proximal bowel obstruction Small bowel intusssuception without a lead point is more common than intussusception with a lead point A lead point intussusception involving the small bowel is more commonly related to a primary or secondary malignant neoplasm Your score is The average score is 46% LinkedIn Facebook Twitter 0% Restart quiz 36 Created on March 13, 2023 Case of the Week 13 March 2023 1 / 2 What is the diagnosis in a patient with sepsis? Cellulitis Vaginitis emphysematosa Pyoderma gangrenosum Fournier’s gangrene 2 / 2 Which of these is false about Fournier’s gangrene? The mortality rate for patients with Fournier’s gangrene is nearly 50%. Fascial air, muscle or fascial edema are the most common findings on CT. Management options include: radical surgical debridement of necrotic tissue, i/v antibiotics and hyperbaric oxygen therapy The most commonly affected regions are the pretibial regions. Your score is The average score is 78% LinkedIn Facebook Twitter 0% Restart quiz 32 Created on March 06, 2023 Case of the Week 06 Mar 2023 1 / 2 What is the diagnosis? Lateral patellar impingement syndrome Iliotibial band syndrome Lateral patellar dislocation Osteoarthritis 2 / 2 Which is the strongest restraint to lateral patellar displacement. Medial patellar retinaculum Lateral patellar retinaculum Medial patellofemoral ligament Vastus medialis oblique Your score is The average score is 48% LinkedIn Facebook Twitter 0% Restart quiz 28 Created on February 27, 2023 Case of the Week 27 Feb 2023 1 / 2 What is the most likely diagnosis based on the given axial and coronal CT images. Right renal forniceal or calyceal rupture (perinephric urinoma) Right perinephric abscess Right subcapsular and perirenal hematoma Right retroperitoneal lymphangiomatosis 2 / 2 Which among the following is true of this pathology? The renal fornix is the most susceptible part of the renal collecting system to rupture from increased pressure. The renal pelvis is the most susceptible part of the renal collecting system to rupture from increased pressure. The most common cause of the renal calyceal rupture is ureteral stricture. On arterial phase imaging urinary contrast will accumulate outside of the collecting system within the urinoma Your score is The average score is 64% LinkedIn Facebook Twitter 0% Restart quiz 32 Created on February 20, 2023 Case of the Week 20 Feb 2023 1 / 2 What is the diagnosis? Rotator cuff tear Rotator cuff calcific tendiniti Synovial osteochondromatosis Greater tuberosity fracture 2 / 2 Which stage of calcific tendinitis is most symptomatic? Formative Resting Reabsorptive All Your score is The average score is 48% LinkedIn Facebook Twitter 0% Restart quiz 35 Created on February 06, 2023 Case of the Week 06 Feb 2023 1 / 2 What is the diagnosis? Lipoma arborescens Synovial hemangioma. Tibial fracture with lipohaemarthrosis. Patellar fracture with lipohaemarthrosis. 2 / 2 Which of these is false about patellar fractures? Most common cause of disruption of the extensor mechanism. Most common mechanism of injury combines direct and indirect patterns Vertical fractures most commonly involves the medial facet 80% of the patellar fractures occur in the middle to lower third of the patella Your score is The average score is 47% LinkedIn Facebook Twitter 0% Restart quiz 30 Created on January 23, 2023 Case of the Week 23 Jan 2023 1 / 2 The patient complains of left lower quadrant pain. Identify the pathology in the given axial and coronal CT images. Acute Epiploic appendagitis Acute Colitis Acute diverticulitis Mesenteric Panniculitis 2 / 2 Which among the following is true of above shown pathology? The most common location is sigmoid colon followed by ileocecal junction. A thin high-density rim, known as the hyperattenuating ring sign is seen with surroundinginflammatory fat stranding and thickening of adjacent peritoneum A central hyperdense dot representing a thrombosed pedicle may be seen. All of the above Your score is The average score is 78% LinkedIn Facebook Twitter 0% Restart quiz 32 Created on January 16, 2023 Case of the Week 16 Jan 2023 1 / 2 The CT scan of the abdomen with contrast shows Right portal vein thrombosis Left portal vein thrombosis Right hepatic vein thrombosis Left hepatic vein thrombosis 2 / 2 The accompanying hepatic attenuation abnormality most likely represents Neoplasm Infarct THAD (Transient Hepatic Attenuation Difference) Hepatitis Your score is The average score is 52% LinkedIn Facebook Twitter 0% Restart quiz 37 Created on January 09, 2023 Case of the Week 9 Jan 2023 1 / 2 What is the diagnosis in this 82 year old male patient with right lower quadrant pain? Ruptured abdominal aortic aneurysm Aortic dissection Penetrating atherosclerotic ulcer. Aortitis 2 / 2 All of the following findings are concerning for impending rupture of abdominal aortic aneurysm except Hyperdense crescent sign Focal contour bulge of the aneurysm Discontinuity of mural calcification Aneurysm size greater than 4 cm Your score is The average score is 47% LinkedIn Facebook Twitter 0% Restart quiz 36 Created on January 02, 2023 Case of the Week 2 January 2023 1 / 2 The contrast CT study images show Cholelithiasis Choledocholithiasis Nephrolithiasis Main portal vein thrombosis 2 / 2 This finding is often seen in association with Biliary obstruction Pancreatitis Both of the above None of the above Your score is The average score is 72% LinkedIn Facebook Twitter 0% Restart quiz 35 Created on December 26, 2022 Case of the Week 26 Dec 2022 1 / 2 Identify the fracture in the above given frontal and lateral radiograph of the wrist. Colles fracture Smith fracture Volar Barton Dorsal Barton 2 / 2 Which among the following is true for the above shown fracture in the radiograph? There is volar angulation of the distal fragment The mechanism of fracture is fall on a flexed wrist or direct blow to back of the wrist These fractures are also known as Reverse Colles fracture All of the above Your score is The average score is 44% LinkedIn Facebook Twitter 0% Restart quiz 38 Created on December 19, 2022 Case of the Week 19 December 2022 1 / 2 Based on the provided CT images, what is the most likely diagnosis? Double aortic arch Pseudocoarctation Coarctation of aorta Right aortic arch 2 / 2 Which of the following is the most common association of this condition? Turner syndrome Intracranial aneurysm Bacterial endocarditis Bicuspid aortic valve Your score is The average score is 46% LinkedIn Facebook Twitter 0% Restart quiz 28 Created on December 12, 2022 Case of the Week 12 Dec 2022 1 / 2 Identify the pathology in the above given Volume rendered 3D image and Axial/Sagittal CT Angio neck Carotid bub ectasia Hypervascular lymphadenopathy Carotid body tumour Glomus Vagale 2 / 2 Which among the following are true for above shown pathology? Carotid body tumours are located at the carotid bifurcation with characteristic splaying of the ICA and ECA, described as the lyre sign. MRI T1W shows characteristic salt and pepper appearance. DSA shows intense blush with early vein phenomenon. All the above Your score is The average score is 88% LinkedIn Facebook Twitter 0% Restart quiz 41 Created on December 05, 2022 Case of the Week 5 December 2022 1 / 2 The following are true about hepatic thrombus, Portal vein thrombus can be seen in malignancy or inflammation Hepatic vein thrombus can present as Budd Chiari syndrome Prior gastric bypass has been linked with hepatic portal vein thrombus. All of the above 2 / 2 The CT findings most likely represent Liver abscess with hepatic vein thrombosis Hemangioma with AV shunting Hepatoma with portal vein thrombus Cholangiocarcinoma with ductal dilatation Your score is The average score is 63% LinkedIn Facebook Twitter 0% Restart quiz 47 Created on November 21, 2022 Case of the Week 21 November 2022 1 / 2 All are true of SAH except Trauma is the most common cause Traumatic SAH tends to be more focal, corresponding to the site of injury MRI is the study of choice in SAH Contrast extravasation is an uncommon finding on CTA. 2 / 2 The likely diagnosis is Ruptured AVM with subdural hemorrhage Ruptured left ICA aneurysm with subarachnoid hemorrhage Ruptured dermoid with hydrocephalus Ruptured Rathke cleft cyst with pneumocephalus Your score is The average score is 63% LinkedIn Facebook Twitter 0% Restart quiz 35 Created on November 14, 2022 Case of the Week 14 November 2022 1 / 2 Identify the abnormality in above given lateral radiograph of the elbow Displaced coronoid fracture with joint effusion Radial head fracture with joint effusion Displaced Capitellum and lateral part of trochlea fracture with joint effusion Supracondylar fracture of the humerus with joint effusion 2 / 2 Which among the following are features of above shown abnormality? These are rare elbow injuries accounting for less than 1% of fractures around the elbow. The mechanism of injury is usually a fall on an outstretched hand, the radius imparting shearing force on the capitellum. The characteristic finding on the lateral x-ray in a type IV fracture is McKee's Double arc sign, because of subchondral bone of capitellum and lateral part of the trochlea All the above Your score is The average score is 66% LinkedIn Facebook Twitter 0% Restart quiz 32 Created on November 07, 2022 Case of the Week 07 Nov 2022 1 / 2 The neck radiograph shows Subglottic narrowing Thickened epiglottis Ballooning of the hypopharynx Retropharyngeal abscess 2 / 2 What is the name of the sign that the radiograph depicts? Steeple sign Thumb sign Candle dripping sign Corner sign Your score is The average score is 39% LinkedIn Facebook Twitter 0% Restart quiz 32 Created on October 31, 2022 Case of the Week 31 October 2022 1 / 2 What is the diagnosis? Organoaxial volvulus with gastric outlet obstruction Mesenteroaxial volvulus with gastric outlet obstruction Gastric ulcer with gastric outlet obstruction Small Bowel Obstruction 2 / 2 Which among the following is true about the above mentioned pathology/diagnosis? Rotation around short axis from the lesser to greater curvature (i.e. perpendicular to the cardiopyloric line) usually incomplete, <180° displacement of antrum above gastro-oesophageal junction; stomach appears upside-down with the antrum and pylorus superior to the fundus and proximal body More common in pediatric population than in adults All the above Your score is The average score is 45% LinkedIn Facebook Twitter 0% Restart quiz 30 Created on October 17, 2022 Case of the Week 17 October 2022 1 / 2 This combination of findings suggests Eosinophil granuloma Leukemia Sickle cell disease Gaucher Disease 2 / 2 The CT scan of the abdomen and pelvis shows Autosplenectomy Extramedullary hematopoiesis H-shaped vertebrae All of the above Your score is The average score is 43% LinkedIn Facebook Twitter 0% Restart quiz