rd decade. Clinical presentation Fibroadenomas present clinically as a smooth, \201 rm, mobile mass. It is some- times referred to as a \200\230breast mouse \200\231 because of its mobility within the breast tissue. Imaging Mammography A \201 broadenoma is seen as a well-circumscribed, oval mass. Sometim es a thin, lucent halo is seen surrounding the mass. In older women, as the \201 broad- e noma involutes, coarse \200\230popcorn \200\231 calci \201 cation may be seen associated with the mass. Ultrasound It is seen as a well-de \201 ned, ovoid, hypoechoic mass with a thin echogenic pseudocapsule (Fig. 25.8 ). As the tumor grows along tissue planes, it tends to be wider th an it is tall. Despite sonographic features consistent with benign disease, needle core bio psy for histological diagnosis is per- formed either clinically or under direct vision with ultrasound guidance. This is necessary to ensure that well-circumscribed cancers are not m issed. Once a benign histological diagnosis is obtained, no further inter- vention is requi red. SUBASH KC/NMC-15TH/2014 Information for the radiologist Relevant risk factors including the patient \200\231s age, personal history of breast cancer, and positive family history. The clinical score (P1 = no rmal, P2 = benign, P3 = indeterminate, P4 = suspicious for malignancy, P5 = malig- nant) is vital to ensure appropriate correlation with imaging \201 ndings. SUBASH KC/NMC-15TH/2014 FIBROADENOMA 427 SUBASH KC/NMC-15TH/2014 Fig. 25.8 Ultrasound demonstrating a well-de \201 ned solid hypoechoic mass with a thin ec hogenic capsule in keeping with a \201 broadenoma. SUBASH KC/NMC-15TH/2014 428 CHAPTER 25 Breast conditions Papilloma A papilloma is a tumor that arises in a duct, either centrally or peripherally wi thin the breast. It represents a focal proliferation of the ductal epithelium that projects into the lumen of the duct. Papillomas are largely considered benign lesions, especially i f solitary within a large subareolar duct. Multiple papillomas tend to be within smaller, p eripheral ducts and are associated with an increased likelihood of atypia and malignancy. Clinical presentation Papillomas are associated with overproduction of secretions that are not balanced by the normal resorptive mechanisms of the duct. This results in distension of the duct and nipple discharge. As they are friable structures that bleed easily, the nippl e discharge may be blood-stained. Occasionally, a palpable mass is evident. Imaging Mammography Papillomas are often not appreciated on mammography due to their small size and intraductal location. When imaging \201 ndings are present, they include a well- circumscribed subareolar mass, solitary or multiple dilated ducts, and infrequently a clust er of microcalci \201 cations. Ultrasound Characteristically, papillomas appear as a hypoechoic, lobulated mass within a d ilated duct or cyst ( malignancy, needle core biopsy under ultrasound guidance is performed for histological diagnosis. If there are no features of atypia, it can be removed percutan eously with a vacuum-assisted biopsy device. If there are features of atypia, then surgical excision is necessary. SUBASH KC/NMC-15TH/2014 Figs. 25.9 and 25.10 ). Due to the association with Information for the radiologist If there is nipple discharge, is it blood-stained? Relevant risk factors including the patient \200\231s age, personal history of breast cancer, and p ositive family history. If there is a palpable mass, the clinical score (P1 = normal, P2 = benign, P3 = indeterminate, P4 = suspicious for malignancy, P5 = malignant) is vital to ens ure appropriate correlation with imaging \201 ndings. SUBASH KC/NMC-15TH/2014 PAPILLOMA 429 Fig. 25.9 Ultrasound image demonstrating 7mm solid papilloma seen projecting into the lumen of the cyst. SUBASH KC/NMC-15TH/2014 (a) (b) Fig. 25.10 a) and b) Ultrasound images demonstrating 6mm papilloma seen sitting within a di lated duct. SUBASH KC/NMC-15TH/2014 This page intentionally left blank SUBASH KC/NMC-15TH/2014 SUBASH KC/NMC-15TH/2014 431 Index A abdominal aortic 122 \200\2233 angiomyolipoma ankle \200\223brachial pressure 234 \200\2235 diaphyseal benign tumors 298 \200\2239 index 124 metastases moth-eaten pain 260 sclerotic lesions tumors 292 \200\2233 258 aneurysm ankle fracture classi \201 cation abdominal calci \201 cation 342 abdominal distension 355 abdominal pain abdominal trauma 3 20 \200\2231 abdominal ultrasound 8 achalasia 374 \200\2235 acoustic neuroma acromio-clavic ular joint subluxation/ dislocation system 337 ankle trauma 3 ankylosing , 336 \200\2237 300 \200\2231 263 , 290 \200\2231 346 spondylitis 272 \200\2233 bone scan 13 \200\22314 anterior humeral line 326 aortic coarctation 110 \200\22311 aortic dissection aortic stenos is appendicitis apple-core deformity avascular necrosis 304 bone metastases 292 bone pain 260 bone tumors 263 , 290 420 breast c ancer diaphyseal benign bone 154 \200\2235 102 \200\2233 112 \200\22313 376 \200\2237 324 \200\2235 acute disseminated encephalomyelitis (ADEM) 148 acute myocardial 106 \200\2237 , 364 arteriography 29 arteriovenous \201 stula asbestos exposure 362 tumors 298 increased uptake 258 myeloma 294 osteomalacia osteomyelitis 278 302 Paget \200 \231s disease prostate cancer 222 proximal femoral fractures 332 renal cell cancer 218 308 superscan appearance 130 \200\2231 308 infarction benign lung disease 84 \200\2235 mesothelioma 404 \200\2235 acute pancreatitis acute pelvic pain 204 acute pyelonephritis 236 acute renal failure 207 acyanotic heart disease 116 adrenal calci \201 cation adrenal masses 232, s16 .f ALARM symptoms alkaptonuria altered consciousness 138 anemia, iron de \201 ciency 353 a neurysmal bone cysts 296 \200\2237 88 \200\2239 ascites astrocytoma atelectasis 64 avascular necrosis 342 , 410 \200\22311 156 304 \200\2235 SUBASH KC/NMC-15TH/2014 201 9 Bosniak classi \201 cation 234 268 Boutonniere deformity bowel, see large bowel; B bamboo spine 272 bare orbit 170 barium examination 4; 380 system 270 small bowel brain abscess 150 \200\2231 brain metastases 160 \200\2231 branchial cleft cysts 196 \200 \2238 Branham \200\231s sign 130 breast; see also mammography 422 \200\2233 abscess cancer 418 \200\22319 cyst 424 \200\2235 differential 413 diagnosis \201 broadenoma needle core biopsy 420 see also double contrast barium enema angiography 6; see also coronary angiography; pulmonary angiography achalasia 374 \200\2235 colonic cancer 354 diarrhea diverticular disease 398 gastrointestin al lymphoma 366 iron de \201 ciency 362 acoustic neuroma 154 acutely painful blue leg 99 aortic stenosis 112 cardiomyopathy coarcta tion of aorta 110 complications 7 contrast agents glioma 156 hypertension indications 6 int ermittent 109 353 systemic sclerosis 78 weight loss 356 31 wheeze becquerels 14 Bennett \200\231s fractur e- anemia 426 \200\2237 6 210 NHS Breast Screening Program 416 dislocation beta-decay 16 bird \200\231s beak 329 papilloma triple assessment 428 \200\2239 claudication 98 416 melaena 352 meningioma 115 mitral valve disease pelvic pain, chronic 206 peripheral vascula r 70 \200\2231 bronchiectasis 184 Brown \200\231s tumors 158 esophagus bladder cancer bladder \201 lling 374 \200\2235 216 \200\22317 defects 200 C caecal volvulus 400 calcaneal fractures calcium pyrophosphate deposition disease 7 , 124 disease procedure 6 thoracic trauma 318 vascular Boehler \200\231s angle 338 bone 338 \200\2239 avascular necrosis benign lesions 296 \200\2237 cysts 296 \200\2237 304 \200\2235 interventions 20 \200\2231 270 SUBASH KC/NMC-15TH/2014 432 INDEX cancer interstitial lung 76 \200\2237 communicating bladder breast 418 \200\22319 224 \200\2235 cervical colonic 362 \200\2233 endometrial gast ric 360 \200\2231 hepatocellular 180 \200\2231 laryngeal lung 17 , 62 \200\2233 oesophageal ovarian pancreatic prostate rectal renal cell testicular thyroid urothelial 216 \200\22317 disease hydrocephalus 152 computed tomography (CT) 10, 11; see also CT headings ischaemic heart disease 118 left ventricular failure 52 \200\2233 226 \200\2237 abdominal distension 355 abdominal trauma 320 \200\2231 acoustic neuroma 154 acutely painfu l blue leg 99 adrenal masses 232 \200\2233 138 altered consciousness angiomyolipoma 234 \200\2235 ankle trauma 336 ankylosing spondylitis aortic dissection 102 \200\2233 aortic st enosis appendicitis 131 arteriovenous \201 stula asbestos-related benign lobar collapse 64 \200\2239 lung abscess lung cancer mediastinal masses 90 \200\2231 mesoth elioma 88 mitral valve disease 368 \200\2239 42 \200\2233 62 \200\2233 358 \200\2239 228 , 231 372 \200\2233 114 \200\22315 222 \200\2233 myocardial infarction 106 peripheral vascular 124 272 364 \200\2235 218 \200\22319 220 \200\2231 disease 112 376 \200\2237 pleural effusion 74 \200\2235 pneumoconiosis pneumonia 44 \200\2235 pneumothorax pulmonary embolism pulmonary 182 80 \200\2231 216 \200\22317 carbon dioxide contrast cardiac catheterization cardiac CT 6 116 54 \200\2235 lung disease 410 \200\22311 84 \200\2235 48 ascites bladder cancer bone cysts bone metastases 292 bone tumors 263 , 290 brain abscess 1 50 \200\2231 brain metastases 160 branchial cleft cysts 196 418 breast cancer bronchiectasi s 70 \200\2231 calcaneal fractures 338 \200\2239 cardiac tumors 120 108 cardiomyopathy cerv ical cancer 225 chest pain 28 cholangiocarcinoma 216 \200\22317 congenital heart hypertension 58 \200\2239 296 disease 116 rheumatoid lung 78 sarcoidosis 82 \200\2233 shortness of breath 32 solitary pulmonary nodul e 60 \200\2231 ischaemic heart 118 cardiac MRI 117 cardiac tumors 120 \200\2231 cardiac ultrasound 9; see also echocardiog raphy cardiomegaly 25 , 94 cardiomyopathy 328 carpal fracture cartilage injuries, wrist cau da equina syndrome 274 cerebellopontine angle disease subphrenic abscess 396 systemic lupus SUBASH KC/NMC-15TH/2014 erythematosus 78 systemic sclerosis 78 thoracic trauma thyroid nodules and 182 108 \200\2239 318 328 masses tuberculosis Wegener \200\231s 86 \200\2237 mass 135 370 \200\2231 cholecystitis/ cervical cancer 224 \200\2235 Charcot foot 286 Charcot \200\231s triad chest pain 28 \200 \2239 chest radiograph granulomatosis weight loss 356 30 wheeze 56 \200\2237 cholangitis 378 \200\2239 378 cirrhosis 408 \200\2239 coarctation of chest trauma 318 \200\22319 cholangiocarcinoma cholangitis cholecystitis chronic obstructiv e 370 \200\2231 aorta 110 \200\22311 colonic cancer 362 \200\2233 connective tissue acutely painful blue leg aortic dissection aortic stenosis asbestos-related benign 99 378 \200\2239 102 112 \200\22313 378 \200\2239 disease 78 \200\2239 pulmonary disease (COPD) 46 \200\2237 406 \200\2237 chronic pancreatitis chronic pelvic pai n 206 cirrhosis 408 \200\2239 claudication clavicular fracture 324 coal worker \200\231s contrast agents 11 COPD 46 cough Crohn \200\231s disease 382 crystal deposition 270 cystic \201 brosis 72 degenerative disc lung disease bronchiectasis cardiomyopathy 108 \200\2239 chest pain 28 coarctation of 84 \200\2235 70 \200\2231 34 98 , 124 aorta 110 \200\22311 congenital heart 116 \200\22317 disease 274 disease pneumoconiosis coarctation of aorta colitis 80 \200\2231 110 \200\22311 diaphyseal benign bone connective tissue tumors 298 diarrhea 354 discitis 280 diverticular disease drawbacks 11 duodenal 78 \200\2239 COPD 46 \200\2237 cystic \201 brosis 3 , 72 \200\2233 emphysema 46 \200\2237 gastrointestinal 366 lymphoma hypertension 210 hypoxia disease infective ulcerative 386 \200\2237 384 \200\2235 398 \200\2239 collateral ligament injuries 334 Colles \200\231 fracture colonic cancer colonic dilatation 342 328 362 \200\2233 ulceration 380 \200\2231 dysphagia ECG-gated 174 38 120 SUBASH KC/NMC-15TH/2014 INDEX 433 46 emphysema encephalitis 148 \200\2239 endometrial cancer 227 166 epilepsy facial trauma g astric cancer gastrointestinal lymphoma gastrointestinal ovarian masses ovarian torsion 248 \200\2239 Paget \200\231s disease 302 372 \200\2233 panc reatic cancer 404 \200\2235 pancreatitis, acute pancreatitis, chronic 406 paralytic ileus p elvic fractures 322 pelvic in \202 ammatory 250 229 \200\22330 vomiting 349 Wegener \200\231s granulomatosis 56 weight loss 31 wheeze 356 314 \200\22315 360 \200\2231 conduitograms 4 congenital heart 116 \200\22317 392 \200\2233 366 \200\2237 disease connective tissue perforation 394 disease 78 \200\2239 138 consciousness consolidation 24 contrast agents cord compression coronary a ngiography disease glioma 36 haemoptysis hand trauma 330 headache 139 head trauma hernia 412 hoarse voice 173 hydrocephalus hyperparathyroidism 184 hypertension hypoxia 38 infective colitis intermenstr ual 156 205 pelvic pain, acute pituitary adenoma 163 pleural effusion 74 pneumoconiosis pneumonia 4 4 pneumothorax 54 postmenopausal 4 , 6 , 11 80 \200\2231 276 \200\2237 312 \200\22313 chest pain 29 ischaemic heart 152 \200\2233 bleeding 212 disease myocardial infarction 118 prostate cancer 222 proximal femoral 210 106 fractures 332 corticotrophic 386 \200\2237 pseudo-obstruction 392 psoas abscess 282 pulmonary adenoma 162 cough 372 Courvoisier \200\231s law Crohn \200\231s disease 382 \200\2233 cruciate ligament 34 bleeding intermittent 211 hypertension 58 236 \200\2237 pyelonephritis rectal cancer 364 218 \200\22319 renal cell ca ncer renal failure, acute 207 renal hamartoma 234 \200\2235 salivary gland infection saliva ry gland claudication 98 interstitial lung disease interventional 20 procedures intussusception 402 \200\2233 iron d e \201 ciency 76 injury 334 crystal deposition 270 \200\2231 CT abdomen and pelvis 205 CT angiogram SUBASH KC/NMC-15TH/2014 anemia 353 190 \200\2231 abdominal aortic 122 \200\2233 jaundice joint replacement, loose/ 350 aneurysm tumors 194 \200\2235 peripheral vascular 124 disease subarachnoid painful 288 knee injuries large bowel sarcoidosis 82 \200\2233 sclerotic bone lesions 300 \200\2231 335 hemorrhage CT colonography CT coronary angiogram 144 362 \200\2233 obstruction 390 \200\2231 shortness of breath 32 shoulder trauma 324 192 sialolithiasis 188 \200\2239 sinus disease s mall bowel laryngeal carcinoma 180 \200\2231 52 left ventricular failure liver tumors lobar collapse lung absces s lung cancer mediastinal masses 90 \200\2231 melaena 352 158 meningioma mesothelioma multi slice/multidetector 118 CT KUB 368 \200\2239 69 , 64 \200\2237 acute pelvic pain 205 haematuria renal tract calculi obstruction 388 \200\2239 208 42 \200\2233 62 \200\2233 solitary pulmonary nodule 60 \200\2231 238 \200\2239 CT myelogram spinal trauma 316 \200\22317 stomach ulceration stroke 142 \200\2233 subarachnoid cord compression 276 degenerative disc 380 \200\2231 disease 274 88 \200\2239 CT number 10 CT pulmonary angiography hemorrhage 144 \200\2235 10 myeloma 294 \200\2235 myocardial infarction 107 nasopharyngeal tumors 176 neck lumps 172 oesophageal scanners subdural (CTPA) 146 \200\2237 subphrenic abscess 396 \200\2237 swollen diabetic foot 286 220 testicular can cer thoracic aneurysm thoracic trauma 318 \200\22319 thyroid nodules and 182 86 hemorrhage haemoptysis 36 hypoxia 38 pulmonary embolism CT urogram 48 , 50 104 \200\2235 bladder cancer haematuria 209 hydronephrosis Cushing \200\231s disease 162 cyanotic heart 216 \200\22317 cancer 358 \200\2239 oropharyngeal tumors 178 308 osteomalacia osteomyelitis 278 228 ovaria n cancer 208 masses tuberculosis ulcerative colitis upper abdominal pain 346 volvulus 384 disease 116 , 231 400 cystic \201 brosis 3 , 72 \200\2233 SUBASH KC/NMC-15TH/2014 434 INDEX D Dawson \200\231s \201 ngers 164 degenerative disc ischaemic heart achalasia aortic dissection cholecystitis/ 378 cholangitis colonic cancer 362 contrast agen ts 4 cough diverticular disease 398 double contrast 4 \200\2235 techniques 374 \200\2235 118 left ventricular failure mitral valve disease 114 106 myocardial infarction pulmonary e mbolism 48 pulmonary disease 102 52 disease DEXA 306 diabetic foot diaphyseal benign bone 274 \200\2235 286 \200\2237 34 58 hypertension , 204 ectopic pregnancy tumors 298 \200\2239 354 diarrhea dilated cardiomyopathy discitis disc prolapse dislocation 244 \200\2235 108 116 Eisenmengerization elbow joint effusion 326 elbow trauma 326 \200\2237 emphysema emphys ematous pyelonephritis 148 \200\2239 380 duodenal ulceration dysphagia 174 gastrointestinal 366 lymphoma gastrointestinal 394 pe rforation 280 \200\2231 274 \200\2235 46 \200\2237 elbow 326 hip 332 lunate 328 328 perilunate shoulder 324 \200\2235 thumb 329 trans-scaphoid perilunate 236 encephalitis 226 \200\2237 endometrial cancer endometrial thickness 212 endometriosis endos copic retrograde gastro-oesophageal re \202 ux 374 GI radiology 4 \200\2235 374 hiatus hernias intussusception 402 jaundice 35 1 joint replacement, loose/ 246 \200\2237 328 cholangiopan- creatography (ERCP) cholangiocarcinoma 370 cholecystitis/ cholangitis jaundic e 351 pancreatic cancer 372 distal radial fractures 328 diverticular disease 398 \200\2239 Doppler ultrasound painful 288 large bowel 130 arteriovenous \201 stula peripheral vascular 378 obstruction 390 neck lumps oesophageal cancer 358 paralytic ileus 392 pseudo-obstruction 392 rectal cancer stomach ulceration 380 systemic sclerosis 78 thoracic aneurysm 105 ulcerative colitis 384 u ro radiology 4 400 volvulus vomiting 349 weight loss 172 disease 124 renal transplant dysfunction 240 stroke 142 endoscopic ultrasound (EUS) SUBASH KC/NMC-15TH/2014 cholangiocarcinoma 370 gastric cancer 358 oesophageal cancer pancreatic cancer 372 406 panc reatitis, chronic 364 double contrast barium 360 enema colonic cancer 362 rectal cancer 364 384 ulcerative colitis endovascular double contrast techniques 4 \200\2235 double line sign 304 dual energy X-ray 306 absorptio metry duodenal ulceration 380 \200\2231 dural tail sign 158 dysphagia interventions 20 \200\2231 126 \200\2237 , ependymoma epididymitis epilepsy 166 \200\2237 exercise testing 28 exudates 156 252 \200\2233 356 football sign 394 fracture ankle 3 , 336 \200\2237 Bennett \200\231s fracture- 74 174 dislocation 329 calcaneal carpal 328 clavicular 328 Colles \200\231 distal radial elbow 326 \200\2237 humer al neck/head 324 malleoli 336 metacarpal 329 neck of femur 334 patella pelvic 322 \200\2233 phalangeal proximal femoral 332 \200\2233 Rolando scaphoid Segond Smith \200\231s talus 338 \200\2239 F facial trauma 296 fallen fragment sign FAST scan 320 FAST screen 142 FDG 16 femur fractur es 332 \200\2233 \201 breoptic bronchoscopy \201 broadenoma \201 bromuscular dysplasi a FIGO staging 224 \201 gure of 3 appearance 110 \201 nger in glove sign Fitz \200\223H ugh \200\223Curtis E ECG-gated CT ECG-gated MRI echocardiography 9; 324 314 \200\22315 120 119 328 see also transoesophageal echocardiography 37 332 \200\2233 aortic stenosis 112 120 cardiac tumors cardiomyopathy 108 chest pain 28 coarctation of aort a 110 congenital heart 426 \200\2237 210 , 226 329 72 329 328 disease cough 34 36 haemoptysis 210 hypertension 116 syndrome 250 334 328 \202 uorodeoxy-D-glucose (FDG) 16 \202 uoroscopy 4 336 SUBASH KC/NMC-15TH/2014 INDEX 435 thumb 329 tibial plateau triquetral avulsion fracture 328 hepatocellular cancer 368 \200\2239 joint replacement, loose/ 334 painful 288 \200\2239 261 hernia 412 joint swelling 374 herpes simplex hiatus K 26 Kerley B lines knee injuries 334 \200\2235 knee osteoarthritis 267 108 Kussmaul \200 \231s sign encephalitis 148 374 G gadolinium contrast galactocoele gallstones 350 12 gamma camera gamma rays 12 gastric can cer gastrointestinal 357 conditions gastrointestinal differential hiatus hernia HIDA scan 350 high resolution computed tomography (HRCT) 272 ankylosing spond ylitis bronchiectasis 70 \200\2231 haemoptysis 36 hypoxia 38 interstitial lung disease 6 , 18 424 \200\2235 L large bowel 360 \200\2231 76 obstruction 390 \200\2231 hilar enlargement 26 hip dislocation hoarse voice 173 holly leaf plaques 84 Houns \201 eld unit 10 humeral neck/head large bowel strictures 344 laryngeal carcinoma 180 \200\2231 94 left atrial enlargement lef t ventricular enlargement 332 341 gastrointestinal \202 uoroscopy gastrointestinal interventions gastrointestinal lymph oma gastrointestinal perforation diagnosis 4 \200\2235 94 20 left ventricular failure 52 \200\2233 leg, painful and blue Legionella pneumonia Lhermitte \200\231s sign 164 ligament injuries fracture 324 99 hydrocephalus 152 \200\2233 hydrocoele 200 hydronephrosis 9 , 207 , 209 184 \200\2235 hyper parathyroidism hyperradiancy 25 \200\223s2.s 10 hypertension hypertrophic 366 \200\2237 44 394 \200\2235 gastrointestinal presenting 345 collateral ligament 334 cruciate ligament 334 wrist 328 syndromes 210 gastro-oesophageal re \202 ux disease (GORD) 374 liver cirrhosis 408 \200\2239 liver tumors lobar collapse Lofgren \200\231s syndrome 4 loop ograms Looser \200\231s zone lunate dislocation 328 lung 108 cardiomyopathy hypoparathyroidism 186 \200\2237 hypoxia 38 hysterosalpingography 227 hy sterosonography SUBASH KC/NMC-15TH/2014 368 \200\2239 64 \200\2239 genitourinary conditions 215 genitourinary differential 199 genitourinary presenting 203 82 206 diagnosis 308 syndromes I infective colitis 386 \200\2237 inferior vena cava giant cell tumors glioblastoma multiforme 156 \200\2237 296 \200\2237 abscess 42 \200\2233 cancer 17 , 62 \200\2233 connective tissue 156 glioma 94 global cardiomegaly glottic carcinoma 180 Golden S sign 67 gonadotroph cell \201 lters 128 \200\2239 disease 78 \200\2239 consolidation 24 hilar enlargement 26 hyperradiancy 25 \200\223s2.s in terstitial disease multiple masses 25 small \201 brotic 26 24 solitary mass solitary pulm onary nodule 60 \200\2231 211 intermenstrual bleeding intermittent claudication 98 interstitial lung 10 76 \200\2237 76 \200\2237 interventional disease adenoma gout 270 \200\2231 414 gynaecomastia 162 radiology 20 \200\2231 intracerebral mass 134 intracranial calci \201 cation 134 intraveno us urogram (IVU) H 208 haematuria haemoptysis 36 \200\2237 hand deformities hand trauma 328 \200\22330 139 h eadache head and neck conditions haematuria 208 renal tract calculi 238 402 \200\2233 upper zone \201 brosis 26 lymphoma, intussusception iodine-based contrast gastrointestinal 366 \200\2237 268 \200\2239 agents 4 , 6 , 11 M macroadenoma 162 magnetic resonance iron de \201 ciency anemia 353 ischaemic heart 118 \200\22319 175 head and neck differential disease angiogram (MRA) 125 169 head and neck presenting 171 312 \200\22313 diagnosis J jaundice 350 magnetic resonance syndromes head trauma cholangiopan- creatography (MRCP) SUBASH KC/NMC-15TH/2014 436 INDEX magnetic resonance 152 hydrocephalus hydronephrosis 209 hyperparathyroidism 184 39 hypoxia intermenstrual 211 spinal trauma STIR stroke 143 subarachnoid 316 19 , 280 \200\2231 cholangiopan- creatography (cont.) cholecystitis/ cholangitis 351 378 hemorrhage 144 jaundice pancreatitis, bleeding intermittent subdural hemorrhage 146 swollen diabetic foot 286 swollen joint testicular cancer 220 thora cic aneurysm 104 318 thoracic trauma thyroid nodules and 182 chronic 406 \200\2237 magnetic resonance claudication 98 261 joint replacement, loose/ enterography (MRE) painful 288 335 Crohn \200\231s disease diarrhea 382 \200\2233 knee injuries laryngeal carcinoma 180 left ventricular failure 52 liver tumors lung cancer 62 mediastinal masses meningioma 158 \200\2239 mesothelioma 88 mitral valve disease 115 mul tiple sclerosis 164 \200\2235 myeloma 294 nasopharyngeal tumors 176 \200\2237 354 magnetic resonance imaging masses 19 , 87 tuberculosis ulcerative colitis 384 Wegener \200\231s (MRI) 18 368 abdominal aortic aneurysm 122 90 abdominal distension 355 154 \200\2235 acoustic neuroma acutely painful blue leg 99 adrenal masses ankle trauma 336 ankylosing granulomatosis 336 malleoli fractures mallet \201 nger 268 mammography 56 232 \200\2233 analog breast abscess 422 breast cancer breast cyst 424 \200\2235 digital 416 family histor y surveillance \201 broadenoma galactocoele 424 indications 416 mean glandular dose 417 m ultiple lesions NHS Breast Screening 416 spondylitis 272 \200\2233 418 \200\22319 aortic dissection aortic stenosis 18 applications arteriovenous \201 stula 131 avascular necrosis 304 bladder cancer 216 bone cysts 296 bone metastases 293 bone pain 260 , 290 bone tumors 263 brain abscess 150 brain metastases 160 \200\2231 branchial cleft cysts breast c ancer calcaneal fractures 338 120 \200\2231 cardiac tumors cardiomyopathy 108 \200\2239 cer vical cancer chest pain 29 cholangiocarcinoma 370 cirrhosis 408 coarctation of aorta 110 18 contraindications cord compression 276 \200\2237 270 crystal deposition degenerative disc 102 112 \200\22313 neck lumps 172 oropharyngeal tumors 178 \200\2239 osteoarthritis 266 osteomalacia osteomyelitis 278 \200\2239 ovarian ca ncer ovarian masses ovarian torsion 248 \200\2239 302 Paget \200\231s disease pancreatic ca ncer 372 pancreatitis, acute 404 pancreatitis, chronic 406 pelvic fractures 322 pelvic in \202 ammatory 250 416 426 308 228 230 SUBASH KC/NMC-15TH/2014 414 416 Program papilloma 428 post-surgical 416 solitary lesion 414 technique triple assessment 416 massive haemoptysis 36 maxillary antrum 170 opaci \201 cation 196 \200\2237 418 416 \200\22317 disease 206 pelvic pain, chronic 163 pituitary adenoma postmenopausal 224 , 225 bleeding 212 mediastinal masses 90 \200\2231 medulloblastoma 156 melaena 352 meningioma meniscal injurie s 334 mesothelioma 88 \200\2239 metacarpal fracture 329 metastases prostate cancer 223 proximal femoral fractures 332 282 \200\2233 158 \200\2239 psoas abscess pulmonary embolism pulmonary 49 274 \200\2235 diaphyseal benign bone disease hypertension 58 364 \200\2235 rectal cancer rheumatoid arthritis 268 salivary gland bone 292 \200\2233 brain 160 \200\2231 liver 368 tumors 298 \200\2239 280 \200\2231 174 discitis dysphagia ECG-gated ectopic pregnancy 244 encephalitis endometrial cancer 227 endo metriosis 166 epilepsy glioma 156 \200\2237 36 haemoptysis 312 head trauma tumors 194 \200\2235 MIBG scan 120 MIBI scan 118 microadenoma 162 micturating 119 82 sarcoidosis sclerotic bone lesions 300 septic arthritis shoulder trauma sialolithiasis s inus disease 188 soft tissue lump 262 solitary pulmonary 148 284 \200\2235 324 cystourethogram (MCUG) 242 \200\2233 millisieverts 14 mitral valve disease 114 \200\22315 m onophonic wheeze 30 moth-eaten bone 258 246 192 nodule 60 SUBASH KC/NMC-15TH/2014 INDEX 437 mother in law blush 158 MUGA scan 118 multiple-ring enhancing jaundice 350 laryngeal carcinoma 180 left ventricular failure 52 64 lobar collapse lung can cer 62 mediastinal masses melaena 352 mesothelioma 88 nasopharyngeal tumors 176 neck lumps 172 oropharyngeal tumors 178 308 paralytic ileus paranasal sinus absence/ 392 \200\2233 hyperplasia parotid gland infection tumors 194 \200\2235 170 lesions 134 multiple sclerosis mumps 190 Murphy \200\231s sign 378 musculoskeletal conditio ns 164 \200\2235 190 \200\2231 90 334 patella fractures pelvic fractures 322 \200\2233 pelvic in \202 ammatory 265 musculoskeletal differential disease pelvic pain 204 250 \200\2231 diagnosis 257 musculoskeletal presenting 259 acute chronic syndromes 206 myeloma 294 \200\2235 myocardial infarction pelvic ultrasound 8 , 204 percutaneous osteomalacia patient preparation 14 radionuclides 12 radiopharmaceuticals 12 rectal cancer 364 shortness of breath 32 solitary pulmonary 106 \200\2237 238 nephrolithotomy perilunate dislocation 328 peripheral vascular 124 \200\2237 , 7 N nasopharyngeal mass nasopharyngeal tumors 176 \200\2237 disease 16 170 PET-CT nodule 60 bone metastases 293 362 colonic cancer contraindications 17 174 dysphagia indications 16 18 0 laryngeal carcinoma lobar collapse 64 lung cancer nasopharyngeal tumors 176 neck lumps 17 2 oesophageal tumor oropharyngeal tumors 178 testicular torsion vesico-ureteric re \202 ux 243 vomiting 349 Wegener \200\231s 254 neck lumps ultrasound 9 neck of femur 172 granulomatosis 56 fracture 332 \200\2233 207 nephrostomy neuro \201 bromatosis type I/II 154 17 , 62 O 17 , oesophageal cancer neurology conditions 141 neurology differential SUBASH KC/NMC-15TH/2014 358 \200\2239 oesophageal strictures 17 diagnosis 133 neurology presenting 344 syndromes 137 156 oligodendroglioma orbital calci \201 cation 170 oropharyngeal patient preparation 16 rectal cancer 364 technique 16 NHS Breast Screening Program 416 non-communicating hydrocephalus tumors 178 \200\2239 phaeochromocytoma 232 329 phalangeal fracture pituitary adenoma 162 \200\2233 pixels plain \201 lm radiography 2; 152 266 \200\2237 osteoarthritis osteoid osteoma 298 308 \200\2239 osteomalacia osteomeatal nuclear medicine 15 , 12 \200\22313 14 advantages arteriovenous \201 stula 131 avascular necrosis 304 bone pain 260 bone tumors 263 cardiac tumors 120 chest pain 28 362 colonic can cer 14 contraindications COPD 46 disadvantages 14 dose 14 174 dysphagia emphysema 46 gastro -oesophageal 10 complex 188 278 \200\2239 304 \200\2235 see also chest radiograph osteomyelitis osteonecrosis 258 osteopenia 267 osteophytes 306 \200\2237 osteoporosis osteo porosis abdominal aortic aneurysm 122 abdominal distension 355 achalasia 374 154 acoustic neuroma a drenal masses 232 alkaptonuria aneurysmal bone cyst 296 ankle trauma 3 , 336 \200\2237 anky losing circumscripta ovarian cancer ovarian masses ovarian torsion 248 \200\2239 302 270 228 , 231 229 \200\22330 spondylitis appendicitis arteriovenous \201 stula 130 ascites avascular necrosis bone cys ts 296 \200\2237 bone metastases 292 \200\2233 bone pain 260 bone tumors 263 160 brain meta stases 272 \200\2233 376 P Paget \200\231s disease 302 \200\2233 pancreatic cancer pancreatitis 404 \200\2235 re \202 ux 374 haemoptysis 36 hydronephrosis hyperpara- 410 209 304 \200\2235 372 \200\2233 thyroidism 39 184 \200\2235 acute chronic hypoxia indications ischaemic heart 406 \200\2237 14 , 290 \200\2231 papillary necrosis 236 papilloma (breast) 428 \200\2239 disease 118 SUBASH KC/NMC-15TH/2014 438 INDEX plain \201 lm radiography 2 rheumatoid arthritis haemoptysis 37 pulmonary (cont.) 268 \200\2239 caecal volvulus 400 calcaneal fractures calcium pyrophosphate deposition disease sclerotic bone lesions 300 284 septic arthritis shoulder trauma sialolithiasis sigmoid volv ulus 400 \200\2231 small bowel obstruction embolism 49 338 \200\2239 pulmonary 324 \200\2235 58 pulmonary artery hypertension 270 192 cardiac tumors colonic cancer 362 cord compression cough crystal deposition degenerative di sc 120 enlargement 95 15 , pulmonary embolism 276 388 \200\2239 48 \200\22350 pulmonary 34 soft tissue lump 262 spinal trauma stomach ulceration 380 subphrenic abscess 396 swollen di abetic foot 286 \200\2237 swollen joint thoracic aneurysm 104 thoracic trauma thyroid nodul es and 182 270 \200\2231 316 58 \200\2239 hypertension pulmonary nodule, solitary 60 \200\2231 disease 274 diaphyseal benign bone pulmonary plethora 116 pyelonephrosis tumors 298 \200\2239 236 \200\2237 diarrhea discitis 280 380 duodenal ulceration dysphagia 174 elbow trauma 326 \200\2237 faci al trauma 314 gallstones 350 gastrointestinal perforation giant cell tumor gout 270 \200 \2231 36 haemoptysis 328 \200\22330 hand trauma head trauma 312 hernia 412 374 hiatus herni a hoarse voice 173 hydrocephalus hyperparathyroidism 184 infective colitis 386 intussuscept ion 402 iron de \201 ciency 354 261 R radiocapitellar line 326 radionuclides 12 radiopharmaceuticals radius, distal fracture 32 8 rectal cancer 364 \200\2235 recurrent laryngeal nerve 318 masses ulcerative colitis upper abdominal pain 346 volvulus vomiting wheeze wrist trauma 328 \200 \22330 384 \200\2235 12 400 \200\2231 348 30 394 \200\2235 296 palsy 173 redcurrant jelly stools 402 re \202 ux 374 renal abscess 234 renal calci \201 c ation 200 renal cell cancer 218 \200\22319 renal cysts renal failure, acute 207 renal hamar toma 234 \200\2235 renal masses, pleural effusion 25 , 74 \200\2235 pleural malignancy pneumatosis intestinalis pneumoconios is pneumonia pneumoperitoneum 343 pneumothorax polyphonic wheeze 30 positron emission 88 \200\2239 343 80 \200\2231 SUBASH KC/NMC-15TH/2014 44 \200\2235 152 54 \200\2235 234 tomography (PET); see also PET-CT benign 234 \200\2235 renal tract calculi renal transplant anemia 353 232 adrenal masses cardiac tumors 120 225 cervical cancer cholangiocarcinoma 370 gastric ca ncer 360 gastrointestinal 366 lymphoma 238 \200\2239 jaundice 350 joint replacement, 288 \200\2239 loose/painful 334 dysfunction 240 \200\2231 renal tuberculosis 236 renal ultrasound acute pelvic pain 204 hypertension knee injuries large bowel obstruction meningioma myeloma 294 oesophageal 390 \200\2231 158 oesophageal cancer 358 pancreatic cancer 372 solitary pulmonary 210 respiratory conditions respiratory differential 23 respiratory presenting 41 cancer 358 osteoarthritis osteomalacia osteomyelitis osteoporosis Paget \200\231s disease p aralytic ileus 392 \200\2233 pelvic fractures 322 \200\2233 pituitary adenoma 162 prostate cancer 222 proximal femoral 332 \200\2233 nodule 60 diagnosis 266 \200\2237 308 \200\2239 278 306 \200\2237 postmenopausal bleeding 212 primary hyperpara- syndromes 27 rest pain 98 restrictive 184 \200\2235 thyroidism prolactinoma 162 prostate cancer proximal femoral 332 \200\2233 ps eudofractures 308 pseudohypopara- 302 \200\2233 108 cardiomyopathy rheumatoid arthritis 268 \200\2239 rheumatoid lung 78 rhinosinusitis rib notching rickets 308 \200\2239 Rigler \200\231s sign Robson \200\231s staging 222 \200\2233 188 110 fractures fractures 394 thyroidism 186 pseudo-obstruction 392 psoas abscess pulmonary angiography pseudo-obstruction 392 psoas abscess 282 rectal cancer 364 238 renal tract calculi system 218 282 \200\2233 Rolando fracture Rovsing \200\231s sign 376 329 chest pain 29 SUBASH KC/NMC-15TH/2014 INDEX 439 S sail sign 66 salivary glands U ulcerative colitis ultrasound 8; see also endoscopic ultrasound calculi 192 \200\2233 infection tumors 190 \200\2231 194 \200\2235 384 \200\2235 subphrenic abscess superscan 396 \200\2237 calculi infection tumors sarcoidosis scaphoid fracture 328 scapholunate ligament 192 \200\2233 190 \200\2231 194 \200\2235 82 \200\2233 abdominal aortic 122 \200\2233 appearance 308 aneurysm supraglottic carcinoma 180 268 swan-neck deformity swollen diabetic foot 286 \200\2237 swol len joint 261 systemic lupus abdominal distension 355 abdominal scan abdominal trauma 320 acutely painful blue leg 99 ao rtic dissection 102 appendicitis 376 arteriovenous \201 stula 130 ascites bladder cancer bone pain 260 263 bone tumors branchial cleft cysts breast abscess 422 \200\2233 breast can cer breast cyst cardiac 9; see also echocardiography 8 injury 329 scintigraphy erythematosus 78 bladder cancer 216 epilepsy 166 neck lumps 172 thyroid nodules and 182 78 systemic sclerosis 410 \200\22311 T talus fractures 336 technetium scan 216 \200\22317 masses sclerotic bone lesions 300 \200\2231 258 12 \200\22313 196 \200\2237 arteriovenous \201 stula 131 testicular torsion 254 vesico-ureteric re \202 ux 243 testi cular cancer 220 \200\2231 testicular masses 200 testicular pain 213 testicular torsion scoliosis Segond fracture 334 septic arthritis sequestrum 278 shortness of breath 32 324 \200\2235 shoulder trauma 172 , 192 \200\2233 sialography sialolithiasis 192 \200\2233 sigm oid volvulus signet ring sign 70 simple bone cysts 296 \200\2237 sinus disease 188 \200\223 9 sinusitis 188 small bowel dilatation 343 obstruction strictures 418 \200\22319 284 \200\2235 424 \200\2235 cardiomyopathy 225 cervical cancer chest pain 28 cholangiocarcinoma 108 213 , 254 \200\2235 testicular ultrasound thallium exercise 8 400 \200\2231 370 \200\2231 cholecystitis/ cholangitis 408 test 28 thoracic aneurysm thoracic aorta 94 enlargement 318 \200\22319 thoracic trauma thumb fractu re/ 329 dislocation 354 thumb-printing thyroid cancer 182 thyroid nodules and 104 \200\2235 SUBASH KC/NMC-15TH/2014 378 \200\2239 cirrhosis 382 Crohn \200\231s disease crystal deposition cystic \201 brosis 72 ectopic pr egnancy endometrial cancer endometriosis 246 \200\2237 epididymitis \201 broadenoma 424 \200\2235 galactocoele gastrointestinal 366 lymphoma haematuria 208 hepatocellular cancer 3 68 hernia 412 173 hoarse voice 152 hydrocephalus 9 , 207 , hydronephrosis 270 388 \200\2239 344 244 \200\2235 226 \200\2237 , 384 \200\2235 small bowel follow through 354 Smith \200\231s fracture soft tissue lump solitary pulmonary nodule 60 \200\2231 somatotrophic 162 adenoma 328 262 252 \200\2233 , 9 182 \200\2233 thyrotrophic cell adenoma 162 masses 426 \200\2237 tibial plateau fractures transient ischaemic 142 334 attacks SPECT spinal cord 185 , 304 transoesophageal echocardiography (TOE) compression 276 \200\2237 aortic dissection 102 thoracic aneurysm trans-rectal ultrasound spinal red \202 ags 280 spinal trauma stents 21 , 126 STIR 19 , 280 \200\2231 stomach ulc eration strictures 344 stridor 30 string of beads sign 210 string of pearl sign 248 stroke 142 \200\2233 subarachnoid 104 316 \200\22317 guided biopsy (TRUS) 222 209 380 \200\2231 hyperparathyroidism 184 hypertension hypoxia 39 386 infective colitis intermenstrual 211 trans-scaphoidperilunate 210 dislocation transudates 74 trauma triangular \201 brocartilage 328 311 complex injury 329 triquetral avulsion bleeding intermittent hemorrhage 144 \200\2235 fracture 328 claudication interventional 98 subdural triquetrolunate ligament injury 329 tuberculosis renal 236 146 \200\2237 180 subglottic carcinoma submandibular salivary gland hemorrhage procedures 20 402 \200\2233 19 , 86 \200\2237 intussusception jaundice 350 SUBASH KC/NMC-15TH/2014 440 INDEX ultrasound 8 (cont.) sarcoidosis septic arthritis 284 shortness of breath 33 192 \200\2233 sialolithiasis soft t issue lump 262 stroke 142 subphrenic abscess swollen joint testicular cancer testicular pai n 213 8 testicular scan 254 \200\2235 testicular torsion thoracic aneurysm 104 thoracic tra uma 318 thyroid nodules and 82 vascular presenting joint replacement, loose/ syndromes 97 painful 288 vascular ultrasound venography 9 180 laryngeal carcinoma liver tumors 368 lung abscess 42 lung cancer 62 mediastinal masses nasopharyngeal tumors 176 arteriovenous \201 stula 130 chronic pelvic pain 206 396 \200\2237 90 ventilation/perfusion (V/Q) scan 14 chest pain 29 COPD 46 emphysema 46 haemoptysis 36 hypox ia 39 pulmonary embolism vesico-ureteric 261 220 \200\2231 neck lumps 172 neck scan 9 oropharyngeal tumors 178 ovarian cancer ovarian masses ovarian t orsion 372 pancreatic cancer pancreatitis, acute 404 pancreatitis, chronic 406 papilloma 42 8 \200\2239 pelvic in \202 ammatory 228 , 231 230 248 15 , 49 182 \200\2233 masses , 9 tuberculosis 87 upper abdominal pain 346 urinary tract scan 8 \200 \2239 vascular scan 9 vesico-ureteric re \202 ux vomiting 349 Wegener \200\231s re \202 ux 242 \200\2233 vestibular