In UK practice, breast abnormalities are evaluated as part of a ‘triple assessment’ process: clinical examination, imaging and subsequent image-guided tissue diagnosis. All breast-imaging tests are assigned a numerical score from 1 to 5 with a prefix for each score:…
Gynaecological imaging 10.1 common indications for gynaecological ultrasound Primary amenorrhoea 1. Constitutional delay. 2. Polycystic ovarian syndrome (PCOS). 3. Congenital genitourinary malformation—broad range of anomalies, see Fig. 10.2 . 4. Gartner duct cyst. 5. Complete androgen insensitivity syndrome (CAIS)—Y chromosome…
Incidental adrenal mass (unilateral) Common incidental finding on CT. A mass <3 cm in diameter is likely to be benign and a mass >5 cm in diameter is probably malignant. On unenhanced CT, 98% of homogeneous adrenal masses with an attenuation of…
Intraluminal gallbladder lesions 1. Gallstones —single or multiple, small or large. ~80% are radiolucent on plain film, but ~80% are visible on CT. Often calcified, may contain central fat or gas. Typically mobile, but can be adherent to the GB…
Pneumoperitoneum Plain film signs include: Erect CXR —free gas under diaphragm or liver. Can detect 10 ml of gas. Takes 10 minutes for all gas to rise. Supine AXR —most sensitive signs are often in the right upper quadrant. Gas outlines…
Gross cardiomegaly on CXR 1. Ischaemic heart disease —and other cardiomyopathies. 2. Pericardial effusion —globular (supine radiograph) or flask-shaped heart (erect radiograph), crisp cardiac outline (as the effusion masks ventricular wall motion). 3. Multivalve disease —particularly regurgitation. 4. Congenital heart…
Tracheal/bronchial narrowing, mass or occlusion Airway narrowing may occur at any site from below the level of the vocal cords down to the segmental/subsegmental airways. In the lumen 1. Mucous plug —e.g. asthma, cystic fibrosis, ABPA. Low density, usually contains…
Linear and curvilinear soft tissue calcification Common causes 1. Arterial —i.e. atherosclerosis. If seen in the hands or feet, this suggests underlying diabetes or hyperparathyroidism (secondary > primary). Calcification can also be seen in aneurysms (e.g. popliteal). 2. Cartilage —i.e.…
Monoarthritis Common 1. Septic arthritis —including tuberculosis. Marked juxtaarticular osteopenia with loss of definition of subchondral bone plate. 2. Trauma —evidence of fracture or lipohaemarthrosis. 3. Osteoarthritis (OA) —marginal osteophytes, subchondral sclerosis and/or cysts, joint space narrowing. Commonly involves weight-bearing…
Scoliosis Scoliosis is a lateral spinal curve on a PA radiograph with a Cobb angle >10 degrees. If <10 degrees then it should be described as spinal asymmetry. Idiopathic (80%) 1. Congenital —0–3 years, M>F. Left side convex. Usually regresses.…