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Radiology ENT.pdf
- 1. XRAYS IN ENT
- 2. Reading an xray Plain or contrast Region: mastoid, pns, soft tissue neck View: AP, lateral, lateral oblique Anatomical landmarks Pathological findings Diagnosis
- 4. Types of Mastoid XRay 15 degree lateral oblique(Law) 30 degree lateral oblique(Schuller): commonly done 45 degree lateral oblique(Myer Owen) Advantage of schuller & owen: Better visualisation of key areas of mastoid(attic, aditus, antrum) Towne’s view: b/l A-P view showing both mastoids & IAC
- 6. Importance of mastoid xray Type of pneumatisation: cellular, sclerotic, diploeic Position of dural plate- look for low lying plate Position of sinus plate- look for forward lying plate Presence of bony destruction Presence of mastoid cavity Presence of cholesteatoma- cotton wool appearance
- 7. Anatomical landmarks TM Joint Ext. auditory canal superimposed on middle ear & internal acoustic meatus Mastoid air cells Dural plate Sinus plate
- 10. Cellular mastoid Seen in 80-90 % cases Defined as presence of plenty of mastoid air cells Presence of air cells beyond the confines of sinus & dural plate is called hypercellular mastoid
- 12. Sclerotic mastoid Absence of mastoid air cells except mastoid antrum which is smaller in size compared to normal Seen in chronic otitis media with effusion, CSOM tubotympanic disease
- 14. Diploeic mastoid < 1 % cases Mastoid cavity are mostly hazy
- 15. Cholesteatoma erosion Central greyish white shadow- Cotton wool appearance Surrounded by radiolucency due to bone destruction Surrounded by dense white bone of sclerosis
- 18. D/D of Mastoid Cavity Cholesteatoma (d/t auto mastoidectomy)- smooth Post mastoidectomy cavity- irregular Mastoid abscess in coalescent mastoiditis Tympanomastoid malignancy Secondary metastasis Histiocytosis Eosinophilic granuloma(hairline appearance) Mega antrum Tb mastoiditis
- 19. Plain Xray of PNS
- 22. Types of PNS X-rays Occipitomental view(Water’s) Occipitomental view with mouth open(Pierre) AP or fronto-occipital view(Caldwell) Lateral Lateral oblique of orbit (Rhese) view Submentovertical view(base skull)
- 23. Water’s view
- 26. Caldwell view
- 27. Importance of PNS Xray Look for sinus opacity- should be more dense than orbital opacity Look for dome shaped opacity in sinus- maxillary antral polyp/cyst Bony opacity- osteoma Look for fracture Look for bone destruction- malignancy Look for radio-opaque foreign body
- 28. Anatomic landmarks Boundary of frontal sinus Boundary of maxillary sinus Ethmoid air cells Sphenoid sinus(seen through open mouth) Medial wall of orbit(lamina papyracea) Innominate line
- 29. Best Xrays for sinus Maxillary- occipitomental(water’s) view -best for maxillary sinus -sinus which is not visible in this? Frontal – anteroposterior (caldwell) view -best for frontal sinus -haustrations are lost in chronic sinusitis Ethmoid – lateral oblique (Rhese) view Sphenoid – submento vertical(base skull/ bucket handle ) view, also shows lesions of palate & zygomatic arch fractures
- 30. Zygoma fracture/ tripod fracture- zygomatico frontal, zygomatico temporal & infraorbital fractures Best seen in water’ s view
- 31. Acute sinusitis Shows air fluid level that moves with change in position of head Concave floor More fluid
- 34. Chronic allergic sinusitis Xray showing bilateral homogenous opacity of multiple sinuses Less fluid,more mucosal thickening or hypertrophy
- 35. D/D of U/L Maxillary opacity Acute maxillary sinusitis- pus(air fluid level) Chronic maxillary sinusitis- thick mucosa Fungal sinusitis Antrochoanal polyp Maxillary mucocele Maxillary antral cyst Dental cyst(erupted tooth) Dentigerous cyst(unerupted tooth) Haemoantrum following trauma Malignancy- bony outline is lost
- 36. Air fluid level
- 37. Rt. Antral Polyp
- 39. Antrochoanal polyp What is the other name? Parts ? Etiology ? Clinical features? Investigations ? Treatment ?
- 40. Maxillary malignancy Etiology ? Clinical features ? Investigations? Treatment ?
- 43. Nasal bone fractures Clinical features? Importance of xray? Treatment? Instruments for fracture reduction? Golden period for fracture reduction?
- 44. Nasal foreign body How to remove it? Precautions to be taken ? Importance of an open safety pin? Clinical features of long standing foreign body nose ?
- 46. Dentigerous cyst
- 47. Xray Nasopharynx extended neck lateral view
- 49. Adenoid Location? What is adenoid facies? Investigation? Treatment? Steps of adenoidectomy? Grisel’s syndrome?
- 50. D/D of nasopharyngeal mass Adenoid JNA Nasopharyngeal carcinoma Dermoid cyst Antrochoanal polyp
- 51. Xray soft tissue neck A-P & lateral view
- 52. Anatomic landmarks Hyoid bone & epiglottis Laryngeal cartilage calcifications(>40 yrs) Vocal cords Pharyngeal air shadow Tracheal air shadow Prevertebral soft tissue shadow widening Cervical vertebral column
- 54. Importance of STN Xray To look for radioopaque foreign body Look for acute epiglottitis (thumb sign) Look for acute laryngotracheobronchitis (croop) Look for retropharyngeal abscess(prevertebral space >2/3rd of AP diameter) Look for cervical vertebrae collapse or fracture
- 58. FB(coin) in cricopharynx Face of coin seen in AP view & rim of coin seen in lateral view- FB esophagus Face of coin seen in lateral view & rim in AP view – FB Trachea How to remove it ? What will happen if we don’t remove it ?
- 59. Importance of lateral view xray? Confirm position of radio-opaque shadow- superficial to skin/soft tissue neck/airway/food passage Confirm position in relation to cervical vertebrae Confirm number of foreign body r/o retropharyngeal abscess
- 60. Open & closed safety pin Significance of open pin & its direction Name an instrument for its removal?
- 62. Chronic retropharyngeal abscess Why cervical spine is straightened? Radiological findings? Etiology? Clinical features? Treatment?
- 64. TB Spine Radiological findings? Etiology? Clinical features? Treatment ?
- 65. Foreign body right bronchus Why does it go into right bronchus? Clinical features? Treatment?
- 67. Why do a chest Xray? Look for radioopaque foreign body Look for hyperventilated lung Look for lung collapse
- 69. Acute epiglottitis Name of this sign? Etiology? Clinical features? Treatment?
- 71. Croup Name of this sign? Etiology? Clinical features? Treatment?
- 75. Submandibular salivary calculus Radiological findings? How do you take this xray? Why stones are more common in submandibular salivary gland?
- 77. Contrast Xrays
- 78. Advantage- can see small pouches & constrictions Contraindication – esophageal perforation, TEfistula MC used barium sulphate- inert, can be mixed with food or water, minimal absorption in GIT but acts as foreign body if leaked out of GIT
- 80. Submandibular sialogram Radiological findings? Name of the duct? How do you take this Xray?
- 82. Branchial fistulogram Radiological findings? Etiology? Clinical features? Treatment?
- 86. Achalasia cardia Name of this sign? Etiology? Clinical features? Treatment?
- 88. Oesophageal malignancy Name of this sign? Etiology? Clinical features? Treatment?
- 90. Oesophageal varices Name of this sign? Etiology? Clinical features? Treatment?