Spotting for MBBS students

1. SPOTTERS

3. Synechiae
• Intra uterine adhesions
• Post curettage and infection
• Linear filling defect
• Arising from one wall
• Multiple+infertility= Asherman syndrome

4. Synechiae. Spot radiograph shows a central oval filling defect within the uterus, a
finding that represents a synechia

6. Diffuse adenomyosis
Spot radiograph shows irregularity of the
uterine contour with small outpunching's of
contrast material, findings that represent
diffuse adenomyosis.

7. Adenomyosis
• Endometrium extends into myometrium.
• Focal or diffuse.
• Nests of endometrium connect to uterine
cavity.
• Out pouching of endometrial cavity.

9. BREAST LIPOMA:
are solitary radiolucent lesion often large at the
time of diagnosis, may show thin capsule,
difficult to palpate clinically (soft)

12. Intraocular cysticercosis
cyst with dot appearance.

14. Ovarian dermoid
• US findings that are characteristic of a mature
cystic teratoma are:
• Hypoechoic mass with hyperechoic
nodule (Rokitansky nodule or dermoid plug)
• Usually unilocular (90%)
• May contain calcifications (30%)
• May contain hyperechoic lines caused by floating
hair
• May contain a fat-fluid level, i.e. fat floating on
aqueous fluid

16. aneurysm of aorta

18. portal cavernoma

20. ureterocele

22. dysphagia lusoria ( aberrant right subclavian A)

24. LUNG ABSCESS

26. GOUT

27. Latent period – 5-10yrs.
1st MTP joint is most commonly
affected because lower body
temperature favours decreased
monosodium urate solubility.
Radiological Features--
-- Periarticular soft tissue swelling
due to tophi.
Tophy may be calcified.

28. -- Periarticular punched out
erosions with overhanging
edge and sclerotic margin.
-- Cartilage loss is a late
manifestation.
-- Osteoporosis is rare.

30. TRICHOBEZOAR

32. NON OSSIFYING FIBROMA

34. Hill–Sachs deformity of the humerus.
Internal rotation view of the shoulder (A) shows
a notch in the posterolateral aspect of the
humeral head (arrow).
(B) Axial T2-weighted MRI from another patient
who previously suffered an anterior shoulder
dislocation demonstrates a Hill–Sachs defect
(arrow). The Hill–Sachs defect is seen as
a notch in the posterolateral humeral head
above or at the level of the coracoid process.

36. Thyroglossal cyst at base of tongue

37. Thyroglossal duct cysts (TGDC's) are the most common
congenital neck cyst. They are typically located in the
midline and are the most common midline neck
mass in young patients. They can be diagnosed with
multiple imaging modalities, including ultrasound, CT,
and MRI.
• The cysts can occur anywhere along the course of the
thyroglossal duct, although infrahyoid location is most
common.
• suprahyoid: 20-25% (less common in adults ~5%)
• at the level of hyoid bone: 15-50%
• infrahyoid: 25-65%
• Typically, they are located in the midline (~70%) with
those off-midline characteristically tucked next to
the thyroid cartilage. Almost all thyroglossal duct cysts
are located within 2 cm of the midline, with more
inferior lesions tending to be off midline.

38. CT
• At CT, thyroglossal duct cysts are thin walled,
smooth, well defined homogeneously attenuating
lesions with an anterior midline or para-midline
location. The generally accepted rule is that they
should be within 2cm of the midline. The may
demonstrate slight rim (capsular) enhancement.
• Sternocleidomastoid muscle is typically displaced
posteriorly or posterolaterally. In some cases,
thyroglossal duct cysts may be embedded in the
infrahyoid strap muscles.

39. • MRI
• T1: variable
– low signal: if low protein or uncomplicated
– high signal (most common 6) due to
• previous haemorrhage or infection
• high protein (probably due to previous complication)
• T2: typically high signal
• T1 C+ (Gd)
– no enhancement in uncomplicated cysts
– thin peripheral enhancement may be seen

40. • Differential diagnosis
• The differential is that of midline neck
masses and includes:
• branchial cleft cyst: three times less common,
and usually well away from the midline
• delphian node adenopathy
• epidermoid cyst: superficial to the strap muscles
• thyroid cyst or thyroid neoplasm
• laryngocoele
• ranula
• parathyroid adenoma

43. Neuroblastoma.
(A)Chest radiography shows posterior mass on
the right in a child with chest pain and no
clinical features of infection.
(B) CT chest (noncontrast) shows calcification in
the mass adjacent to the spine. There was no
evidence of extradural extension on MRI

45. Sagittal synostosis.
(A) Brain CT and
(B) lateral scout view showing the typical ‘boat-
shaped’ skull or scaphocephaly of sagittal
synostosis

47. Thyroglossal duct cyst.
(A) Axial T1-weighted spin-echo
(B) T2-weighted fast spin-echo images
show a well-defined high signal
intensity thyroglossal duct cyst just
anterior to the hyoid bone.

49. Fibrous dysplasia.
AP radiograph of the proximal femur showing a
well-defined expanded lesion with typical
ground-glass matrix mineralization and a
thick, sclerotic margin (rind sign).
A stress fracture is present in the lateral cortex
(arrow).

51. Sacral chordoma. AP radiograph of the sacrum
shows a central, lytic destructive lesion
(arrows).
CT shows a predominantly lytic mass with
small foci of calcification.

53. Meniscal cyst.
A cystic structure is seen arising deep to the
lateral collateral ligament (arrow), intimately
related to the lateral meniscus. An oblique
tear is seen through the meniscus confirming
that this represents a meniscal cyst.
Meniscal cysts occurs when synovial fluid
becomes encysted, often secondary to
ameniscal tear. When they extend beyond the
margins of the meniscus they are
termed parameniscal cysts.

55. Luftsichel sign.
(A)A left upper lobe collapse demonstrating
paramediastinal lucency (arrow).
(B) CT shows interposition of aerated lung
between the collapse and the mediastinum
(arrow). There is also a large right
paratracheal node causing some distortion of
the SVC.

56. The Luftsichel sign is seen in some cases of left
upper lobe collapse and refers to the frontal
chest radiographic appearance due to
hyperinflation of the superior segment of the
left lower lobe interposing itself between the
mediastinum and the collapsed left upper
lobe.

58. Osteitis condensans ilii. There is triangular
sclerosis along the iliac sides of both SI joints.
The sacral sides and SI joints are normal. This
is a stress-related phenomenon usually of no
clinical significance.
The main differential diagnosis is a sacroiliitis,
but with osteitis condensans ilii the SI joint is
normal with no irregularity, erosions or loss of
joint space.

60. Right lower lobe collapse. (A) Frontal view of an
example of right lower lobe collapse
demonstrating a triangular density which does
not obscure the right hemidiaphragm
silhouette.
(B) The lateral radiograph shows the typical
features of increased density of the posterior
costophrenic angle and loss of the silhouette
of the right diaphragm posteriorly.