SC aoe 22 “Must See” Diagnostic Images for Medical Students Index with hyperlinks at end All images retain the copyrights of their original authors GaAMSER’s “Shortlist” + AMSER is the national Alliance of Medical Student Educators in Radiology Their National Curriculum for Medical Students, developed by Kitt Shafer, MD and Petra Davis, MD, contains a “Diagnostic Shortlist” of “must see" images “all students should recognize” This is a limited list of diagnoses that AMSER believes all students should be able to recognize, regardless of their planned specialtyThe Owl Seite ave M Mel Ee ele em ites slide contains a hyperlink to additional information. Click on the blue linkDiagnosisCan you tell why this patient is short of breath? te]Tension pneumothoraxecu iit ree Pred en CeCe erecta eee! Tension pneumothorax Pam LT and trachea to oisPun cea Tur ke eas aa Bete csucecnc) top and displaces Gromit) PneumothoraxPneumothorax * To learn more about pneumothorax, go to: Recognizing a Pneumothorax retake LC)DiagnosisSie aces Eerieet try RiecUs mes Pe eee tte) ern ae Peetu! PCL cei)Peele ed Meer) Ns et] pee tea) meee) foe ete col) Petia poi icag emis distal CeeeeitryPneumomediastinum * To learn more about pneumomediastinum, go to: Pneumomediastinum retake LC)Diagnosisetnies Pireetucal reg Greate sae ial Reus Peet re Reurelesaies tal Pneumoperitoneum te]Pure eto)Pneumoperitoneum * To learn more about eLeVUlnace) OreLai CoaCcLUL UMM [ok (c -iRReteenenInna! Free Air retake LC)Detect Ae Cusig Ea im R ely etic) Pier WUE Bree Curio eee Pee ciel ciel) Pleural Effusionsbaer allt}Effect of Position - Layering In the supine position, the fluid layers out posteriorly and produces a haziness, especially near the bases (since the patient is actually semi- recumbent). In the erect position, the fluid falls even more to the bases.Pleural Effusion * To learn more about pleural effusions, go to: Recognizing a Pleural Effusion retake LC)William Herring, M.D. © 2003 Recognizing A Pleural Effusion Sn aNormal Anatomy Visceral pleura is adherent to the lung Space between visceral and parietal pleura is a potential space Infoldings of visceral pleura form TESOL K =e) Loose connective tissue beneath visceral pleura = subpleural space ne | edOn the frontal film, the highest point of the apparent right hemidiaphragm is displaced laterally (it is usually in the center). On the lateral film, there Pe Ria els RRR emu CRU Mur) elm gy hn | eaWhen 200-300cc of fluid accumulate in pleural space, the usually acute costophrenic angle (sulcus), as seen on the right in this person, becomes blunted (as seen on the left in this person) Sn a ceLa Rome ig along the edge of EM oie oal producing an upside down “U” or meniscus shape Meniscus Sign PSEffect of Position - Layering Supine Lacteig In the supine position, the fluid layers out posteriorly and produces a haziness, especially near the bases (since the patient is actually semi- Ctl Rete lee RR RCRA Me Ol UML tte Sn | aA loculated effusion has an unusual shape (lentiform) or fee M Um Ud thoracic cavity BUR Ble 1i) CTE] heOMe tlm) tet) between the lung and the visceral pleura in the loose Te RC Rela) ETT) eyed CLL eB y oy [el -3 Laminar effusions are usually seen with CHF or lymphangitic spread of tumor Laminar Effusion Sn a ceBical litg ee hae [oy Tey BCU CE Bi aols the heart and Bie Teul 1) from the side of opacification aay characteristic of a Pee tcl a} PS | Large Right Pleural EffusionA straight edge, ite LferCel e Rete} interface, in this CTT TT Ce) claret Mee eel) tat Mile Lag imelce (Tm OEE) ETM (aC MT -3 pleural space, there must be a pneumothorax present. Hydropneumothorax