Rapid Review of Radiology, 1st Edition

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Dedications
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Contents
!'rdJ.cc

Contri butors 5
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G,'nnJI Imrodllcl ion ,

Ch'l'tcr I - ChC51 1"'.ginS II

CI,.ptcr 2 - ,\bdomin.1 I""sing 71

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 Preface
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Contributors
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,
 GENERAL
INTRODUCTION

This book has been written primarily for senior radiology exposure to as many ofthese cases as Ix>ssible. Radiological
ITJinces preparing for final radiology exams and in particular atlases and film libraries provide ready access ro many of
fo r trainees studying for the Fellowship of [he Royal these classic cases, which can then be committed to
College of R3diology. With Ihis in mind, the cases memory. You can prepare a ready-made description of
presented herewith have been presented in the exact these cases for rhe viva. Ifro\! arc sure of the diagnosis,
manner that the cases are presented in the Ro}'al College dispatch the film promptly with your preprepared 'speech'
of Radiology FRCR 2B exam. In the exam, long cases and so that you can progress to the next case as soon as
viva cases are presented with a very minimal bur highly possible. Of course there may be 'Aunt Minnie' cases that
relevant history and the required response is expected to yO ll haven't secn and rhis may present a problem, Such
be presented in a particular way. This format of reporting ' cases arc often not amenable to working out the diagnosis
involves giving a Description/ Interpretation of the images; - you either know it or you don't . The o nly thing ro do is
Diag nosis; Differential Diag nosis; and advice on Furrhcr be methodical in your analysis and description of the
Management. We have laid Ollt the answers here in exactly findings so that at the very least you can suggest whether
this manner and have included a Discussion [Q give in - you feci an abnormality is li kely 10 be lo ngstanding and
depth further information about each condition which wi ll benign or orhenvise, and make appropriate suggestions on
enable the sntdent to answer any qucstions directed to him how you would proceed.
or her in the viva situation, By tollowing the RCR exam
formal , thc candidate should be ideally prepared for t his The 'test of observation'
e.l:am and for [he future as a Consultant Radiologist. H ere, there is an abnormality prescnt that once seen, may
wclllcad to an easy d iagnosis. The abnormality is subtle or
hidden however, such that it tests the candidate's
FILM TECHNIQUE perception and approach [Q a case. Perceptual abi lity,
Whatever the imaging modality, the radiologist interprets however, is variable, not only between people bur also in
images using all the infonnation and clues available, to the same obscn'er on diflcrcllt days (this is particularly [rue
prod uce a differential diagnosis and/or advise on further in examinat:ions where anxiety levels arc high). You must
investigation and management. Above all else, this mUSt be therefore be systematic in analysing each film if there is no
done in a SAFE manner, and this often requires one [Q be ob\'io us abnormality [ 0 sec on firsr inspection. There arc
systematic in approach. Secondly, this process must be done mallYdiflerent s}'srcmatic approaches and it is beyond [he
in a SENSIBLE manner - it is easy to quote endless lists of scope of this discussion to be morc prescriptive. Howcver,
differential diagnoses but if these are not refined for each make sure you haye a system and usc it. Moreover, describe
individual case, the r.:tdiologisr's input is of little value.1l1e the process you are going through aloud in the viva so that
following discussion concentrates in particular o n the examiner knows that you arc practising safe radiology.
perfo rming these tasks in the examination viva scenario.
However, much of the advice is applicable to everyday The 'jigsaw puzzle'
practice [Qo, in particular the emphasis on a safe and This type of case presents several findings that once
sensible approach. identified and considered together, lead to a specific or
differential diagnosis. This nOt only tCSts perceptual skill
and systematic approach, but also the ability ro mentally
TYPES OF FILM 'cross-reference' se\'eral diflcrential diagnosis lists for the
The rypes of film one may enCounter in an exam/viva arc as various abnormalities identified , to find thc 'best fit'
fo llows: diagnosis. Whenever producing a differential diagnosis in
an examination or real life, it is \'ital to produce a sensible
The ' Aunt Minnie' list, not just a recital oflong lists learnt from books. To do
There arc certain disorders that have a characteristic this, you must use all clues available from the clinical
appearance on imaging that allows one to make an instant histOry and film, and combine this information with
'Spot diagnosis'. It \\~Il be assumed the candidate has come knowled ge of the incidence of each possibility in a given
across it before, and thus t he best preparation here is patient population.
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 Ge neral Introdu ctio n

GENERAL VIVA CONS IDERATIONS

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 Chest Imaging Cases \, 2

CASE 1
History
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 Answe r 1 Chest Ima ging

ANSW ER 1
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