Island Med Student

Here is the long-awaited list of some more “stuff learned” in radiology. As always, this list is very incomplete.

1) You have to have at least 400 cc of fluid to be able to recognize and diagnose a pleural effusion on x-ray.

2) A positive HIDA scan is when you can’t see the gallbladder.

3) To best diagnose an aortic dissection, you should get a CT with contrast.

4) If someone ODs on heroin, you miss see massive pulmonary edema on CXR.

5) A right lower lobe pneumonia does not obscure the right heart/lung border, but the middle does.

6) A left upper lobe pneumonia obscures the left heart/lung border.

7) Osteomyelitis tends to go to the vertebral discs, not the body.

8 ) MRI can date a fracture, whereas x-ray and CT cannot.

9) A sign of tethered cord syndrome is a sacral dimple.

10) Charcot’s joint happens to diabetics. Because of neuropathy, they feel no pain, although their feet can be destroyed all the way to the bone.

11) A fat pad sign is seen with a fracture. The fluid in the joint displaces the fat pad, and you can see it on x-ray.

12) Osteomyelitis doesn’t show up for over 3 weeks on x-ray, so doing a bone scan can help you better diagnose.

13) Your “5 friends” on a chest x-ray are trachea, heart borders, hemidiaphragms and costophrenic angles, and aortic arch. You should also look at the hilum, and pulmonary vasculature.

14) Beware “breast attenuation” on female chest x-rays. The breast tissue can make the film appear more congested.

Note: Photos are of my bestest buds in Dominica, the Ren brothers. Oh how I miss them!