Key Points for Exam Preparation
- Only content included in the syllabus will be tested.
- Each imaging modality will test only one diagnosis.
Syllabus
| Category | Disease |
|---|---|
| Chest X-ray – Ribs | Rib fracture |
| Chest X-ray – Heart | Mitral valve type, aortic type, generalized enlargement type |
| Chest X-ray – Lungs | Normal chest X-ray; pneumonia; lung cancer; infiltrative pulmonary tuberculosis; pneumothorax; pleural effusion |
| Abdominal X-ray | Normal abdominal plain film; gastrointestinal perforation; intestinal obstruction; radiopaque urinary calculi |
| Gastrointestinal Contrast Study | Esophageal varices; esophageal cancer; peptic ulcer; gastric cancer; colorectal cancer |
| X-ray – Fractures | Long-bone fractures (Note: In rare, atypical cases, short-bone or flat-bone fractures may appear!) |
| Cranial CT | Skull (skull fracture) Brain hemorrhage (acute epidural hematoma, acute subdural hematoma, intracerebral hemorrhage) Cerebral ischemia (cerebral infarction) |
| Thoracic CT | Lung (pneumonia, pulmonary tuberculosis, lung cancer) |
| Abdominal CT | Liver (hepatocellular carcinoma, hepatic hemangioma, hepatic cyst, liver injury) Spleen (splenic injury) Kidney (renal injury) Pancreas (acute pancreatitis) |
Chest X-ray
Ribs
Chest – Heart
| Alternate Name | Pathophysiological Mechanism | Commonly Seen In | |
|---|---|---|---|
| Mitral valve type | Pear-shaped heart | Left atrial enlargement | Mitral stenosis |
| Aortic type | Boot-shaped heart | Left ventricular enlargement | Aortic regurgitation |
| Generalized enlargement type | Flask-shaped heart | Bilateral cardiac enlargement | Pericardial effusion |
Lungs
| Normal Finding | ||
|---|---|---|
| No opacity | Symmetric pulmonary markings; sharp costophrenic angles; normal cardiac silhouette | Normal chest X-ray |
| Absence of pulmonary markings (with lung compression line); increased lucency | Pneumothorax | |
| Opacity | Concave-upward arc-shaped shadow (inner low, outer high); large dense shadow | Pleural effusion |
| Nodular shadow | Lung cancer | |
| Patchy shadow localized to the lung apex | Infiltrative pulmonary tuberculosis | |
| Patchy shadow located outside the lung apex | Pneumonia | |
Abdominal X-ray
Step 1: Check for free intraperitoneal gas beneath the diaphragm → presence indicates gastrointestinal perforation.
Step 2: Look for “fishbone” sign or step-like fluid levels in the central abdomen → presence indicates intestinal obstruction.
Step 3: Identify high-density foci along the urinary tract beside the spine → presence indicates radiopaque urinary calculi.
Upper Gastrointestinal Contrast Study
Esophagus:
- Beaded appearance → portal hypertension, esophageal varices
- Esophageal narrowing, rigidity, and irregularity → esophageal cancer
Stomach:
- Gastric ulcer: niche located outside the gastric contour
- Gastric cancer: niche located within the gastric contour
Duodenum:
- Niche located outside the duodenal bulb → duodenal ulcer
Colon:
- Barium enema obstruction → colorectal cancer
Fracture X-ray
Upper limb: Humerus fracture, ulna fracture, radius fracture, ulnar–radial fracture, scapula fracture
Lower limb: Hip fracture, right femoral neck fracture, femoral shaft fracture, tibia fracture, fibula fracture, tibiofibular fracture, medial malleolus fracture
Thoracic CT
Pneumonia, pulmonary tuberculosis, lung cancer
- Shadow morphology
- Nodular shadow → lung cancer
- Patchy shadow
- At lung apex → pulmonary tuberculosis
- In lung parenchyma → pneumonia
Cranial CT
Assess skull continuity:
- Discontinuity → skull fracture
- Continuity intact → assess lesion density:
- Hyperdense (white) lesion → cerebral hemorrhage; further identify location:
- Epidural hemorrhage (lenticular/convex shape)
- Subdural hemorrhage (crescent-shaped)
- Intracerebral hemorrhage
- Hypodense (black) lesion → cerebral infarction
- Hyperdense (white) lesion → cerebral hemorrhage; further identify location:
Abdominal CT
Liver
- Hepatocellular carcinoma (no history of trauma; irregular hypodense lesion)
- Hepatic hemangioma (no history of trauma; well-defined hypodense lesion; peripheral enhancement on contrast-enhanced scan)
- Hepatic cyst (no history of trauma; well-defined hypodense lesion; no peripheral enhancement on contrast-enhanced scan)
- Liver trauma (history of trauma; hyperdense lesion)
Spleen (splenic injury)
Kidney (renal injury)
Pancreas (acute pancreatitis)
Tutorials
- Chest X-ray: Test-Taking Strategies (for Licensed Physicians / Standardized Residency Training / Final Certification Exams)
- Abdominal X-ray: Test-Taking Strategies (for Licensed Physicians / Standardized Residency Training / Final Certification Exams)
- Fracture X-ray: Test-Taking Strategies (for Licensed Physicians / Standardized Residency Training / Final Certification Exams)
- Thoracic CT: Test-Taking Strategies (for Licensed Physicians)
- Cranial CT: Test-Taking Strategies (for Licensed Physicians)