Radiology AIIMS NOV 2015

Q-1. Investigation of choice for glass foreign body in finger?
a) Plain X-ray
b) USG
c) CT scan
d) MRI

Answer: Plain X-ray
Radiologic evaluation of soft tissue injuries plays an important role in detecting, evaluating, and planning the potential removal of a foreign body.
Radiographs are most useful in detecting radiopaque foreign bodies. However, for the detection of non-radiopaque foreign bodies (eg, wood, rubber, plastic, and other foreign bodies), the sensitivity of radiography is low.

Q-2. In coarctation of aorta, rib notching is seen in?
a) 3rd to 9th ribs
b) 1st to 9th ribs
c) 11th & 12th ribs
d) All ribs

Answer: 3rd to 9th ribs
Radiological findings of coarctation of aorta:
Widening of the left subclavian artery border is the most common finding, but the most useful radiographic sign is an abnormal contour of the aortic arch, which may appear as a double bulge above and below the usual site of the aortic knob. This pattern has been described as a figure-3 sign.
Rib notching occurs along the inferior margin of the third to the ninth ribs; it is caused by pulsation of dilated intercostal arteries.

Q-3. A patient presents with history of breathlessness. Radiological findings are as in Chest X-ray film. What is your diagnosis?

a) Pleural effusion
b) Lung abscess
c) Hydro-pneumothorax
d) Malignant infiltration

Answer: Hydro-pneumothorax
Chest radiography shows hydro-pneumothorax with a collapsed right lung and an adjacent thoracic air–liquid level
Radiographic features of hydro-pneumothorax: An air-fluid level in the pleural space
Generally, the air is found peripheral to the white line of the pleura.
In an upright film this is most likely seen in the apices.
Radiographic features of pneumothorax: The presence of air within the pleural space

The diagnosis of pneumothorax is established by demonstrating the outer margin of the visceral pleura, known as the pleural line, separated from the parietal pleura by a lucent gas space devoid of vascular marking.

Q-4. A patient presented with neck pain and rigidity which gets relieved after bathing in hot water and also after exercises. Radiological findings are as in cervical X-ray film. What is your diagnosis?

a) Spondylolisthesis
b) Spondylosis
c) Spondyloptosis
d) Spondylitis

Answer: Spondylosis
The x-ray shows cervical spondylosis associated with bone spurs called osteophytes and narrow degenerated discs in the lower vertebra.
Cervical spine films can demonstrate disk-space narrowing, osteophytosis, loss of cervical lordosis, unco-vertebral joint hypertrophy and apophyseal joint osteoarthritis.

Q-5. 20 year old male presented with pain on movement and X-ray shows lytic lesion on the upper end of tibia identify the lesion?

a) Tibia Giant Cell Tumor
b) Adamantinoma
c) Simple bone cyst
d) Ewing’s sarcoma

Answer: Tibia Giant Cell Tumor
Giant Cell Tumor:
The peak incidence of giant cell tumor is seen in the 3rd decade of life.
The most commonly involved locations include ends of long bones – distal femur, proximal tibia and distal radius. Roughly half of all cases occur around the knee joint. Sacrum is another common location.
Plain radiograph shows an expanding lytic lesion in an epiphyseal location extending to the articular cartilage.

Q-6. A 45 yr old man, chronic smoker, progressive jaundice with pruritus and clay stools for 2 months, h/o waxing and waning of jaundice. On CT common bile duct and main pancreatic duct dilated. What is the diagnosis?
a) Ampullary Ca
b) Ca head pancreas
c) Pancreatitis
d) Cholangio-carcinoma

Answer: Ca head pancreas
The double duct sign refers to the presence of simultaneous dilatation of the common bile and pancreatic ducts.
The two most common causes of the double duct sign: Carcinoma of the head of the pancreas
Ampullary tumors (e.g. carcinoma of the ampulla of Vater)
Important point:
Occasionally an impacted gall stone in the distal duct, with associated edema, can also result in obstruction of the pancreatic duct.