CHEST RADIOLOGY QUIZ FOR B.C.G.

1. CHEST RADIOLOGY QUIZ FOR B.C.G. VIVEK PATEL

2. Case 1 • A 23 y/ male presented with acute onset of left sided chest pain and breathlessness. • Went to a physician who got an X-ray chest PA which showed gross left sided pleural effusion. • The effusion was tapped approx. one and half lit. • Within 24 hrs. again fluid filled up and a repeat X-ray chest follows.

3. A follow up X-ray after refilling of pleural effusion.

4. A CT scan was advised

5. A CT guided Bx was carried out • Diagnosis???? • A correct differential diagnosis will also be given points. Maximum of three d/ds are allowed.

6. Case 2 • A 36 yr. male patient presented with dry cough and progressive exertional breathlessness. • An HRCT was advised.

7. HRCT

8. CASE 2 • What is the DIAGNOSIS. • No d/ds are allowed.

9. CASE 3 • A 70yr./ Female presented with left sided haemorrhagic effusion. • Pleural fluid cytology for malignant cells was negative. • Patient was operated for Carcinoma of soft palate before 20 yrs. • Was advised a CT scan.

10. X-ray Chest

11. CT scan

12. CT scan (contd.)

13. What is the diagnosis???? • Differentials are allowed (max. 3) • If the first differential is correct, full marks will be awarded. • If second or third d/d is correct 50% marks will be awarded. • If more than 3 d/d are sent, will be disqualified.

14. CASE 4 • A 46 yr/male presented with right sided chronic chest pain and effusion. Patient had occupational history of working with false ceilings in the gulf for almost 30 yrs. At present he had retired. • An ICD was placed. • Pleural fluid was straw coloured and didn’t show any malignant cells. • Was advised a CT scan.

15. X-ray chest

16. CT scan

17. CT scan (contd.)

18. CASE 4 • DIAGNOSIS ???? • A complete diagnosis is required. • d/d not allowed.

19. CASE 5 • A 57 yr./male had c/o dry cough and wt. loss. • Was being treated for pulmonary koch’s for past four months without significant response.

20. X-ray chest

21. H.R.C.T.

22. CT SCAN (contd.)

23. CASE 5 • DIAGNOSIS????? • No d/d allowed

24. CASE 6 • A 44 Yyr./male patient was referred to a neurologist for severe headache. • CSF examination was abnormal but not fitting into T.B. or pyogenic meningitis. • Patient’s HIV was negative.

25. CHEST X-RAY

26. H.R.C.T.

27. CT scan (contd.)

28. CASE 6 • DIAGNOSIS ???? • Maximum 3 d/d are allowed. • If the first of the three d/ds is correct, full marks will be awarded. If second or the third d/d is correct 50% marks will be awarded.

29. CASE 7 • A 39yr./male had c/o chronic cough with two episodes of haemoptysis. • He was detected to have a right hilar opacity on X-ray chest for which he was being treated with Anti-T.B. for four months without significant response. • Was referred for a CT scan.

30. H.R.C.T.

31. Contrast enhanced CT

32. Coronal Recon. HRCT

33. Virtual Bronchoscopy

34. CASE 7 • DIAGNOSIS ???? • No d/d allowed.

35. CASE 8 • A 56 yr./female had h/o chronic cough and breathlessness for four months. • She is in to making potato wafers commercially at home involving boiling of large qty. of potatoes in closed room.

36. X-ray chest

37. End insp. HRCT

38. End-exp. HRCT

39. Coronal insp and exp. hrct

40. Case 8 • DIAGNOSIS ????

41. CASE 9 • Incidental abnormality noted on a non-contrast CT of chest

42. Non-contrast CT chest

43. CT scan (contd.)

44. CT scan (contd.)

45. Case 9 • DIAGNOSIS ????

46. CASE 10 • A 16 yr./female presented with inspiratory stridor. • Bronchoscopy revealed extrinsic impression on posterior tracheal wall. • CT advised to r/o posterior mediastinal nodes.

47. X-ray chest

48. CT scan with oral and I.V. contrast

49. Coronal Recons.

50. CASE 10 • DIAGNOSIS ????