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GENERALITIES
1. Types of radiation in the electromagnetic spectra: ULTRASOUND, UV RAY, X-RAY,
GAMMA RAY
2. The highest source of radiation exposure of the world’s population after 2006 is due to:
DECREASING OZONE LAYER IN THE ATMOSPHERE
3. The different forms of electromagnetic energies differ only from each other because of
the difference in: FREQUENCY
4. The basic principle of the characteristics of the different electromagnetic energies as far
as their inherent energy levels are concerned: THOSE WITH HIGHER FREQUENCY HAVE
HIGHER ENERGY LEVELS
5. The energy carried by each photon is proportional to the frequency, this proportionality
constant is called: PLANCK’S CONSTANT
6. True of radiation: IT IONIZES THE WATER MOLECULE AND ALLOWS THE PRODUCTION
OF FREE RADICALS
7. Free radicals are fixed in the presence of: OXYGEN
8. They demonstrated radiation dermatitis as a reaction, when the radioactive source is
placed on the skin: PIERRE CURIE AND BECQUEREL
9. This process entails showing a data set with different width of gray scale values and at
different density levels: WINDOWING
10. It uses sealed sources of radiation: NUCLEAR MEDICINE
11. The average propagation velocity of sound: 1540 M/SEC
12. Pleural fluid accumulation may be best imaged with: ULTRASOUND
X-RAY
1. X-ray photons that reach the film are called: PRIMARY BEAM
2. The blackening of a film is proportionate to the amount of: RADIATION EXPOSURE
3. Produce the significant influence on the resulting density on an x-ray film: ATOMIC
WEIGHT/TISSUE THICKNESS
4. Tungsten is chosen as material for the anode because of its: HIGH MELTING POINT
5. Maximal conversion of the kinetic energy of electrons that are traveling towards the
anode from the filament of the tube is achieved when it: COLLIDES WITH THE NUCLEUS
OF A SURFACE TUNGSTEN ATOM
6. Higher penetrating characteristics of x-ray photons will be due to: HIGH KILOVOLTAGE
ELECTRICAL ENERGY APPLIED TO THE X-RAY TUBE
7. Increasing kilovoltage is beneficial to the patient because it: REDUCES RADIATION DOSE
8. Increase in kilovoltage will reduce image contrast because: ABSORPTION PROCESS WILL
DECREASE
9. Inside the x-ray tube, the number of electrons is indicative of: HIGHER MILIAMPERAGE
LEVEL OF ELECTRIC CURRENT
10. The shadow of tissue that attentuates the x-ray beam less effectively than surrounding
tissue: LUCENCY
11. The chest wall may best be imaged with: X-RAY
12. The chest x-ray is taken in the PA projection in order to: REDUCE MAGNIFICATION OF
THE HEART
13. Fat is seen on x-ray as: RADIOLUCENCY (DARK)
14. Removing scatter radiation is achieved with the: USE OF IMPLEMENTS CALLED GRIDS
15. The effect of secondary radiation to the image in the radiographic film is: DECREASE
CONTRAST OF THE IMAGE
16. Bending fracture of the radius in a 7 y/o patient is best diagnosed by: PLAIN
RADIOGRAPH
17. Appearance of malignant primary bone tumors on plain radiograph: POORLY
MARGINATED BORDERS
18. Patients no longer with radiation after procedure: DIAGNOSTIC IMAGING
19. Utilizes energy within the kv range: DIAGNOSTIC X-RAY
20. Utilizes energy in the megavoltage range: THERAPEUTIC X-RAY
21. Absorbed in tissues of high density: DIAGNOSTIC X-RAY
22. Little differential absorption in tissues of different densities: THERAPEUTIC X-RAY
23. The equipment usually have very limited rotation: DIAGNOSTIC X-RAY
24. The linear accelerations can rotate 360 degrees around the patient: THERAPEUTIC X-RAY
CT SCAN
1. Cross-sectional imaging modality: CT SCAN
2. Involves the highest radiation exposure but displays a digital image: CT SCAN
3. This is the basis for the different densities noted in a CT scan image: ELECTRON DENSITY
OF THE STRUCTURES
4. The main disadvantage of using multidetector CT scan: HIGHER RADIATION DOSE
5. The advantages of multidetector helical CT over conventional CT in evaluating organs
with possible disease: MULTIPLANAR DEMONSTRATION OF IMAGES WITHOUT LOSS OF
RESOLUTION, IMPROVED RESOLUTION TO DEMONSTRATE SMALL LESIONS, ABILITY TO
DEMONSTRATE THE DIFFERENT PHASES OF CONTRAST ENHANCEMENT
6. CT scan is superior to MRI in showing: LUNG PARENCHYMA
7. This will give a negative CT number: FAT
8. The combination of Positron Emission Tomography (PET) and Computed Tomography
(CT) produces an image that is: DISTINCTLY DIFFERENT
9. This will be a hindrance to performing CT scan of the brain: RESTLESS AND HIGHLY
AGITATED PATIENT WHO CANNOT BE SEDATED
MRI
1. Produces the least spatial resolution: MRI
2. Produces better soft tissue resolution: MRI
3. This poses no radiation hazards to the patient: MRI
4. This is the basis for the different intensities noted in an image using T2 weighted MRI:
PROTON DENSITY
5. The important component of MRI that is responsible for making the protons of hydrogen
susceptible to radiofrequency stimulation that is needed in image production:
RADIOFREQUENCY
6. MRI is superior to CT in showing involvement of the following: BRACHIAL PLEXUS AND
SUBCLAVIAN ARTERY, CHEST WALL AND MEDIASTINUM, VERTEBRAL BODIES AND
SPINAL CANAL
7. The bright signal appearance of normal tissues in T1 weigted pulse sequences is due to:
FAST VERTICAL RELAXATION OF THE PROTONS OF HYDROGEN IN FAT
8. This is dark in T1 weighted image: SUBCUTANEOUS FAT
9. These are bright in T1 weighted image: METHEMOGLOBIN, CALCIUM, GADOLINIUM
10. Lung T2 image will mean: BRIGHT SIGNAL, HYDROGEN PROTONS STAYS IN PHASE FOR A
LONG TIME, TYPICAL OF HEALTHY CEREBROSPINAL FLUID
11. The best example of short T2 structure in the normal subject is: BONE
12. The longer the protons of hydrogen maintains uniform movement in transverse phase,
THE BRIGHTER IS T2WI
13. The cortical part of bones will be seen as dark in MRI due to: SCANTY AMOUNT OF
HYDROGEN PROTONS PRESENT
14. Flowing blood is seen on MRI as: HYPOINTENSITY
RADIATION THERAPY
1. Radiation therapy may destroy the DNA through an indirect approach and this is the
event that occur during indirect cell killing: THERE IS HYDROLYSIS OF WATER AND
FORMATION OF HYDROGEN ION
2. Steps needed in the preparation for radiation therapy: PREPARATION OF
IMMOBILIZATION DEVICES, CT STIMULATION, IDENTIFICATION OF TUMOR TARGETS
AND CRITICAL ORGANS, DOSIMETRY
3. Immobilization devices are: THERMOPLASTIC MASKS USED FOR HEAD AND NECK
IMMOBILIZATION, ALLOWS US TO TREAT PATIENTS WITH BETTER PRECISION
4. Palliative radiation therapy is given for: SYMPTOM-DIRECTED TREATMENT, BONE PAIN
AND BLEEDING TUMORS
5. To properly prepare a treatment program for a patient with malignancy, it is important
that we stage the patient. This means that: WE NEED TO KNOW THE TUMOR SIZE,
EXTENT OF LYMPH NODE INVOLVEMENT, SITES OF METASTASIS
6. Radiation therapy is a localized treatment hence, precision in identifying target volume is
important, this treatment is given: ONCE DAILY OVER FIVE DAYS A WEEK UNTIL THE
TOTAL PRESCRIBED DOSE IS GIVEN
7. In radiation therapy, treatment course is usually: OVER 6-8 WEEKS
8. One of the main methods to improve the results of radiation therapy is through
biological optimization and this is done via: ADDING A RADIOSENSITIZER LIKE
CHEMOTHERAPY TO MAKE RADIATION MORE EFFECTIVE, HYPERFRACTIONATION
BRACHYTHERAPY
1. This refers to internal radiation or radiation source that is directly implanted into the
tumor: BRACHYTHERAPY
2. Used for tumors in various sites, it is most commonly used a part of complete treatment
regimen for uterine malignancies, an applicator is needed to serve as a conduit for the
passage of radioactive source: BRACHYTHERAPY
3. Advancement in brachytherapy technology has now allowed us to: TREAT PATIENTS ON
AN OUTPATIENT BASIS
MECHANICS
1. If the patient cannot assume an upright projection, this is an alternative position: LEFT
LATERAL DECUBITUS
2. To demonstrate small lesions in the apex of the lung that can be obscured by bones, this
examination is helpful: APICO-LORDOTIC RADIOGRAPH
3. The important mechanism of expiratory radiograph in evaluating the lung fields for small
amount: INCREASE THE DENSITY OF THE LUNG PARENCHYMA, REDUCE VOLUME OF
THE PLEURAL SPACE, RENDER THE VOLUME OF PNEUMOTHORAX RELATIVELY LARGER
IN RELATION TO THAT OF THE PLEURAL SPACE
4. The appearance of the heart in an underinflated lung is: MAY BE SLIGHTLY TO
MODERATELY WIDENED
5. The chest x-ray is taken at the end of a moderately deep inspiratory effort in order to:
INFLATE THE ALVEOLI WITH AIR
6. Patient is examined with moderate to full inspiratory effort: TELERADIOGRAPHY
INFECTIONS
1. When an adult presents with multiple pulmonary nodules, this feature will favor
infection: VARYING SIZES OF LESIONS
2. Components of the inverted S-sign of Golden: APICAL LUNG MASS, CENTRAL TUMOR,
ATELECTASIS
3. True of lobular pneumonia or bronchopneumonia: HAZY AND PATCHY INFILTRATES
4. The difference between a Ghon’s lesion and a round pneumonia: A GHON’S LESION
DOES NOT CLEAR COMPLETELY BUT GRADUALLY DECREASES IN SIZE AND CALCIFIES
AFTER MONTHS OF ANTI-KOCH’S TREATMENT
5. Characteristics of gram-negative pneumonias: NECROSIS
6. Common finding in Staphyloccal pneumonia: PNEUMATOCOELE FORMATION
7. Characteristics of Klebsiella pneumonias: BULGING FISSURE
8. Millet seed pattern is often correlated with: MILIARY TB
9. True for pneumococcal pneumonia: USUALLY COMMUNITY ACQUIRED
10. True of interstitial pneumonia: SELF-LIMITED AND RESOLVES SPONTANEOUSLY AFTER 7-
14 DAYS, USUALLY VIRAL IN ORIGIN, HYPERAERATED LUNGS
11. In Pneumocystis jirovecci, cavitary lesions are: REVERSIBLE
12. The prototype of cavities resulting from pulmonary vasculitis is: WEGENER’S
GRANULOMATOSIS
13. Most common and diagnostic sign of pleural effusion: PLEURAL MENISCUS
14. In the face of multiple pulmonary nodules, one should be thinking of: TUBERCULOSIS
TRAUMA
1. Barotrauma commonly presents as: PNEUMOTHORAX
2. Signs of pneumoperitoneum: CRESCENT SIGN, FALCIFORM LIGAMENT, DOGE’S SIGN
3. Relevant in the diagnosis of patients with atelectasis: HOMOGENOUS OPACITY OF A
LUNG AREA, DISPLACEMENT OF A FISSURAL MARKING, ELEVATION OF THE
DIAPHRAGM AT THE AFFECTED SIDE
HYALINE DISEASE
1. A branching lucency that represents air-containing bronchus surrounded by airless lung:
AIR BRONCHOGRAM
2. A peripheral or pathologic air bronchogram is commonly seen in: HYALINE MEMBRANE
DISEASE
3. True of hyaline membrane disease: DUE TO SURFACTANT DEFICIENCY
4. Adhesive atelectasis can be caused by: LACK OF SURFACTANT FUNCTION IN THE
ALVEOLAR MEMBRANE
5. Air space disease usually presents with: AIR BRONCHOGRAM/INTERSTITIAL
INFILTRATES
6. A thin-walled lucency within or contiguous to the visceral pleura: ATELECTASIS
ADENOCARCINOMA
1. Characteristics of adenocarcinoma involving the lungs: MOST COMMON CELL TYPE IS
SEEN IN WOMEN, SEEN AMONG NON-SMOKERS, FREQUENTLY SEEN IN THE UPPER
LOBES
2. Characteristic of bronchioalveolar carcinoma: SUBTYPE OF ADENOCARCINOMA
3. This type of malignancy may be difficult to diagnose because it can mimic pneumonia:
BRONCHOALVEOLAR CARCINOMA
4. Non-small cell bronchogenic carcinoma can be considered when the presentation of the
lesion is: PERIPHERALLY LOCATED
FINDINGS
1. Likened to a ‘heart of a cow’ appearance of the heart is seen in: AORTIC INSUFFICIENCY
2. The figure of eight configuration of the heart maybe seen in: SUPRACARDIAC PAPVD
3. Scimitar sign on chest x-ray may indicate the presence of: ANOMALOUS PULMONARY
VASCULAR DISEASE
4. Coronary artery calcification is best detected this imaging modality: CT SCAN
5. Presence of an aortic aneurysm could be considered in the following radiologic findings
in the chest: PRESENCE OF A MEDIASTINAL MASS DENSITY WITH A SMOOTH BORDER
AND CONTOUR
6. Mitral heart form in radiology means that the heart has the following findings on chest
x-ray: CONVEX MAIN PA SEGMENT
7. This congenital heart disease has a convex main pulmonary artery segment: ATRIAL
SEPTAL DEFECT
8. Pulmonary oligemia is seen in this condition: TOTAL ANOMALOUS PULMONARY
VENOUS RETURN
9. A dilated aortic knob is seen in this condition: PATENT DUCTUS ARTERIOSUS
TOF
1. Congenital heart disease with right to left shunt: PULMONARY VALVE ATRESIA WITH
VENTRICULAR SEPTAL DEFECT
2. TOF main pathology stem from the: INTERVENTRICULAR SEPTAL DEFECT AND
PULMONIC STENOSIS
3. Pentalogy of Fallot is Tetralogy of Fallot with: ATRIAL SEPTAL DEFECT
4. Pulmonic stenosis in TOF could give rise to: CONCAVE MAIN PULMONARY ARTERY
SEGMENT
CHF
1. Radiographic features of CHF: KERLEY LINES, PLEURAL EFFUSION, THICKENED MINOR
FISSURE
2. Caused by distension of anastomotic channels between peripheral and central
lymphatics: KERLEY LINES
3. When Kerley lines are seen on chest x-ray, it may suggest: MEAN LA OR PVR OF >20 MM
HG
4. Sluggish movement of the heart on cardiac fluoroscopy could be seen in: PERICARDIAL
EFFUSION
5. This radiographic finding is characteristic of interstitial edema: PERIBRONCHIAL
CUFFING
TGA
1. In Transposition of the Great Arteries: PATIENT MAY SURVIVE WITH AN ASSOCIATED
SHUNT AT ANY LEVEL
ESOPHAGUS
1. The most common structural abnormality of the upper GIT: HIATAL HERNIA
2. The most common cause of tapered narrowing of distal esophagus with absence of
peristalsis: ACHALASIA
3. Symmetric narrowing at the lower end of the esophagus: LOWER ESOPHAGEAL
MUCOSAL RING
4. Smooth, tapered, narrowing above a hiatal hernia: REFLUX ESOPHAGITIS
STOMACH
1. In the supine position, barium will not stay in this structure: GASTRIC BODY
2. Barium studies poorly evaluate: GASTRIC FUNCTION
3. Lesser curvature gastric lesion: BENIGN GASTRIC ULCER
4. Hampton’s line is seen in: BENIGN GASTRIC ULCER
5. Hourglass deformity is seen in: BENIGN GASTRIC ULCER
6. Causes of polypoid gastric mass: GASTRIC LYMPHOMA, GASTRIC LEIOMYOSARCOMA,
MALIGNANT GASTRIC ULCER
7. Least likely cause of polypoid gastric mass: LARGE GASTRIC ADENOMA
SMALL INTESTINES
1. The most sensitive examination for flat or small intestinal erosions: CAPSULE
ENDOSCOPY
2. This is the least effective method of evaluating the small intestine: PER ORAL SMALL
BOWEL STUDY
3. Barium collection in the duodenal bulb: DUODENAL POLYP
4. Nodular appearance of the duodenal bulb: DUODENAL CARCINOMA
5. Saccular structure at the distal small bowel: MECKEL’S DIVERTICULUM
6. Differentials for diffuse fold thickening in the central small bowel: SMALL BOWEL
HEMORRHAGE, SMALL BOWEL EDEMA, SMALL BOWEL MALIGNANCY
7. Least likely etiology of diffuse fold thickening in the central small bowel: ISCHEMIC
ENTERITIS
SIGMOID
1. Two adjacent loops of distended colon: SIGMOID VOLVULUS
2. Large polypoid lesion in the sigmoid colon: POLYPOID CARCINOMA
RECTUM
1. Irregular, annular narrowing of the rectum: RECTAL CARCINOMA
LIVER
1. On sonography, the portal vein is dilated if it measures: 13-15 MM
2. Ultrasound follow-up revealed internal echoes in a previously seen large hepatic cyst.
This may be due to: HEMORRHAGE
3. This is an invasive procedure that can be done under sonographic guidance:
PERCUTANEOUS TRANSHEPATIC CHOLANGIOGRAM
4. True about hepatic adenomas: CAN BE ASSOCIATED WITH TYPE 1 GLYCOGEN STORAGE
DISEASE, MAY UNDERGO MALIGNANT TRANSFORMATION, MAY BE ENCAPSULATED,
OFTEN SEEN IN WOMEN OF CHILD-BEARING AGE
5. Calcified hepatic matastases are seen secondary to: COLON CARCINOMA
6. True about hepatocellular carcinoma: APPEARANCE ON ULTRASOUND IS VARIABLE
7. On ultrasound, fatty infiltration of the liver can show: DECREASED VISUALIZATION OF
THE PORTAL VEINS
8. The hepatorenal area is also known as: MORRISON’S POUCH
9. In ultrasound, the Morrison’s pouch is an important location to identify: ASCITES
GALLBLADDER
1. Bilomas on CT scan will show this CT number: 15-20 HU
2. This is true about GB cholesterolosis: IT IS FIXED TO THE WALL DURING GB
SONOGRAPHIC SCANNING
3. This is true about hydrops of the GB on ultrasound: SHAPE BECOMES BICONVEX
4. Postprandial ultrasound of the gallbladder will normally show evidence of:
CONTRACTION
5. True about cholesterolosis: DIFFUSE FORM CANNOT BE APPRECIATED
SONOGRAPHICALLY
6. Porcelain gallbladder will show: WALL CALCIFICATION
7. Postprandial sonography is used for: GALLBLADDER
8. This is a characteristic of a simple cyst on ultrasound: POSTERIOR SHADOWING
9. Aerobilia is seen as white on: CT SCAN
10. This component will make gallstones opaque on scout film: CALCIUM
11. This is a cost effective study for gallstones: ULTRASOUND
PANCREAS
1. This is true about pseudocyst of the pancreas as seen on CT scan: HAS THICK CAPSULE
2. This procedure will better show calcifications in chronic pancreatitis: CT SCAN
3. The majority of pancreatic carcinoma is seen on the: HEAD
4. On CT scan, the head of the pancreas lies: ANTERIOR TO THE INFERIOR VENA CAVA
5. CT scan finding in chronic pancreatitis: CALCIFICATION
6. This is the better modality to document complicated pancreatitis in an obese patient: CT
SCAN
7. Used as landmarks for localizing the pancreas on sonography: SPLENIC VEIN, SUPERIOR
MESENTERIC ARTERY, CELIAC ARTERY
SPLEEN
1. This organ is hard to visualize if obscured by the overlying gas on ultrasound: SPLEEN
TOPIC 5: GENITOURINARY RADIOLOGY
ANATOMY
1. There is communication of the three retroperitoneal spaces in the: PELVIC BRIM
2. Located in the perirenal space: ADRENAL GLAND
3. On CT, this structure appears as a linear, arrowhead or inverted Y: ADRENAL GLAND
4. Total number of narrowing in the ureters: 3
5. The normal course of the ureter is: BETWEEN THE TIP OF THE TRANSVERSE PROCESS
AND PEDICLE
DIAGNOSTIC PROCEDURES
1. The most realistic role of the KUB as an imaging tool for the GUT is: SHOW PRESENCE OF
ABNORMAL CALCIFICATIONS
2. To be useful in identifying calcifications or lithiasis in the GUT, KUB film would need this
preparation: ADMINISTRATION OF ORAL CATHARTICS OR LAXATIVES
3. Visualization of the GUT collecting system by means of injection of contrast thru a
percutaneous nephrostomy tube: ANTEROGRADE PYELOGRAPHY
4. Procedure which utilizes cystoscope followed by ureteral catherization and finally
retrograde injection of contrast to visualize urinary collecting system: RETROGRADE
PYELOGRAPHY
5. Intravenous pyelography (IVP) is a procedure used to evaluate: BOTH FUNCTION AND
ANATOMY OF THE KIDNEYS
6. In intravenous urography (IVU), the ability of the proximal tubules to reabsorb water and
concentrate the contrast can be seen in the: NEPHROGRAM PHASE
7. After contrast injection, the corticomedullary phase is seen, if the scanning is performed
during the first: 20-70 SECONDS
8. Intravenous contrast agent used in IVU is visible in the radiograph because of this agent:
IODINE SALT
9. ‘One-shot IVU’ can be done in the following condition: RENAL TRAUMA
10. This is the present standard for diagnosing renal stone: CT STONOGRAM
FINDINGS
1. This is the initial finding of pyelonephritis: RENAL ENLARGEMENT/PYELOCALIECTASIS
2. Clubbing of the renal calyces by IVP would be a diagnosis of: HYDRONEPHROSIS
3. This is the most characteristic finding of grade IV hydronephrosis: THINNED OUT RENAL
PARENCHYMA
4. Disease entity which may cause non-obstructive hydronephrosis: HYPOKALEMIA
5. Calcifications in the renal parenchyma is secondary to: NEPHROCALCINOSIS
6. CT without contrast is typically performed for: RENAL AND URETERAL CALCULI
7. If a nephrolithiasis is visualized by CT scan and not by x-ray, the stone would most likely
be: STRUVITE CALCULI
8. In T2 weighted image of MRI, a nephrolithiasis would appear as: HYPERECHOIC
9. Recent studies show that no more than this range of percentage of urinary tract stones
are detected on plain radiograph: 40-60%
10. In ultrasound, if there is splitting of the central collecting complex of the kidney, it would
denote: STONE
11. A discrepancy of this value, in the size between the two kidneys is indicative of presence
of a pathology: GREATER THAN 2 CM
12. Emphysematous pyelonephritis by ultrasound will show: HYPERECHOIC FOCI WITH
DIRTY SHADOWING
13. Features of renal abscess: LOCAL ENLARGEMENT OF THE KIDNEY, INDISTINCT PSOAS
MUSCLE IN THE IPSILATERAL SIDE, SCOLIOSIS WITH CONCAVITY OPPOSITE THE
INVOLVED SIDE
14. The ‘claw sign’ is seen in: RENAL CYST
15. Renal cyst with thin septation and minimal calcium along the wall in a Bosniak
classification belongs to: TYPE II
16. ‘Flower vase’ appearance of the ureter can be seen in: HORSESHOE KIDNEY
17. Cobra head deformity of the distal ureter is produced by: UTEROCELE
18. UB ultrasound is requested to diagnose these conditions: URINARY RETENTION,
CYSTITIS, CYSTOLITHIASIS
19. Tuberous sclerosis is commonly associated with: RENAL CELL CA
20. This is considered as a urologic emergency with high mortality rate and maybe
diagnosed on plain film: EMPHYSEMATOUS PYELONEPHRITIS
54 year-old male who came in because of pain of the left knee for about 1 year. PMH: Patient
claims to have an abnormal OGTT since a year ago with no follow-up with his attending
physician. He had history of anti-TB medications with chest x-ray of bilateral upper lobe fibrosis.
PPE showed minimal swelling of the left foot with no movement limitation nor soft tissue
crepitations.
1. The most likely diagnosis in this case: SEPTIC ARTHRITIS
2. Plain radiograph of the knee showed rat bite deformity of the distal femoral epiphysis-
metaphysis complex. The most likely diagnosis is: TB ARTHRITIS
3. Common coexisting finding in chronic septic arthritis like in this case: LYTIC CHANGE
FORM BACTERIAL INFECTION
4. Because of absence of soft tissue calcifications, this may be excluded in the differential
diagnosis: GOUTY ARTHRITIS
5. This can be considered in the differential diagnosis because of abnormal OGTT:
NEUROPATHIC ARTHROPATHY
54-year old male who came in because of pain and swelling of the left foor with occasional
numbness of both lower extremities. PHx – patient claims to have an abnormal OGTT since a
year ago with no follow up with his attending physician. PPE showed swelling of the left foot
with no movement limitation nor soft tissue crepitations.
1. The most likely diagnosis in this case: NEUROPATHIC ARTHROPATHY
2. Plain radiograph of the foot showed calcified interdigital arteries with associated
fragmentation of the metatarsophalangeal joints. Negative for soft tissue calcifications:
GOUTY ARTHRITIS
3. The pathophysiology of bone fragmentation is likely attributed to: VASCULAR
ANGIOGRAPHY AND MICROINFARCTION
4. Because of absence of soft tissue calcifications and presence of narrowed and
fragmented joint spaces, this disease entity can be safely ruled out: GOUTY ARTHRITIS
5. A common complication is the onset of secondary bacterial infection, hence this disease
can be considered in the differential diagnosis: SEPTIC ARTHRITIS