22 “Must See” Diagnostic Images for Medical Students

AMSER’s “Shortlist”
AMSER is the national Alliance of Medical Student Educators in Radiology
Their National Curriculum for Medical Students, developed by Kitt Shaffer, MD and Petra Lewis, MD, contains a “Diagnostic Shortlist” of “must see" images “all students should recognize”
This is a limited list of diagnoses that AMSER believes all students should be able to recognize, regardless of their planned specialty

The Owl
Wherever you see the owl graphic, that slide contains a hyperlink to additional information. Click on the blue link

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To learn more about pneumothorax, go to:  Recognizing a Pneumothorax

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To learn more about pneumomediastinum, go to: Pneumomediastinum

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To learn more about pneumoperitoneum, go to: Recognizing Free Air

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Effect of Position - Layering

Pleural Effusion
To learn more about pleural effusions, go to: Recognizing a Pleural Effusion

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Pulmonary Edema
To learn more about pulmonary edema, go to: Recognizing Congestive Heart Failure

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Aortic Dissection
To learn more about aortic dissection, go to: Aortic Dissection

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Ruptured Aortic Aneurysm
Enlargement of abdominal aorta > 3cm
Usually 2° to atherosclerosis
Below renals, above iliacs
About 20-25% rupture
<4cm~10%; >10 cm~60%
Retroperitoneal, usually on left
Into GI tract: massive hemorrhage
Into IVC: rapid cardiac decompensation

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Diaphragmatic Rupture
5% of all diaphragmatic hernias
Most (90%) are left-sided
Central and posterior >10cm in length
Contain stomach, colon, small bowel, omentum, spleen
Half have no initial abnormal radiographic findings
Half are missed clinically

Diaphragmatic Rupture
Associated with
Fx ribs
Ruptured spleen
Delayed diagnosis = higher mortality
MRI most useful in showing site of tear

Diaphragmatic Rupture
To learn more about diaphragmatic rupture, go to:  Diseases of the Diaphragm

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Small Bowel Obstruction
To learn more about small bowel obstructions, go to: Recognizing Obstruction and Ileus

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Cecal and Sigmoid volvulus
To learn more about sigmoid volvulus, go to: Sigmoid volvulus

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Carcinoma of the Colon
To learn more about carcinoma of the colon, go to: Carcinoma of the Colon

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Misplaced Lines and Tubes

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Misplaced lines and tubes
For more on the proper location of lines and tubes, go to: Tubes and Lines: What, Where and Whoops

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Child Abuse
For more on Battered Child Syndrome (child abuse), go to : Child abuse

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Hangman’s Fracture
Most common fracture of C2
Most common cervical spine fracture
Hyperextension/compression fracture
Fractures through the pedicles of C2 with anterior slip of C2 on C3
Not associated with neuro deficit

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Cervical Spine Injuries
For more on injuries to the cervical spine, go to : Cervical Spine Fractures and Dislocations

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Fractures and Dislocations
For more on fractures and dislocations, go to : Recognizing Fractures and Dislocations

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Fractures and Dislocations
For more on fractures and dislocations, go to : Recognizing Fractures and Dislocations

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Fractures and Dislocations
For more on fractures and dislocations, go to : Recognizing Fractures and Dislocations

The 22 “Must-See” Diagnoses
Pleural effusion
Pulmonary edema
Aortic dissection
Aortic rupture
Diaphragmatic rupture

The 22 “Must-See” Diagnoses
9.  Small bowel obstruction
10. Cecal and sigmoid volvulus
11. Distal Large Bowel Obstruction
12. Ascites
13. Misplaced lines and tubes
14. Child abuse
15. Stroke

The 22 “Must-See” Diagnoses
16. Traumatic intracranial hemorrhage
17. Increased intracranial pressure
18. Space occupying lesions
19. Cervical spine injury
20. Fracture with extension into joint
21. Elbow joint effusion
22. Shoulder dislocation

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