USmle Radiology 1

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USMLE Step 1 Radiology buzzwords

AppleCorelesion signifies annular carcinomas of the colonlooks like anapplecoreornapkinring(see below) due to circumferential narrowing of thelumen, noted on contrast studies.

click image to enlarge

Bamboo Spine fused spinal segments with their syndesmophytes look, on radiographs, similar to bamboo stalksclassically associated with ankylosingspondylitis.


Bird's Beak noted onUpperGIwith contrast, a dilated upper/middle esophagus with an abrupt taper to exceptionally narrowedlumen, typical of achalasia.


Boot-shaped Heart due to RVH, the LV is lifted above the edge of the diaphragm, forming the toe of the boot. Classic for Tetralogy of Fallot.


Bat's Wing/Butterfly this appearance on CXR is classically associated with CHF and resultant pulmonary edema.

Cobblestone appearance this sign is produced on barium studies due to ulcerative pockets, usually in the terminal ileum, indicative of Crohn's.


Codman's Triangle a triangle on plain film of extremities that signifies reactive bone, classically associated with osteosarcoma, or other infectious/hemorrhagic process that causes periosteal elevation.


Coin lesion solitary pulmonary nodule; may be cancer or granuloma.

Cutter lesions metastatic lesions to bone cortex, or Paget's.


Crescent sign classic sign of avascular necrosis, femoral head.


Egg-on-a-string a large, ovoid-shaped heart on newborn CXR, classically signifying complete transposition of the great vessels with intact ventricular septum.


Ground glass a white-out on CXR, usually PCP pneumonia or ARDS.

Hampton's Hump a peripheral triangle, usually near pleural edges, classically PE.


Honeycomb lung used to describe any pathologic process that causes radiographic appearance of multiple small, thick-walled cystic spaces; e.g. pulmonary fibrosis.

Lead pipe sign classic narrowing of bowellumen, with loss of haustraUC.


NapkinRing sign seeApplecorelesion above; pathology identical, butlumenmore narrowed.

Onion-skinning layered look of periosteum in Ewing's Sarcoma.

Rachitic Rosary this is a string of beads appearance on x-ray, a thickening of costochondral margins that is noted in Ricketts(Vit. D Deficiency).


Sail sign (elbow) fat pad noted on plain film, indicative of elbow disclocation.


Sail Sign (ChestXray) Thymic shadow in children seen inchestXray.


Scotty dog(collar) on posterior oblique, the lumbar vertebrae look like aScottishterrier. The neck is the pars interarticularis, and a break(a collar) noted there indicates spondylolysis.


String sign thin, slightly irregular shadow in narrowedlumenof ileum, suggestive of Crohn's.


Silhouette sign obliteration of cardiovascular silhouette due to adjacent disease, ie pneumonia, TB, etc.


Stepladder appearance distended bowel loops, often indicative of obstruction, usually SBO.


Sunburst appearance clouds, clumps, and consolidated rays of tissue emanating from bone cortex, or within bony structures, indicative of osteosarcoma.


Thumb(print) sign on lateral c-spine, an enlarged epiglottis appears as a thumbepiglottitis.

Westermark's sign abrupt end to a pulmonary vessel, signifying oligemia or PE.


Thanx toMyeng

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USmle Radiology 1

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