Rad 211 ch 1-3

Polycystic Kidney Disease (PKD)

Congenital familial kidney disorder; tiny, nonfunctioning cysts replace the renal tubules within the nephron; present at birth; seen on sonography; occurs in 1 in 100 live births; clinical symptoms become apparent in adulthood; lower back pain, UTIs, stone formation, renal hypertension; diagnosed using sonography or CT; IVU shows enlarged kidney with poorly visualized outlines.

Pyelonephritis

Infection/inflammation of the renal pelvis and interstitium of the kidney; often starts as a lower urinary tract infection (ascending via ureters) and spreads into renal parenchyma; in more severe or complicated cases, obstruction, reflux, or urinary stasis contribute; microabscesses can form in the renal cortex or medulla; chronic episodes can lead to scarring; diagnosed using ultrasound, CT, MRI.

Cystitis

Inflammation of the urinary bladder mucosa (and sometimes deeper layers: submucosa, muscularis); usually due to infection (most common) but may also be chemical, radiation, or interstitial (noninfectious); caused by bacteria, radiation, chemical irritants, foreign bodies, catheterization, neoplasia or trauma; symptoms include dysuria, urinary frequency, urgency, hematuria (sometimes), lower abdominal discomfort, suprapubic pain; x-ray does not show.

Renal Cell Carcinoma (RCC)

Malignant tumor arising from renal tubular epithelium, primarily in the cortex of the kidney; also known as hypernephroma; more common in males; incidence increases with age (60s +); symptoms include hematuria, flank pain, palpable mass, weight loss, fever, hypertension, paraneoplastic syndromes; CT is the best imaging modality.

Nephroblastoma (Wilms Tumor)

Most common primary malignant renal neoplasm in children; ages 2-5 years, most cases by age ~3; abdominal mass or swelling (often unilateral) is the most common finding; symptoms include hematuria, abdominal pain, fever, sometimes hypertension; diagnosed using ultrasound or CT.

Bladder Carcinoma

Malignant tumors arising from the lining of the bladder; 3 times more often in men than women; more common after age 50; risk factors include cigarette smoking, chemical exposure, recurrent UTIs, catheterization; symptoms include painless hematuria; lesions near ureterovesical junction may cause ureteral obstruction; diagnosed using ultrasound, CT, MRI.

Sign

Objective finding.

Symptom

Subjective perception.

Pathogenesis

The biological/physical changes that lead to the development and manifestation of a disease.

Etiology

The cause of a disease.

Syndrome

A group of signs and symptoms that occur together and indicate a condition, often without a known cause.

Prevalence

The total number of existing cases of a disease in a population at a given time.

Incidence

The number of new disease cases in a population over a specific period of time.

Importance of prevalence and incidence

Helps identify outbreaks, track disease patterns, and guide prevention and public health decisions.

Disease etiology: degenerative

Deterioration of organ function or structure over time.

Disease etiology: hereditary

Caused by inherited genetic abnormalities.

Disease etiology: traumatic

Caused by mechanical forces, temperature extremes, or ionizing radiation.

Osteogenesis Imperfecta

A congenital connective tissue disorder with defective bone formation ("brittle bone disease").

Features of Osteogenesis Imperfecta

Frequent fractures, decreased bone mass, blue sclera, hearing impairment, limb deformities.

Diagnosis of Osteogenesis Imperfecta

Prenatal fibroblast testing; x-ray shows low bone density and wide trabeculae.

Achondroplasia

Most common skeletal dysplasia causing dwarfism due to abnormal cartilage-to-bone conversion.

Prenatal diagnosis of Achondroplasia

Sonography.

Features of Achondroplasia

Short stature, lumbar lordosis/kyphosis, spinal stenosis, bowed legs, large forehead, midface hypoplasia, narrow foramen magnum.

Developmental Dysplasia of the Hip (DDH)

Malformation of the acetabulum or femoral head causing superior/posterior femoral head displacement.

Best imaging for DDH in newborns

Sonography.

Why x-ray is unreliable for DDH in newborns

Hips are not yet ossified enough for radiographic visualization.

Rheumatoid arthritis

Chronic autoimmune inflammatory disease affecting synovial joints.

Symptoms of rheumatoid arthritis

Joint pain, swelling, stiffness, exacerbations and remissions.

Radiographic findings of rheumatoid arthritis

Soft tissue swelling, osteoporosis, joint space narrowing, bone/cartilage destruction, subluxation, ankylosis.

Ankylosing spondylitis

Progressive arthritis causing inflammation and fusion of axial skeleton ("bamboo spine").

Symptoms of ankylosing spondylitis

Night back pain, morning stiffness, fever, fatigue, weight loss, anemia.

Imaging finding of ankylosing spondylitis

Fusion and calcification of spine producing 'bamboo spine.'

Osteosarcoma

Aggressive osteoid-producing malignant bone tumor, usually in metaphysis of long bones.

Radiographic appearance of osteosarcoma

Sunburst spicules between cortex and periosteum.

Best imaging for soft tissue and bone involvement in osteosarcoma

PET scan.

Common metastasis site for osteosarcoma

Lungs → appears as multiple rounded calcified nodules.

Ewing sarcoma

Rare, highly malignant bone tumor originating in medullary cavity; occurs in ages 5-15.

Radiographic appearance of Ewing sarcoma

Onion-skin periosteal reaction.

Best imaging for Ewing sarcoma

CT & MRI for diagnosis; nuclear medicine for follow-up.

Chondrosarcoma

Malignant tumor of cartilage affecting long bones, pelvis, and ribs.

Radiographic appearance of chondrosarcoma

Irregular circular radiolucencies with granular calcifications and cortical destruction.

Osteoarthritis

Degenerative joint disease due to cartilage wear or joint stress.

Imaging findings of osteoarthritis

Joint space narrowing, osteophytes, cartilage erosion.

Common sites of osteoarthritis

Weight-bearing joints (hips, knees, ankles) and fingers.

Cystic fibrosis gene

Mutation of CFTR gene (autosomal recessive).

Cause of lung damage in cystic fibrosis

Thick secretions → obstruction → infection → tissue destruction.

Late lung findings in cystic fibrosis

Bronchiectasis, cyst formation, scarring, lobar atelectasis, pulmonary hypertension, right heart failure.

Early imaging findings in cystic fibrosis

Bronchial thickening and hyperinflation.

Diagnosis of cystic fibrosis

Sweat test (high sodium/chloride), genetic testing, family history.

Cause of pneumococcal pneumonia

Streptococcus pneumoniae.

Pattern of pneumococcal pneumonia

Lobar pneumonia affecting an entire lung lobe.

Pneumonia type associated with pneumatoceles

Staphylococcal pneumonia.

Bronchiectasis

Irreversible dilation of bronchi due to destruction of elastic and muscular bronchial walls.

Best imaging for bronchiectasis

CT scan.

Cause of tuberculosis

Mycobacterium tuberculosis.

Imaging findings in tuberculosis

Ghon lesions (calcified granulomas indicating necrosis and scarring).

Squamous cell carcinoma lung location

Major bronchi near the hilar region.

Imaging finding of squamous cell carcinoma

Unilateral hilar mass causing airway obstruction; later atelectasis and pneumonitis.

Adenocarcinoma lung location

Peripheral lung parenchyma.

Classic x-ray finding for adenocarcinoma

Solitary radiopaque nodule ("coin lesion").

CT advantage in lung cancer

Detects nodules <6 mm and shows lymph node/organ metastasis.