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Examination 1

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case 01 1.1 Postero-anterior (PA) chest radiograph (a) Left brachiocephalic vein. The left brachiocephalic vein forms a silhouette with the adjacent lung. This interface ‘fades’ above the clavicles as it becomes more anteriorly placed and ‘merges’ with the anterior chest wall. (b) Pulmonary trunk. (c) Right atrium (right heart border). (d) Right cardiophrenic recess. (e) Azygos fissure. The azygos fissure is seen in 0.5% of chest radiographs. It is formed by the caudal invagination of the azygos vein through the apex of the right upper lobe. It begins as a line in the upper portion and extends in an arc caudally toward the ‘teardrop’ density that is the azygos vein. The azygos vein is outside the parietal pleura – the line is therefore composed of two visceral and two parietal pleural layers. The so-called azygos ‘lobe’ is the segment of lung between the fissure and the trachea. It is not a true separate ‘lobe’ as the total bronchial anatomy in the right upper lobe ...
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Examination 2

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case 01 2.1 Coronal T1-weighted MR left hip (a) Ligamentum teres. This strong ligament inserts into the fovea centralis of the femoral head along with important nutrient vessels. (b) Acetabular labrum. This incomplete fibrocartilaginous ring contributes to hip joint stability. It may undergo traumatic or degenerative tearing leading to hip pain, instability and mechanical symptoms such as clicking. (c) Gluteus medius tendon. This is an important abductor and lateral rotator of the hip that inserts upon the lateral and posterior facets of the greater trochanter. (d) Iliotibial band (ITB) or tract. This long dense fascial band is a continuation of the tensor fascia lata muscle. It may undergo friction with resultant thickening and inflammation as it passes over the greater trochanter, producing painful, proximal ITB friction syndrome. (e) Transverse part of the ilio-femoral ligament. The ilio-femoral ligament is a thickening of the joint capsule and is the strongest o...
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Examination 3

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case 01 3.1 AP radiograph of the pelvis (a) Lesser trochanter of the right femur. The iliopsoas tendon attaches here. This is a powerful flexor of the hip. (b) Greater trochanter of the right femur. Gluteus medius and gluteus minimis attach here. These tendons act to perform hip abduction and lateral rotation. They can produce avulsion fractures of the greater trochanter in trauma. (c) Left L5 transverse process. The ilio-lumbar ligament attaches here. Traction of this ligament in pelvic trauma can cause an avulsion fracture of the transverse process. It also acts as an anatomical landmark on MRI for identifying the L5 vertebral body. (d) Pubic symphysis. It is a secondary cartilaginous joint. (e) Left inferior pubic ramus. Adductor magnus and adductor brevis attach here acting to adduct the hip. case 02 3.2 Axial T2-weighted lumbar spine through L5 (a) Left L5 nerve. At the level of the L5/S1 disc, the L5 nerve has already left the neural exit foramen. It may ...
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