BCSE Diagnostic Imaging Interpretation 4

Question 1

On a plain radiograph of the hand, which finding is most characteristic of rheumatoid arthritis rather than osteoarthritis?

Accepted Answer

Periarticular osteopenia with marginal erosions at the MCP joints

Answer

Rheumatoid arthritis causes periarticular osteopenia and marginal erosions preferentially at the MCPs and PIPs due to synovial pannus formation.

Question 2

A CT scan shows a hypodense area in the right middle cerebral artery territory with loss of the gray-white matter differentiation. This finding is most consistent with:

Accepted Answer

Acute ischemic infarct

Answer

Loss of gray-white differentiation in an arterial territory on CT indicates acute ischemic infarction due to cytotoxic edema.

Question 3

On MRI of the spine, which imaging finding is most concerning for spinal cord compression requiring urgent evaluation?

Accepted Answer

T2 hyperintensity within the cord at the level of disc herniation with cord edema

Answer

Intramedullary T2 hyperintensity indicates myelomalacia or edema from cord compression, signaling a neurological emergency.

Question 4

On a plain abdominal radiograph, which pattern of bowel gas distribution is most consistent with small bowel obstruction?

Accepted Answer

Multiple dilated loops of small bowel centrally with a paucity of colonic gas

Answer

Small bowel obstruction produces centrally located dilated loops (>3 cm) with a step-ladder pattern and absent distal colonic gas.

Question 5

On ultrasound, which characteristic of a thyroid nodule most strongly indicates the need for fine-needle aspiration biopsy?

Accepted Answer

Microcalcifications within a solid hypoechoic nodule >1 cm

Answer

Microcalcifications in a solid hypoechoic nodule >1 cm are high-risk features per ACR TI-RADS and warrant fine-needle aspiration.

BCSE - Basic and Clinical Sciences Examination Practice Test

BCSE - Basic and Clinical Sciences Examination Practice Test

BCSE Diagnostic Imaging Interpretation 4