Source / episode info
- **Episode:**26
- **Title:**Divine Intervention Episode 26 – USMLE Radiology.
- **Published:**2018-05-07
- Source:Episode page
One-liner
This episode reviews high-yield radiological signs across multiple systems, including the "apple core lesion" for colon cancer screening, "bird's beak sign" for cauda exalasia, and various congenital/inflammatory findings like the "snowman sign" (TAPVR) and "whirlpool sign" (malrotation).
High-yield summary
- GI Tract: The apple core lesion on colonoscopy suggests potential colorectal cancer; red-currant jelly stools with a target sign indicate intussusception.
- Esophagus/Stomach: Bird's beak sign points to impaired distal esophageal relaxation (achalasia); the signet ring cells and diffuse wall thickening suggest advanced gastric adenocarcinoma associated with E-cadherin mutations.
- Pulmonary/Thoracic: The snowman sign is pathognomonic for Total Anomalous Pulmonary Venous Return (TAPVR), a cyanotic heart defect; batwing opacities indicate cardiogenic pulmonary edema.
- Skeletal/Oncologic: A sunburst pattern combined with Codman's sign suggests osteosarcoma, while the "onion skin" appearance is classic for Ewing sarcoma.
- Congenital Anomalies: The whirlpool sign in a neonate with bilious vomiting mandates ruling out malrotation and midgut volvulus; scaphoid abdomen strongly suggests Congenital Diaphragmatic Hernia (CDH).
Learning objectives
- Identify the key radiological signs associated with common GI pathologies (e.g., intussusception, volvulus).
- Differentiate between various congenital heart defects using characteristic imaging findings (e.g., TAPVR vs. TGV).
- Recognize the classic radiographic patterns of malignancy and inflammatory processes in both bone and bowel.
- Understand the critical differential diagnosis for bilious vomiting in neonates (malrotation vs. atresia).
- Correlate specific clinical syndromes (e.g., DiGeorge, Trisomy 21) with associated physical or imaging findings.
Board exam buzzwords