Radiology Handbook

Chest X-Rays

Disease/Study	Findings / Appearance	Interpretation
Normal Chest X-ray	Clear lung fields, normal cardiac silhouette	Normal study
Pneumonia	Homogeneous opacity with air bronchograms	Lung consolidation
Pulmonary Tuberculosis	Upper lobe infiltrates, cavitation	Active TB
Pleural Effusion	Blunting of costophrenic angle, meniscus sign	Fluid in pleural cavity
Pneumothorax	Absent lung markings, visible pleural line	Air in pleural space
COPD	Hyperinflation, flattened diaphragm	Obstructive lung disease
Pulmonary Edema	Bat-wing appearance	Congestive heart failure
Cardiomegaly	CTR >50%	Enlarged heart
ARDS	Bilateral diffuse infiltrates	Acute respiratory distress syndrome
Lung Abscess	Thick-walled cavity with air-fluid level	Necrotizing infection

Emergency Airway X-Rays

Disease/Study	Findings / Appearance	Interpretation
Croup	Steeple Sign	Subglottic narrowing
Epiglottitis	Thumb Sign	Swollen epiglottis
Foreign Body Aspiration	Hyperinflation or radio-opaque object	Airway obstruction
Retropharyngeal Abscess	Widened prevertebral space	Deep neck infection

Abdomen X-Rays

Disease/Study	Findings / Appearance	Interpretation
Intestinal Obstruction	Multiple air-fluid levels	Mechanical obstruction
Paralytic Ileus	Generalized bowel dilatation	Non-mechanical obstruction
Perforation	Free air under diaphragm	Hollow viscus perforation
Volvulus	Coffee Bean Sign	Twisted bowel
Fecal Impaction	Large stool burden	Constipation
Renal Stone	Radio-opaque shadow	Nephrolithiasis

Pediatric X-Rays

Disease/Study	Findings / Appearance	Interpretation
Rickets	Cupping and fraying of metaphysis	Vitamin D deficiency
Intussusception	Soft tissue mass	Bowel telescoping
Hirschsprung Disease	Dilated bowel loops	Congenital aganglionosis
NEC	Pneumatosis intestinalis	Necrotizing enterocolitis
Meconium Ileus	Soap bubble appearance	Cystic fibrosis association

Cyanotic CHD X-Rays

Disease/Study	Findings / Appearance	Interpretation
Tetralogy of Fallot	Boot-Shaped Heart
Transposition of Great Arteries	Egg-on-a-String
TAPVC	Snowman Sign
Ebstein Anomaly	Box-Shaped Heart
Tricuspid Atresia	Variable appearance
Pulmonary Atresia	Similar to TOF

Musculoskeletal X-Rays

Disease/Study	Findings / Appearance	Interpretation
Osteoarthritis	Joint space narrowing, osteophytes	Degenerative arthritis
Rheumatoid Arthritis	Joint erosions	Inflammatory arthritis
Osteomyelitis	Bone destruction	Bone infection
Osteoporosis	Reduced bone density	Fragile bone disease
Bone Tumor	Lytic or sclerotic lesion	Neoplasm

Common USG Abdomen

Disease/Study	Findings / Appearance	Interpretation
Fatty Liver	Bright echogenic liver	Hepatic steatosis
Liver Cirrhosis	Nodular liver surface	Chronic liver disease
Liver Abscess	Hypoechoic lesion	Liver infection
Gallstones	Echogenic focus + shadow	Cholelithiasis
Acute Cholecystitis	Thick GB wall + stones	Inflamed gallbladder
Choledocholithiasis	Dilated CBD with stone	CBD obstruction
Pancreatitis	Enlarged hypoechoic pancreas	Pancreatic inflammation
Ascites	Free fluid	Peritoneal fluid collection
Splenomegaly	Enlarged spleen	Portal HTN/hematologic disease

Common Renal USG

Disease/Study	Findings / Appearance	Interpretation
Renal Stone	Echogenic focus + shadow	Nephrolithiasis
Hydronephrosis	Dilated PCS	Urinary obstruction
Pyelonephritis	Enlarged kidney	Renal infection
Polycystic Kidney	Multiple cysts	PKD
Renal Failure	Small echogenic kidneys	CKD

Pelvic USG

Disease/Study	Findings / Appearance	Interpretation
Ectopic Pregnancy	Empty uterus + adnexal mass	Ectopic gestation
Fibroid Uterus	Hypoechoic uterine mass	Leiomyoma
Ovarian Cyst	Anechoic cyst	Benign ovarian cyst
PCOS	String of pearls appearance	Polycystic ovaries
Endometrial Hyperplasia	Thickened endometrium	Excess endometrial growth

Obstetric USG

Disease/Study	Findings / Appearance	Interpretation
Normal Pregnancy	Intrauterine gestational sac	Viable pregnancy
Missed Abortion	No fetal cardiac activity	Fetal demise
Placenta Previa	Placenta over os	APH risk
Oligohydramnios	Low AFI	Reduced amniotic fluid
Polyhydramnios	High AFI	Excess amniotic fluid

FAST Scan

Disease/Study	Findings / Appearance	Interpretation
Morrison Pouch	Free fluid	Hemoperitoneum
Splenorenal Recess	Fluid collection	Splenic injury
Pelvis	Fluid in pouch	Pelvic bleeding
Pericardium	Fluid around heart	Cardiac tamponade

Common CT Brain

Disease/Study	Findings / Appearance	Interpretation
Epidural Hemorrhage	Biconvex hyperdense lesion	EDH
Subdural Hemorrhage	Crescent hyperdensity	SDH
SAH	Hyperdensity in sulci	Subarachnoid bleed
Ischemic Stroke	Hypodensity	Cerebral infarction
Intracerebral Hemorrhage	Hyperdense bleed	Hemorrhagic stroke
Brain Tumor	Space occupying lesion	Neoplasm
Hydrocephalus	Enlarged ventricles	CSF obstruction

Common CT Chest

Disease/Study	Findings / Appearance	Interpretation
Pulmonary Embolism	Filling defect in PA	PE
COVID Pneumonia	Ground glass opacities	Viral pneumonia
Bronchiectasis	Dilated bronchi	Chronic airway disease
Lung Cancer	Spiculated mass	Malignancy
Interstitial Lung Disease	Honeycombing	Fibrotic lung disease

Common CT Abdomen

Disease/Study	Findings / Appearance	Interpretation
Acute Appendicitis	Dilated inflamed appendix	Appendicitis
Acute Pancreatitis	Peripancreatic fat stranding	Pancreatitis
Diverticulitis	Inflamed diverticulum	Colonic inflammation
Bowel Obstruction	Dilated bowel loops	Mechanical obstruction
Perforation	Free intraperitoneal air	Hollow viscus rupture
Liver Abscess	Hypodense lesion	Hepatic abscess
Renal Calculus	Hyperdense stone	Urolithiasis

High Yield Emergency Imaging Signs

Disease/Study	Findings / Appearance	Interpretation
Bat Wing Sign	Pulmonary edema
Meniscus Sign	Pleural effusion
Air Bronchogram	Pneumonia
Steeple Sign	Croup
Thumb Sign	Epiglottitis
Coffee Bean Sign	Sigmoid volvulus
Rigler Sign	Pneumoperitoneum
Ground Glass Opacity	COVID/ILD
String of Pearls	PCOS
Double Decidual Sign	Early pregnancy
Crescent Sign	Subdural hematoma
Lens Sign	Epidural hematoma