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Archives of Quizzes: Contents of Volume 1

The Archives of volumes 1-13 - ie till Dec 2012, are available as a CD. The CD contains around 593 quizzes that were put up on the REF site in the years 1999-2012. For details on purchasing the CD, click here.

Section Editors :

Abdominal : Dr. Dushyant Sahani
Neuro : Dr. Gaurang Shah
Head & Neck:Dr. Meher Ursekar

- Abdominal
- Chest
- Head & Neck

- Musculoskeletal
- Neuro
- Pelvis


 A 69 years old lady with recurrent severe abdominal pain for the last four months. A barium study (Fig. 1) and CT images (Figs. 2,3) are available.
 Carcinoid of the Small Bowel
 A 2 months old child presented with hepatomegaly. Ultrasound (Figs. 1, 2) and CT (Figs. 3, 4)
 Infantile Hemangioendothelioma (IH)
 A 26-years old patient came with a history of pain in the abdomen, abdominal distension and vomiting for 3 days. A plain radiograph of the abdomen (Fig. 1) and a barium examination were performed (Fig. 2).
 Focal jejunal pneumatosis (due to SMV thrombosis)
 A 40-years old man presented with dysphagia. This is a transparent, color, volume rendered image of the upper abdomen, simulating a common conventional radiologic procedure.
 Squamous Cell Carcinoma of the Gastro-Esophageal Junction
 A 20-years old man presented with sudden onset pain in the right iliac fossa. A barium enema was performed.
 Appendicular Intussusception
 A young lady presented with episodic pain in the abdomen. She had a discharging sinus in the anterior abdominal wall related to a previous surgery. While doing a CT to evaluate intra-abdominal extension of the sinus, a finding was seen which may have actually been the cause of her episodic upper abdominal pain (Fig. 1, 2)
 Roundworm in a Jejunal Loop
 A middle-aged man presented with acute abdomen. A plain radiograph and CT scans were obtained. What is the complete diagnosis?
 Spigelian Hernia with Obstruction and Gangrene
 A 22 years-old lady presented in an emergency with cramping pain in the abdomen, vomiting and constipation. She had undergone lung transplantation in the past. On examination, the abdomen was tender with guarding. A contrast enema with water-soluble iodinated contrast (Figs. 1,2) and a CT (Figs. 3,4) were performed.
 Pancreatic Atrophy and Fat Infiltration and Small-Bowel Obstruction due to Inspissated Mucus in a patient with Cystic Fibrosis
 A 45 years old man visited the hospital for mild left flank discomfort. CT and MR were performed. A left renal lesion was seen. What is the most likely diagnostic consideration?
 Renal Oncocytoma
 A 55 years old man came with pain in the abdomen and low grade fever. CT (not available) was performed and the patient was referred for a guided FNAC. MR (Figs 1-3) was performed prior to the biopsy.
 Retroperitoneal Arterio-Venous Malformation
 A 35-years old lady presented with dull aching in the right hypochondriac region. Screening USG showed a hypoechoic mass in the right lobe of the liver. The patient was subjected to MR for characterization of this mass. Pre-contrast T1W and T2W images and dynamic multi-phase, post-contrast T1W images are provided.
 Focal Nodular Hyperplasia


 A 40-years old man presented with a history of dull aching right sided chest pain for 15 days. There was a past history of pulmonary tuberculosis. His ECG and vital parameters were within normal limits. His chest radiographs revealed a well-defined nodular opacity with a differential density in the medial segment of the right middle lobe (Figs. 1, 2). Subsequent investigations were performed to obtain the diagnosis
 Pulmonary Arterio-Venous Malformation (PAVM)

 A middle-aged woman presented with a 3-months history of left arm pain. No other significant history was available.
 Left Apical Neuroma with Dextrocardia
 A 25-years old man presented with low grade fever, cough and mild dyspnea on exertion for three months.
 Hypersensitivity Pneumonitis
 A 50 years old man presented with a history of hemoptysis. Chest radiographs are available (Figs. 1, 2)
 Apergilloma (fungal ball) in a Tuberculous Cavity
 A 12-years old girl presented with breathlessness and cough. Chest radiographs (Figs. 1,2) and ultrasound (Fig. 3) were obtained.
 Terato-Dermoid - Posterior Mediastinal
 A 23 years old lady presented with cough and recurrent pneumonia. A CT was performed (Figs. 1-3).
 Broncho-esophageal Fistula due to Tuberculosis
 A 30-years old lady presented with repeated attacks of cough and fever over a period of six months. A chest radiograph and CT were obtained.
 Bronchial Carcinoid
 A 5-years old girl presented with a swelling in the left lower chest wall and upper abdominal wall. A chest radiograph was obtained (Fig. 1).
 Ewing's Sarcoma of Rib
 A 46-years old man had a history of recurrent episodes of dyspnea since childhood and was being treated as an asthmatic. A chest radiograph was performed (Fig. 1).
 MacLeod's Syndrome
 A 35-years old lady presented with pain in the chest. A chest radiograph (Fig. 1) and CT (Figs. 2, 3) were obtained. What is the most likely diagnosis?

Head & Neck

 A 12 years old boy presented with a gradually increasing mass in the left cheek (Fig. 1)
 Mandibular Osteochondroma
 A 21-years old man presented with a swelling in the submandibular region. CT (Figs. 1, 2) and ultrasound (Fig. 3) were performed.
 Sublingual Space Epidermoid
 A 23-years old man presented with pain and swelling in the right cheek. An OPG (Figs. 1, 2) and a CT (Figs. 3, 4) were obtained.
 Tuberculosis Mandible
 A 24 years old lady presented with pain in the left orbit with redness for a period of 4 days. An ultrasound of the orbit was performed (Fig. 1). A lesion was found in relation to the lateral rectus muscle.
 Cysticercus Granuloma of the Lateral Rectus Muscle
 A 65-years old hypertensive lady, non-diabetic, presented with ataxia. MRI of the brain showed a cerebellar infarct. In addition, another lesion was seen.
 Fibrous Dysplasia
 A 20-years old lady presented with a painful, hard swelling over the upper jaw that had been present for 6 months. A CT scan was obtained. What is the most likely diagnosis?
 Infra-orbital Nerve Schwannoma
 A 5-years old girl presented with a swelling in the left lower chest wall and upper abdominal wall. A chest radiograph was obtained (Fig. 1).
 Giant Cell Reparative Granuloma (GCRG) / Giant cell Tumor (GCT)


 A 1 year old child presented with sudden pain and swelling in the right knee. The radiograph of the right knee was obtained in the AP and lateral view.
 Scurvy with Subperiosteal Hemorrhage
 A 6-years old boy presented with a history of swelling of the right ankle for six months duration.
 Tuberculous Arthritis of the Ankle
 A 36-years old man presented with with pain in the abdomen and puffiness of face. Biochemical and clinical profiles revealed renal failure. A radiograph of the chest (Fig. 1) and an ultrasound of the abdomen (Fig. 2) were performed as baseline investigations.
 Tuberous Sclerosis (TS)
 A 14 years old boy presented with pain in the left groin after his school sports day. A radiograph of the pelvis was obtained (Fig. 1)
 Avulsion of the Ischial Tuberosity Apophysis
 A 20-years old Muslim lady presented with chronic fatigue and backache. A spine series and a pelvis with both hips were obtained.
 Osteomalacia due to Vitamin D Deficiency
 A 37 years-old man presented with a history of pain along the plantar aspect of the right foot since 2 years. There was no history of trauma or fever. On examination there was severe tenderness along the plantar aspect of the calcaneum, posteromedially. No local warmth or swelling was noted. The opposite foot was normal. An MR was performed.
 Plantar Fasciitis


 A 31-years old man presented with fever, altered sensorium, headache and one episode of right focal convulsions
 Cortical Vein Thrombosis with Venous Infarct
 A three-months old boy presented with seizures. He was born of a non-consanguineous marriage and was a full-term normal delivery. There was no history of birth asphyxia or any perinatal insult.
 Menke's Kinky Hair Syndrome
 An eight-years old girl presented with gradual onset of paraparesis of 3 months duration. MR of the dorso-lumbar spine was performed (Figs. 1, 2).
 Hydatid Cyst - Extradural
 A 40 years old man presented with convulsions. CT and MR of the brain were performed (Figs. 1-3).
 Cysticercus Granulomas
 A 15-years old boy presented with sudden headache and double vision. An MR was performed.
 Multiple Hemangiomas
 A six-years old boy, operated at birth for a myelomeningocele, presented with mental retardation, ataxia and seizures refractory to medication and a neurogenic bladder. An MR of the brain was performed.
 Neuronal Migrational Anomaly with Arnold-Chiari II Malformation
 These images belong to a 30-year old African-American male who was a chronic consumer of alcohol and heroin and presented with increased fatigue, inordinate weight gain (30-40 pounds in 5 months), increasing thirst, blurring of vision and increased frequency of urination.


 A forty-two years old lady who had been seeing a gynecologist for chronic pelvic pain and menorrhagia was referred for transvaginal ultrasound of the uterus and adnexa. Subsequently an MR was also performed (Figs 1-3).
 A 43-years old researcher presented with episodes of low abdominal pain lasting for 3-4 hours along with a palpable pelvic mass. MR images are provided to make a diagnosis.
 Right Ovarian Dermoid



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