id stringlengths 64 64 | question stringlengths 27 410 | images listlengths 1 1 | options unknown | answer_idx stringclasses 10
values | caption stringlengths 5 9.26k |
|---|---|---|---|---|---|
3aab51a77b91f0b8ffeac6b5148339d0a2a7e6f37b288f2fa0489b00703325d0 | The arrow in this specimen most likely indicates tumor extension into which layer? | [
"images/30/30f6370bdf380461ef5785beaea9e0ea06cedad7beccf6e4db87e2df9df5eb69.jpg"
] | {
"A": "Submucosa",
"B": "Serosa",
"C": "Muscularis propria",
"D": "Mucosal epithelium only"
} | A | Microsopic examination showed a well differentiated adenocarcinoma; tumor cells surround the orifice of the minor papilla with slight invasion into submucosa (arrow) (Elastica Masson staining, original magnification ×20). |
a09f905b1f0a713e0fa90fb10680f40a5ef860c52643ec6f552048aa715f9fa7 | On this coronal oblique CT image, the focal anterior abdominal wall defect indicated by the short arrow is most consistent with which diagnosis? | [
"images/16/16a983719e91bc61d5d8cfd45df4fdf7dea6b6ffa678acd41783d442779ea184.jpg"
] | {
"A": "Spigelian hernia",
"B": "Umbilical hernia",
"C": "Incisional ventral hernia containing small bowel",
"D": "Epigastric hernia",
"E": "Femoral hernia"
} | B | Coronal oblique CT image in case 1 showing the umbilical hernia (short arrow) containing omental varices (long arrow). |
763b14391c136dbb9a8b69ae8319bf4e8b10d6e8e96d7d09d1c27265dd86d0b2 | How does the T1-weighted appearance at the arrow in panel B compare with that at the arrow in panel I? | [
"images/19/1962597152f3326c8dd503a9805bd83d3a8542549d89a7df2e3ac3aa5db56f0d.jpg"
] | {
"A": "The panel I site is hyperintense, whereas the panel B site is not hyperintense",
"B": "The panel I site contains a signal void, whereas the panel B site is isointense",
"C": "The panel B site contains a signal void, whereas the panel I site is hyperintense",
"D": "Both sites show comparable marked hyper... | E | A case of both HIP and non-HIP lesions in a single patient. (A and H) Whole-heart coronary MR angiographic images show severe coronary stenoses (indicated by arrow) in the proximal LAD (A), and mid right coronary artery (RCA) (H). (B, C, I) Coronary T1WI CMR images. The area corresponding to the LAD lesion shows hyperi... |
9a1cf3532dd3d7aef9eb3b7000037b5f62665c0c4c6610f24ac9503d336d962c | In panel (b), which region shows focal tracer uptake? | [
"images/36/36d03d876e4d211db2ad02e9fe38e4251426790db865fd11590703f819c0ced6.jpg"
] | {
"A": "Left temporal subcutaneous tissue",
"B": "Cervical soft tissue along the electrode track",
"C": "Right temporal subcutaneous tissue",
"D": "Right chest wall soft tissue",
"E": "Left chest wall soft tissue",
"F": "Right frontal intracranial tissue"
} | E | 99mTc-sulesomab immunoscintigraphy (SPECT/CT fusion images). (a) Three plane images of Patient 2, showing focal tracer uptake restricted to the subcutaneous left temporal area, corresponding to the connector site. (b) Three plane images of Patient 7, showing left chest wall focal tracer uptake, in the area correspondin... |
e6b64c1d8ba3b77a2c7a6bb6f5c13028e10616e39494db81c675176633230534 | In which labeled retinal photograph does the torpedo maculopathy lesion appear to involve the foveal region? | [
"images/65/65da573c394d34f98e5a47331ea09f70fd110cea6c87eef6e0ce0755493ab237.jpg"
] | {
"A": "Panels B, C, and D",
"B": "All panels A through E",
"C": "Panel A only",
"D": "Panels A and E only"
} | A | Arrows show location of torpedo maculopathy (TM) lesions on each retinal photograph. Foveal involvement of TM lesions are seen in (B) (Patient 2), (C) (Patient 3) and (D) (Patient 5). Location of boxes demonstrate corresponding structural changes of TM lesions on OCT imaging, including (A). Absence of ellipsoid zone an... |
149769d6e3dbeeeb727926d5367debfee2fe66908071e95efbd43e5fb53fd42e | What is the imaging projection shown for this injury evaluation? | [
"images/79/799b5a06c5347984d8e48e711ef923efb0f1e873cc42ba1235850fa6de373f17.jpg"
] | {
"A": "Posteroanterior radiograph of the right hand",
"B": "Lateral radiograph of the left hand",
"C": "Anteroposterior radiograph of the left hand",
"D": "Oblique radiograph of the right wrist"
} | A | X-ray posteroanterior view of right LF proximal phalangeal base avulsion fracture. |
7bb015e51c00b0369139693bdc4353feee4ac6d677109316304fe15cb7872bf6 | In panel D, what structure is shown covering the arrowed region in the ILM en face view? | [
"images/95/95e37a6d7bf2e0662ad2041221228f8ea9fdedd95fcc98508a92f7b1a422474e.jpg"
] | {
"A": "A dense glial membrane",
"B": "A sheet of proliferating endothelial cells",
"C": "A layer of subretinal fibrin",
"D": "A collection of inflammatory exudates",
"E": "A retinal pigment epithelial monolayer",
"F": "A network of choroidal vessels"
} | A | Histopathologic presentation of donor 3 (FFB 878). (A) Gross image reveals the area of RPE atrophy (defined by arrows), where choroidal vessels are visible. (B) UEA lectin staining demonstrates CC attenuation in the atrophic region (arrows). (C) Müller cell processes labeled with vimentin (green) and GFAP (red) occupy ... |
9599841414bb644a5f24711308aca551794b2f30802d0330d7cf3e7b7809a9fd | The prominent oscillating mass in this image is attached to which cardiac structure? | [
"images/23/23e41215f4e68fff686af0ec22aaa6f131a0f958ceb54f2c262dfcac88732637.jpg"
] | {
"A": "Posterior leaflet of the mitral valve",
"B": "Interatrial septum",
"C": "Tricuspid valve anterior leaflet",
"D": "Left ventricular apex",
"E": "Aortic valve noncoronary cusp"
} | A | Transoesophageal echocardiogram revealing a large posterior mitral valve leaflet vegetation. |
c4c0e3b89934cf38a0eaacca4f732c1b1a98858ac5f2a863cd0365ed2a2b2081 | Which statement best matches the visualized abnormality on this barium swallow series? | [
"images/13/13c3a68829d2dea2dac50fd15e22703778dbe83fb7e24c9a1784762f1fb8281f.jpg"
] | {
"A": "There is a Zenker diverticulum causing proximal esophageal obstruction",
"B": "The esophageal mucosa appears preserved despite distal narrowing from an adjacent hernia",
"C": "The entire stomach is intrathoracic with organoaxial volvulus",
"D": "There is long-segment Barrett esophagus with multiple stri... | B | 61-year-old male with history of hiatal hernia undergoing pre-operative evaluation. Patient underwent BAS alone. a and b BAS demonstrated normal esophageal mucosa with narrowing of the distal esophagus due to extrinsic compression from a large type II paraesophageal hernia (arrow). c Erect AP view demonstrates the type... |
47f5ce2912281619c11bc9d334929e5ac678a94998304f7f445b4f9a9b806d66 | Which pair of adjacent disc spaces is most noticeably narrowed in panel B? | [
"images/29/292eb9aedeffba7387bda931acc778caef33dad4b07439ba43afa5f0fb164a79.jpg"
] | {
"A": "C6–C7 and C7–T1",
"B": "C7–T1 and T1–T2",
"C": "C5–C6 and C6–C7",
"D": "C3–C4 and C4–C5",
"E": "C2–C3 and C3–C4",
"F": "C4–C5 and C5–C6"
} | F | A 48‐year‐old male patient with proximal‐type CSA at the C4/5 and C5/6 levels. (A) The pre‐operative X‐rays of the cervical spine showing cervical hyperplasia bone hyperplasia, narrowed C4/5 and C5/6 intervertebral space. (B) Sagittal T2‐weighted magnetic resonance image showing cord compression at the C4‐C6 space. (C)... |
2a2ae0ae5a41eb8014b1e6218e2ddd6218277daa62831deedf05697c39c39175 | Which side and bone are involved by the fracture visible on this radiograph? | [
"images/6d/6d9e5d37f971e4180cd0acdc1b07ff73cc930397b3f67ba811e3bf4505d461f7.jpg"
] | {
"A": "Left femoral neck",
"B": "Right femoral neck",
"C": "Left acetabulum",
"D": "Right superior pubic ramus"
} | A | X-ray of the left hip and femur: a left subcapital femoral neck fracture (black arrow) can be seen. |
094b5a92ebeb536953161ebcf0737fd297b4e72cc8e40f05f446bb97885bcc80 | On this PA wrist radiograph, which description of distal radioulnar length relationship is most accurate? | [
"images/fa/fa869c5a1ea4bd3a5dfce224fe02129412af2788c154032f8a31f309b5d0d1f0.jpg"
] | {
"A": "Slight positive ulnar variance",
"B": "Severe negative ulnar variance with clear lunate uncovering",
"C": "Ulnar neutral variance with the distal articular surfaces at approximately the same level",
"D": "Mild negative ulnar variance with proximal ulna relative to radius",
"E": "Marked positive ulnar ... | C |
Plain radiograph of the wrist showing ulnar neutral variance.
|
145e9e42b79ab7864cc834dc6b2d29da94cae561716e67d9a0b6e7f2d2711fcc | On this standing lower-extremity radiograph of a young child, which coronal alignment abnormality is most evident at the knees? | [
"images/f0/f0101ddadb849440975e22d3bfcdd9bac2654647573d918c04d5e70eb550ebab.jpg"
] | {
"A": "Right-sided windswept deformity with valgus only",
"B": "Left-sided windswept deformity with varus only",
"C": "Bilateral genu varum",
"D": "Normal neutral mechanical alignment",
"E": "Bilateral genu valgum"
} | C | Lower extremity radiograph at 2 years 9 months old. |
df444280c5263aa4c09b1ecf068a14ed6ea1d9de189d30c76452a305d5d50e99 | What best describes the T-wave direction in relation to the major QRS deflection in the abnormal leads on this tracing? | [
"images/73/736e67e1490a970bc6a32781e41fff00ac6604580304d5352dcc4b39326a9ce5.jpg"
] | {
"A": "T waves are inverted despite a predominantly positive QRS complex",
"B": "T waves are biphasic in leads with a negative QRS complex",
"C": "T waves are positive in leads where the QRS complex is also positive",
"D": "T waves are flattened in all precordial leads"
} | C | Electrocardiogram - Sinus rhythm, left bundle branch block and positive T
waves on an also positive derivative of the QRS complex. |
a54d9eea2b18cac6fbfb62514aeb855985e92ddb6ce294171d27b592ba7cfaf0 | Which intracardiac abnormality is most consistent with the need for an eccentric occluder as suggested by this apical echocardiographic view and the measured defect size? | [
"images/e5/e509918bc0b229a5c0c66d7aa5906ecf07e0e2e93e78a7518778b300d81e8c60.jpg"
] | {
"A": "Perimembranous ventricular septal defect",
"B": "Atrioventricular canal defect",
"C": "Secundum atrial septal defect",
"D": "Left ventricular pseudoaneurysm",
"E": "Sinus venosus atrial septal defect",
"F": "Cor triatriatum",
"G": "Partial anomalous pulmonary venous return",
"H": "Muscular ventr... | A | The waist size of the eccentric occluder is shown. |
60aea905305ba4251ec65c47635f595ca0549b849d10d4c5de8eda9b1c8fa809 | Which diagnosis is most consistent with the visualized left adrenal lesion showing focal 68Ga-pentixafor uptake? | [
"images/ff/ffc2f0e7c6cd797985b42b47d44ba5dd6df7c62fc79bac8840efbfc94afedf0e.jpg"
] | {
"A": "Adrenal myelolipoma",
"B": "Adrenal metastasis",
"C": "Left aldosterone-producing adenoma",
"D": "Pheochromocytoma"
} | C | 68Ga-pentixafor positron emission tomography–computed tomography (PET-CT) (a) axial, (b) coronal, and (c) sagittal sections of CT and PET-CT fusion images show a hypodense (HU <10) left adrenal nodule (arrow) measuring 0.7 cm × 0.8 cm × 1.1 cm with significant enhancement on late arterial phase and showing significant ... |
903963846f3019b6b7e03e51d409172dadc259bdd8c62704560577a4a703bd31 | After gadolinium administration, what enhancement pattern is demonstrated by the lesion on the post-contrast sagittal image? | [
"images/51/515c9ac21ed8d6d4b3f4992ea39e2c2efc8955145b84076fc91f1bca604dfbf5.jpg"
] | {
"A": "Peripheral rim enhancement",
"B": "No visible enhancement",
"C": "Homogeneous solid enhancement",
"D": "Central nodular enhancement only"
} | A | MRI Sagittal View of the Spine: Ganglion cyst (yellow arrow) arising from the PLL (posterior longitudinal ligament), exhibiting a hypointense signal on T1-weighted images (A) and hyperintense signal on T2-weighted (B) and STIR images (C), with rim enhancement following observed after administration of gadolinium (D). |
c5ba587011ea73c76b61eef7dc4a72a5a28377470f360eeb1b161e4a6c2c64eb | In panel B, where is the prominent intraoral swelling located? | [
"images/c4/c4c47f2c8e9ef288c5c3cd2a0723317a36d0a6a0557c9d626251d2906dba353c.jpg"
] | {
"A": "Floor of the mouth",
"B": "Left hard palate",
"C": "Right buccal mucosa",
"D": "Ventral tongue",
"E": "Posterior pharyngeal wall",
"F": "Right hard palate"
} | B | Clinical, radiographic, and microscopic pictures of the current case of spontaneous osteosarcoma arising from pre-existing fibrous dysplasia (FD) without prior irradiation. (A) Ulcerated swelling over the left palate. (B) Facial asymmetry with bony swelling over the left maxilla. (C) Panoramic radiography: an ill-defin... |
0f273ba1ba5f319f539ce634c3f0070ecdd79b5bf18c41d8a5b48447e8175a26 | What enhancement pattern is shown by the mass on the contrast-enhanced CT panels b and c? | [
"images/a9/a9e5bdebe79d3398bd3d2c4482787295dc1627efd86f5ae8e367e67a0961183f.jpg"
] | {
"A": "Strong heterogeneous enhancement with nonenhancing low-density areas",
"B": "Uniform enhancement matching the adjacent blood pool",
"C": "Enhancement limited to a thin internal septum",
"D": "No appreciable enhancement throughout the mass",
"E": "Uniform enhancement less than that of the adjacent myoc... | A | Male, 74 years old, right atrium angiosarcoma. (a–c): The mass (red arrow) in the right atrium presents as inhomogeneous density with low-density areas on plain CT scans (a) and shows strong heterogeneous centripetal enhancement on enhanced CT scans (b,c), and the low density area (pink star) shows no enhancement. (d–f... |
e0cd179dac60393fce24338986c7081aab736eedad45e5ccbeceb6833182649a | In panel b, which pattern of thigh muscle involvement is shown? | [
"images/af/af37b7920c760d9e1c76e5dfb16b418e1c42ba6365be978e4fcdb15d20dbd8e7.jpg"
] | {
"A": "Predominant involvement of the anterior compartment with medial muscle preservation",
"B": "Uniform involvement of all thigh muscles",
"C": "Isolated bilateral involvement of the posterior compartment",
"D": "Predominant involvement of the lateral compartment with medial muscle preservation",
"E": "Is... | F | Clinical image, muscle CT, tongue MRI, and cardiac MR. Clinical image (a) showing the “hanging big toe sign”. Muscle CT of the mid-thigh (b) enlightens a selective pattern of involvement with the sartorius (s) and gracilis (g) muscles respectively severely and moderately affected, and the other muscles still well prese... |
308214824ece9f4c680dcdc866e76f13b28b67c3164e076406e0f5f205aa7b33 | Based on the visible fracture pattern in this metacarpal specimen, which AO fracture type is most consistent with the image? | [
"images/cf/cf6f725be18ec12df9fda93288c8bd2d1f175e73f64f0f63874a6b5fc516eac9.jpg"
] | {
"A": "AO C3",
"B": "AO A1",
"C": "AO B1",
"D": "AO A2"
} | D | Metacarpal fracture line passes from the dorsal cortex to the volar cortex short oblique or transverse (AO A2 fracture type). |
b1794db2517ac64d8c25db4893ddcd06ab53a935a0ed7db00986e7929bbc87f8 | Which anatomic structure is primarily opacified and being instrumented in this image? | [
"images/66/66569b60379ecbf036a5e9f5539f42a00767c95098c4aaac84c0b10e3a6d8366.jpg"
] | {
"A": "Duodenal lumen",
"B": "Common bile duct",
"C": "Main pancreatic duct",
"D": "Portal vein",
"E": "Cystic duct only"
} | B | Cholangiogram during the procedure: extraction of the stones using a Dormia basket |
917f9a463e4090856006e9e9128b2fd9003e0c3903a1b348f07dbaf17411567a | The dotted arrow marks a dental implant. Based on its visualized position in these images, where is the implant located? | [
"images/dd/dd067a545de8bd6eb6826202878c22e93b70f1453df77de9328ba5500425ee14.jpg"
] | {
"A": "Between the second premolar and first molar",
"B": "Between the lateral incisor and canine",
"C": "Within the mandibular symphysis",
"D": "Between the first and second premolars",
"E": "Between the canine and first premolar"
} | E | The figure depicts sagittal reconstructions of photon-counting computed tomography (PCD-CT) scans (A: high-dose; B: standard-dose; C: low-dose) and cone-beam computed tomography (CBCT) scans ((D: standard-dose; E: low-dose) of the same pig mandible. The standard-dose and low-dose PCD-CT scans were acquired at radiation... |
a848a224fd4345257845b40628baad751dec62507603cf3772b4fabd2094d343 | What is the principal myocardial abnormality visible in panel I? | [
"images/5f/5ff89cd9b0492349f023ac748316b10201523c27ae8285cce80b406f3bc67a05.jpg"
] | {
"A": "A visible defect through the interventricular septum",
"B": "Prominent left ventricular wall thickening",
"C": "A discrete mass within the left ventricular cavity",
"D": "Marked thinning of the left ventricular wall",
"E": "A large circumferential pericardial effusion",
"F": "A focal aneurysm of the... | B | The nevi of younger sister (Panels A–C). The nevi of older sister (Panels D–F). (CMR) imaging (elder: Panel G, younger: Panel H). (CMR) the thickness of basal segment of the septum (Panels I), (CMR) left and right ventricular outflow tract obstruction (Panel J). (CMR) high–speed blood flow (Panel K). (CMR) Late gadolin... |
c4da0a90b93d6f392581c30a22d3fdcb21c3f75782be74ea7ef72fa47f98adff | How does the tracer uptake at the arrowed site in panel B compare with that in the brain? | [
"images/08/08d7157633f8bfddb44d0c69b9e4c003a4e46508e12ba937f51881595089912d.jpg"
] | {
"A": "It is approximately equal to brain uptake",
"B": "It is lower than brain uptake",
"C": "It cannot be compared because panel B contains no PET information",
"D": "It is mildly greater than brain uptake",
"E": "It cannot be compared because the brain is outside the field of view",
"F": "It is markedly... | B | PET-CT findings of the patient. (A) A 1.5cm sized bulging lesion with soft tissue attenuation, involving subcutaneous layer of scalp along the left parietal area. (B) This lesion had a measured SUVmax value of 2, indicating a slight degree of hypermetabolism. (C) Maximum intensity projection images of PET-CT showed no ... |
40651eb79b22ab495820be45a490d5d79d2afc4d963f246aa5bcd468f4e39b9a | In this arthroscopic shoulder view, which labeled structure corresponds to the tendon lying on the right side of the field adjacent to the fixation construct? | [
"images/0a/0ae75c8419dcd9818b90d6df57e84cc4030a7800d9948ad6d16c2226e7c1436a.jpg"
] | {
"A": "Long head of biceps",
"B": "Glenoid",
"C": "EndoButton loops",
"D": "Terminal adjustable-loop device wires"
} | A | Glenoid (A), terminal adjustable-loop device wires (B), EndoButton loops (C), high-resistance wire (D), and long head of biceps (E), with optics through posterior portal. |
505cdf9a996ad0c4dde82189243a415a99c7c79e30d585e4fa2649f519a1ddc3 | Which nodal station shows abnormal hypermetabolic involvement above the diaphragm on this scan? | [
"images/7c/7c595c91840e875db9915ff138645fa07c88cd8db8ff21f6122fc8ba55eeef6e.jpg"
] | {
"A": "Subcarinal lymph nodes",
"B": "Right axillary lymph nodes",
"C": "Right hilar lymph nodes",
"D": "Left supraclavicular lymph nodes"
} | D | Positron emission tomography scan of the retroperitoneal mass
Coronal view of the 7.3-cm centrally necrotic retroperitoneal mass is visualized along with hypermetabolic left supraclavicular, para-aortic, and mesenteric lymph nodes. |
1c9b9ea0a3dd5942d4dfa21bf5a7076fce6cb3e6874ee253a70130069a26bd0b | The abnormality shown at the distal esophagus is most consistent with which severity classification of reflux esophagitis? | [
"images/1b/1ba0f6a2c2198c6f47f3eb01e69c9e6d4acb15e5f62e05eb750cdd4ded84fa91.jpg"
] | {
"A": "Barrett's esophagus without erosive disease",
"B": "Los Angeles grade D",
"C": "Los Angeles grade C",
"D": "Los Angeles grade A"
} | D | Reflux esophagitis (grade A) using white light imaging, linked color imaging, and blue LASER imaging. a White light imaging (WLI). Reflux esophagitis (LA grade A). b Linked color imaging (LCI). The reflux esophagitis was clearly detected and became highlighted in a red color. The LCI image was scored as + 15 points rep... |
9dc744909a538b91417d52e09f440a3f8e547eba50828f058019706ecc519d2c | What additional pulmonary finding is indicated by the arrows on panel D? | [
"images/4b/4b7a4327a9e956800d042a7c3363fc405285573812f8e96e287c47de7723f426.jpg"
] | {
"A": "A dominant ground-glass opacity confined to one upper lobe",
"B": "Bilateral pleural effusions",
"C": "Diffuse smooth thickening of the pleura",
"D": "A single large cavitary lesion in the left lung",
"E": "A solitary central hilar mass",
"F": "Multiple peripheral nodules in the lower lungs"
} | F | A 1-month-old boy with aspergillus infection. (A) On chest CT, a large cavity with thin and smooth wall was found in the right upper lobe, ranging 3 cm in diameter (long arrow). (B) On T2WI image, the linear separations and gas liquid leveling were found inside (long arrow). Multiple enlarged lymph nodes were found in ... |
8f0e5be0f986fefdd36214d32083d98a61c1d7d665d349e24accd4b0450b38fc | In this postoperative clinical photograph following maxillary reconstruction, which additional visible finding is most evident in the lower neck? | [
"images/c8/c80e151d3b6d0c510ddf2e904407ac11dbabd846189c790a76d5ac11ced28db8.jpg"
] | {
"A": "Cervical halo fixation device",
"B": "Occlusive dressing over a tracheostomy site",
"C": "Submental drain exiting the skin",
"D": "Thyroidectomy scar with Steri-Strips",
"E": "Central venous catheter insertion site"
} | B | Post operative picture after maxillary reconstruction with vascularised free fibula bone graft |
9767677575f01d46371e1ad1a7e32c9f7829759e0aa72f67523f2728a94ecb17 | What is the approximate heart rate? | [
"images/27/27a02b0ecac658d3d208e751410891f14b7542a6114588ea821c68b698d7aa1a.jpg"
] | {
"A": "110 beats/min",
"B": "55 beats/min",
"C": "150 beats/min",
"D": "200 beats/min",
"E": "40 beats/min",
"F": "75 beats/min"
} | F | A follow-up electrocardiogram (ECG) following the tube thoracostomy. A follow-up ECG after the tube thoracostomy revealed normalization of increased heart rate and the resolution of all the ECG abnormalities recognized on initial ECG |
db2f4d538b28b9807f8e95db0d0d95bcf79246bef44202d5d1384ee908274241 | Which overall interpretation is best supported by the grayscale and color Doppler ultrasound appearance of the right testicle? | [
"images/6d/6de190850001426a736ae7f7e1e50805d90c0c67c2200c9c7bce6423454d7865.jpg"
] | {
"A": "Intact right testis without sonographic evidence of tunica albuginea disruption",
"B": "Complete right testicular torsion with absent perfusion",
"C": "Necrotic intratesticular abscess replacing most of the right testis",
"D": "Right testicular rupture with parenchymal extrusion and devascularization"
} | A | Testicular integrity at ultrasound (US) scan. Tunica albuginea covering the right testicle is not interrupted. Color Doppler US shows normal testicular vascularity. |
e116612e28933041f9a7022465d65d9ef25f4053b71e35a2b47899df00cf47ad | Based on the combined imaging, bronchoscopic, and histologic findings shown, which final diagnosis is most consistent with this case? | [
"images/51/51028134f64722ec7abd55806b180f26721fb1fd1a1dc4e00bb5fa2c5daab8f5.jpg"
] | {
"A": "Squamous cell carcinoma",
"B": "Organizing pneumonia",
"C": "Small cell carcinoma",
"D": "Adenocarcinoma in situ"
} | D | Representative case 3 of transbronchial cryobiopsy (TBCB) using the ultrathin bronchoscope (UTB) (BF-XP290) guided by virtual bronchoscopic navigation (VBN). (A) The high-resolution computed tomography (HRCT) axial section showed a pure ground-glass opacity (GGO) located in the anterior segment of the left upper lobe, ... |
cf2585064f014420514c2b4e039311edcea82c4f52a019beaf62b1c7f424251d | The rightmost fluoroscopic image corresponds to which imaging projection of the pacemaker lead? | [
"images/45/4568c8ce677da8d9e165928a4c9411562bf012c4c972ceebe358344b4b859b26.jpg"
] | {
"A": "Left lateral projection",
"B": "Left anterior oblique projection at approximately 28°",
"C": "Right anterior oblique projection",
"D": "Anteroposterior projection"
} | B | Apical five-chamber view showing temporary pacing lead by TTE (A). Fluoroscopy image shows that the pacemaker lead was seen in the right anterior oblique projection (RAO) (B). Fluoroscopy image shows that the pacemaker lead was seen in the left anterior oblique (LAO) projection at 28° (C) |
5baa0550dd713ed6c85603664a70bc8a27e10254441ae454a6ae548dee0b1872 | On this lateral skull radiograph, which sellar configuration is most clearly demonstrated? | [
"images/34/34e1705ed9a33d0753b724a6159d2911a6ec7db9d9e5e8127e40de8ea9da0033.jpg"
] | {
"A": "Ballooned sella turcica from pituitary macroadenoma",
"B": "J-shaped sella turcica",
"C": "Normal shallow pituitary fossa",
"D": "Double-floor sella deformity",
"E": "Empty sella with floor erosion"
} | B | Lateral skull radiograph showed diffuse skull-base sclerosis associated with J-shaped cella turcica and a large sphenoid sinus, multiple patent sutures, mild nasomaxillary/mandibular hypoplasia and odontoid hypoplasia. |
41a635316ae2c052690b958d5f201d71f74c57f8f843279e6a4edde2a89efbbf | Compared with panels E and F, what is the mammographic appearance in panels G and H? | [
"images/a9/a92b7f35f893995f481369edb4a505311f66f5ec69d313f0e9f807bc23f9b3fd.jpg"
] | {
"A": "The focal mass is less conspicuous, though residual architectural distortion remains",
"B": "The prior focal finding is replaced by diffuse bilateral skin thickening",
"C": "The focal finding is unchanged and sharply circumscribed",
"D": "The focal mass is more conspicuous and has developed coarse calci... | A | The difference between before and after NACT.
Notes: Pathologic images of breast cancer before (A) and after (B) NACT. Sonographic volume measurement of breast cancer mass before (C) and after (D) NACT. Mammography of breast cancer mass before (E and F) and after (G and H) NACT.
Abbreviation: NACT, neoadjuvant chemothe... |
1f71ad037f39ab00f76c724c600248995d25fd11a9d44ab68e3fa66087ab42b7 | On the coronal post-contrast brain MR image, where is the dominant tumor centered? | [
"images/64/645e1a3f099d853293842c0b76c0d67380828092ab1f0053fbbeb1dc46720ae4.jpg"
] | {
"A": "Suprasellar region",
"B": "Foramen magnum",
"C": "Parasagittal frontal convexity",
"D": "Pineal region",
"E": "Cerebellopontine angle",
"F": "Fourth ventricle"
} | A | Case 2, a 39-year-old female patient with adamantinomatous craniopharyngioma. Preoperative coronal T1-weighted MR image after injection of gadolinium indicating a solid lesion with cysts in the suprasellar region (A). Preoperative FDG-PET coronal image demonstrating no glucose uptake in the suprasellar tumor (B). Patho... |
8cfb11f5360d71bf3327ba26f8ae513ae210f9872465c9040cab4f7bfabce7a9 | In this multipanel fetal MRI figure, the structure indicated by the white arrow in panels a and c most likely represents which of the following? | [
"images/8e/8eafa31d76fe249555282863c21f4fbf8553f2c564dfd00b34c3da77b7c70db1.jpg"
] | {
"A": "Maternal bladder dome",
"B": "Placental margin",
"C": "Fetal scalp electrode",
"D": "Surface coil cable artifact",
"E": "External transducer placed on the maternal abdomen",
"F": "Umbilical cord insertion"
} | E | Coronal (a), sagittal (b), and axial (c) MRI balanced turbo-field-echo (bSSFP) images of a 36-week gestational age fetus scanned at 1.5 T. Example of localizers (yellow lines) and transducer placement (white arrow in a and c). (d) 3D segmentation demonstrating fetal volume calculation to obtain fetal weight. |
f27bbf34803f3ea93996354adca6eb53bc13a87a13c00ca3a86a2ae261d410ee | What is the relationship of the posterior vitreous to the macula in the OCT scan in panel c? | [
"images/f9/f93d7bfb6192437f6126af13bbf4c583e4565f1bc9332a9e13df64081e55b313.jpg"
] | {
"A": "Vitreous prolapse through a full-thickness macular hole",
"B": "Persistent vitreomacular adhesion",
"C": "Complete absence of the vitreous body",
"D": "Vitreous hemorrhage obscuring the macula",
"E": "Vitreous incarceration in a retinal tear",
"F": "Complete posterior vitreous detachment from the ma... | B | A 75-year-old female presents in 2011 with bilateral AVL and comorbid SRDD. Advice is given and the patient discharged. In 2015, they re-present with reduced vision (LogMAR 1.0 and 0.5 in the right and left eyes respectively). The right AVL (a) has regressed, and there is widespread outer retinal atrophy with loss of t... |
9fc90a1f981f00e96f12a9fd8e011a56bd2385167758d9a58a0fe932b30b10a2 | Which sonographic description best matches the lesion shown? | [
"images/33/33ec5e735e48b8c1a002cbb54e32e774b3106864376ea22d0313d90fa67b8481.jpg"
] | {
"A": "Complex fluid collection with internal debris and thick capsule",
"B": "Avascular hematoma with fluid-fluid level",
"C": "Cluster of microcysts without a discrete solid component",
"D": "Markedly hyperechoic oval mass parallel to the skin",
"E": "Purely cystic lesion with thin imperceptible wall",
"... | I | Ultrasound of the left breast at the 6:00 region reveals a mildly hypoechoic mass with ductal extension. |
2bccaf127132473f2eedb4b783a86197ff0c89954cdea72c64d6ab781f8b2d38 | Which statement is most consistent with the lesion demonstrated in the elastography box? | [
"images/5e/5eb76c87bd1b7490f8dca49e05064c752dbe339041b96b2af463c36441281503.jpg"
] | {
"A": "The lesion shows mixed but red-dominant elasticity mapping, favoring a softer thrombus",
"B": "The study is color Doppler, and the red regions represent brisk intraluminal blood flow through a patent vein",
"C": "The imaged thrombus appears mechanically hard because the lesion is mainly blue",
"D": "The... | A | Follow-up ultrasound examination 7 days after detection of the thrombus. US elastogram presenting a thrombus with predominance of red color – high elasticity. |
ef8e1f5f7c645f5cbc05834cedeeb853bf076f8d8519ce1bfb86f9431748e1ad | What is the relationship of the lesion marked by the thick arrow to the organ indicated by the thin arrow? | [
"images/33/330de6b7f6e244ba03bbb618d6fd73c37480f3f92dbbcf750d8636c1af21502a.jpg"
] | {
"A": "It is located superior to the liver",
"B": "It is located within the renal collecting system",
"C": "It is located anterior to the right kidney",
"D": "It is located behind the left kidney",
"E": "It is located medial to the urinary bladder"
} | D | Transabdominal ultrasonographic appearance of cystic ovaryin the left upper quadrant. Cystic hypoechoic structure (thick arrow) in behind of the left kidney (thin arrow) (5 MHz multifrequency, convex probe, B-mode real-time ultra-sonography device) |
4a372592654f86158fd8fd70a056642fb7f64985b4a0d0fc8a3e585a1d0840e3 | Based on the visible pattern of virilized external genitalia, which Prader stage is most strongly suggested? | [
"images/70/70a2d40c99f8deee8f89b9cc14468a42073e6756300814544758b51b95508990.jpg"
] | {
"A": "Prader stage 2",
"B": "Prader stage 3",
"C": "Prader stage 1",
"D": "Prader stage 5",
"E": "Prader stage 4"
} | B | Single perineal opening in case 2 suggesting Prader 3 genitalia. |
2b285ce75f43a6d50a4c9d63d23aec7fe47b7092740234058280137e4626e4d3 | In this echocardiographic image, which labeled chamber lies in the upper left portion of the sector? | [
"images/cd/cd42be3b2c6ff9969d897d3f7ab36a16d6e171ae3a71c8c1175859d711e8790d.jpg"
] | {
"A": "Interventricular septum",
"B": "Left ventricle",
"C": "Right atrium",
"D": "Pericardial space",
"E": "Left atrium",
"F": "Right ventricle"
} | F | Normal echocardiographic view of Case 2 in her latest examination. LA = left atrium; LV = left ventricle; RA = right atrium; RV = right ventricle. |
220c5d34993452680e58dcdf6a6cc87565cc073cfdc0dfb5463d234fa9dfb88c | Which statement best matches the abnormal rotational relationship demonstrated on the axial MRI images? | [
"images/e8/e85a7dce5b326dbfc0c72e75feb44e8698ecc57f430e3685ecae9fcb94ee1346.jpg"
] | {
"A": "The femur is excessively internally rotated relative to the tibia without tibial malrotation",
"B": "There is no rotational malalignment between the tibia and femur",
"C": "The tibia is excessively externally rotated relative to the femur",
"D": "The tibia is excessively internally rotated relative to t... | D | MRI demonstrating intact ACL graft, good tunnel positions in femur and tibia (A), and excessive internal rotation of the tibia (B) with respect to the femur (C), with posterior axes highlighted. ACL, anterior cruciate ligament; MRI, magnetic resonance imaging. |
1bec569c58b565b558e1c14bbb4aa76ae7e1e319b4a9facaa5ab0e1bf98c4e57 | What pattern of distant involvement is demonstrated by the arrowed findings in panels e and f? | [
"images/cf/cff7605ff8a6fe684bbd1a44f5b5b956766be4822b37da804586cfb749399b7f.jpg"
] | {
"A": "Splenic and adrenal lesions",
"B": "Lung and pleural lesions",
"C": "Thyroid and cervical nodal lesions",
"D": "Peritoneal and bladder lesions",
"E": "Liver and bone lesions",
"F": "Renal and pancreatic lesions"
} | E | A 33-year-old patient presented with bleeding per rectum. Rectal growth biopsy is suggestive of malignant melanoma. Immunohistochemistry revealed tumor positive for HMB 45 and S100 protein. FDG PET/CT scan was done for initial staging. MIP images (a) show increased tracer uptake at multiple sites in the pelvis, liver, ... |
235114212b8a8bc9c8ee35fb9898e1a14533ea924338fb1780d9af0027ec81cb | On this coronal MR image of the brain and orbits, which abnormality is most clearly demonstrated within the orbital compartments? | [
"images/9a/9ac4a6e97e35c7fc78ae76a8761736c83e70f7e0514195f1d4f008b158e5239b.jpg"
] | {
"A": "Diffuse enlargement of the extraocular muscles",
"B": "Unilateral retinal detachment",
"C": "Lens dislocation in both globes",
"D": "Optic nerve sheath calcification",
"E": "Bilateral engorgement of the orbital vasculature"
} | E | Magnetic resonance imaging/magnetic resonance venography of brain and orbits coronal view: Engorged orbital vasculature |
3f4f7ee7f3e87f26795113fda7b7985e27680bf2b476cdbb2e8e331474eec5f8 | The sagittal MR image of the spine shows metastatic involvement at which vertebral level? | [
"images/f3/f3e420edbf3b78b0d72cc072be4a823048b052b44eb5f1323f65fa881875b49d.jpg"
] | {
"A": "T10",
"B": "T12",
"C": "T6",
"D": "T8"
} | A | Imaging techniques. A. Chest x-ray: a little pleural effusion occupying the bilateral hemithorax (blue arrow); B. Chest computed tomography: The left lung is atelectatic and compressed by a little pleural effusion (black arrow). Additionally, right breast skin was thickened, a irregular mass with lobular boundary conne... |
900b29fc8225b9da2ead06e804118347b11812eda6cb4a1e766dc23c473184da | Which hemithorax shows the dominant pleuropulmonary abnormality on this axial CT, including basilar consolidation/atelectatic change with an adjacent pleural fluid collection? | [
"images/1d/1d22b89551d3914a49897ca758a221ada1a8b16be923da32691a745f78b52a7f.jpg"
] | {
"A": "Right hemithorax",
"B": "Left hemithorax",
"C": "No focal pleuropulmonary abnormality is visible",
"D": "Bilateral lungs equally"
} | B | CT Chest/Abdomen/Pelvis demonstrating consolidation and atelectasis in the left lower lobe suspicious for pneumonia with an adjacent loculated pleural effusion concerning for empyema. Soft tissue stranding present through chest wall with effacement of left anterior sixth rib with additional organized fluid collection i... |
f28e4647f5435b1bf11a9c94dd9b6c3af235d832764cffe768ec04b450c37da3 | Comparing the baseline and follow-up FDG PET images, what is the most accurate description of the dominant abdominal tumor focus? | [
"images/f0/f0658d91e780f1062aa6592b348e2d13bc52b5b2a64684913b9572bab4ea6d79.jpg"
] | {
"A": "It becomes more intensely hypermetabolic and larger on follow-up",
"B": "It migrates from the left upper abdomen to the pelvis",
"C": "It shows marked loss of FDG uptake despite a residual mass-like abnormality",
"D": "It remains intensely FDG-avid with no meaningful interval change",
"E": "It disappe... | C | Pre- and Post FDG PET in an 82 old female with gastro-intestinal stromal tumor (GIST). Baseline FDG/PET study was performed off tyrosine kinase inhibitor therapy and she was initiated on a therapy. Repeat study was performed two weeks after initiation of Gleevec® (Imatinib) a specific c-KIT inhibitor. Both anatomic and... |
1d3551bc066b419b7023903e16b6771c960023f04d47ddf773fc75f77fbac79b | In panels (d)–(f), which bony injury is demonstrated? | [
"images/4d/4ddd52461ba2d8a3fd19eadad2267cb12f417c57a895728e112c58feaaade134.jpg"
] | {
"A": "Comminuted fracture of the medial malleolus",
"B": "Comminuted fracture of the talar body",
"C": "Distal tibial plafond fracture with central impaction",
"D": "Calcaneal fracture involving the subtalar facet",
"E": "Comminuted fracture of the distal fibula at the lateral malleolus",
"F": "Isolated p... | E | A 34-year-old patient (No. 12) suffered comminuted fracture of left lateral malleolus associated with deltoid ligament rupture and open dislocation. (a) Preoperative X-ray ankle joint anteroposterior view showing the dislocation of ankle (b) lateral and (c) anteroposterior views after reduction showing comminuted dista... |
be55e0f71b292f1bc3a018ab6616ed3e5f8e43face4860cd2cad3f327afdfbb9 | The calipers in the image are placed across the wall of which visualized structure? | [
"images/54/54f5f6189df98123201c9b118c4a1f90c293b7ef20bcbe30f9ea5b303550375d.jpg"
] | {
"A": "A superficial venous varix",
"B": "The gastric antrum",
"C": "A dilated gallbladder",
"D": "An extra-abdominal intestinal loop",
"E": "The urinary bladder wall"
} | D | Two-dimensional ultrasonography in sagittal view showing the measurement of intestine wall thickening in extra-abdominal intestine loops > 3 mm |
dbc506b8da7cb21b2e710fcd2ebbaf857853142efb10f5ef9263beb500bbc352 | On this axial fetal abdominal ultrasound, which organ contains the well-circumscribed multiloculated cystic lesion? | [
"images/69/691b2fc3870db13a3d374af30e6f407b4748836a29a1fe90d169629213483c00.jpg"
] | {
"A": "Liver",
"B": "Right kidney",
"C": "Stomach",
"D": "Spleen"
} | A | Axial view of fetal abdomen at 34 weeks showing well‐circumscribed, multi‐sepatate nature of the liver cyst, measuring 4 cm × 3 cm × 4 cm in size. |
9cd7e278c764c03e6a7f4cbf1558c5b5690d9e072e9ac317b14f662f4256d5bd | Which imaging feature is the dominant abnormality demonstrated on this sagittal fast spin-echo T2-weighted pelvic MRI? | [
"images/4c/4c3d7dc1b98acade498731506a1097e152042bd36b7eff9e2c3fd4f95c76b1d6.jpg"
] | {
"A": "Hyperintense cystic lesion of the prostate invading the bladder",
"B": "Circumferential low-signal fibrotic stricture without a focal mass",
"C": "Intermediate T2-signal mass-like tissue involving the upper rectum",
"D": "Free intraperitoneal fluid layering in the rectovesical pouch",
"E": "Diffuse sa... | C | 68 year old male presenting with 3.5 month history of rectal bleeding. Colonoscopy revealed an 1.5cm ulcerated rectal lesion at 10–12 cm from the anal verge.
A: Sagittal FSE T2-weighted MRI revealing intermediate T2 signal mass-like tissue likely representing tumor-region (white arrows). Vaguely apparent thin fascial l... |
6cd1016484aa2785e05383cff91e96f4e6f32f45e1dc7e6dab4c188c0dddd6c0 | Which extraocular muscle is most closely associated with the cystic orbital lesion, appearing to insert at its posterior pole? | [
"images/f3/f345f387e23b21216f620433583e7aaef9fdaf6a9d6ce7c7d19b81fad600475d.jpg"
] | {
"A": "Superior rectus",
"B": "Medial rectus",
"C": "Superior oblique",
"D": "Lateral rectus",
"E": "Inferior rectus"
} | B | Magnetic resonance imaging of the left orbit showing a well-encapsulated cyst, overlying the medial globe without surrounding erosion; the medial rectus muscle appears to insert at the posterior pole of the cyst. |
489386db73c1cb1d9239a52a8c5963c9a1b11cdd47b48c5cf7b2b0f2677a1d47 | Which histologic feature is most clearly demonstrated along the mucosal surface in this colonic biopsy? | [
"images/e7/e79f2dd028ed6b17e82a79783714e4de2ff2c7b790668331cd2e1cd069798d85.jpg"
] | {
"A": "Crypt elongation with basal plasmacytosis and goblet cell depletion",
"B": "Dysplastic glands with dirty necrosis invading desmoplastic stroma",
"C": "Transmural granulomatous inflammation with fissuring ulcers",
"D": "Surface epithelial sloughing capped by a fibrinopurulent pseudomembrane"
} | D | At higher power, C. difficile pseudomembranous colitis is characterized by sloughing off of superficial epithelial cells. The coating of fibrinopurulent material creates a pseudomembrane. |
7304e98c6a0eea7342315ec5e8c97ecdf738ccd69ac7e7b83dfd86e6b01f9207 | Inspect the postoperative radiograph. Which orthopedic construct is most clearly demonstrated spanning the knee joint? | [
"images/71/71f63647bf1cd562c815aa7bedeb16612ea2aac687f7557d8a6ab90c97e2ea7b.jpg"
] | {
"A": "Hinged total knee arthroplasty",
"B": "Anterior monorail external fixator used for knee fusion",
"C": "Locked intramedullary nail across the femur and tibia",
"D": "Posterior cruciate ligament reconstruction hardware"
} | B | Immediate post-operative lateral plain radiograph showing knee arthrodesis performed with an anterior monorail fixator |
67f204db1d5adb3b8047892d092e884121e618aeb7fa7f6d907d8db2076c7608 | In panel D, which structure is sampled by the green region of interest? | [
"images/38/38ad2ce95f36149817c6b3f0858a2f49feaf6fb0c198781d29c96de06f9e5e5c.jpg"
] | {
"A": "Spinal canal",
"B": "Paraspinal muscle",
"C": "Vertebral body",
"D": "Spinous process",
"E": "Aorta",
"F": "Intervertebral disc"
} | A | Demonstration of a drawing of the region-of-interest for FDG uptake in the spinal cord at each vertebral body level. (A) Fused PET/CT image in sagittal view. (B) Sagittal PET image. (C) Sagittal CT image. (D) Axial view of fused PET/CT image at the level of the yellow cross mark of the image. (E) Axial view of the CT i... |
d1ccb0bd656c5837153f75f48309c540c452f4b22a97700141a8aac4b9a3857b | What does the thin, high-attenuation coiled structure at the center of the lesion most likely represent? | [
"images/c5/c5fcd71171dfb35d39704b33267b261b522dbc1d73b26ad67d499a5f5bc9754a.jpg"
] | {
"A": "A surgical clip outside the lesion",
"B": "A catheter tip within a pleural collection",
"C": "A calcified pleural plaque",
"D": "A bronchial stent within an airway",
"E": "A calcified vessel within a pulmonary nodule",
"F": "A radiopaque marker within a retained surgical sponge"
} | F | Un-enhanced CT scan section of the thorax, in bone window (a) and lung window setting (b) showing a well-defined, hypodense, pleural based mass in the right lower hemithorax. The whorl-like structure is representing the sponge itself, which is having air droplets (Large Arrows) and a thin, coiled structure of high dens... |
3298caf2ccbef908c41f994ab017a1d0447c5715188b097348dab452db52bcc9 | The red arrow highlights a subtle structure near the lateral ventricle. Which denoising result appears excessively smoothed at the arrowed region, with loss of local edge definition compared with the cleaner reference appearance? | [
"images/75/751d23732c8854875ef3fc5fe06e857946c55211a747280175948aceed74e1ce.jpg"
] | {
"A": "RicianNet (h)",
"B": "BM3D (d)",
"C": "NLM (c)",
"D": "ODCT3D (e)"
} | C | Denoising effect of different methods with 9% noise level. (a) Noisy image; (b) noise-free image; (c) NLM; (d) BM3D; (e) ODCT3D; (f) PRI-NLM3D; (g) CNN-DMRI; (h) RicianNet; (i) 2D-DCRNet; (j) 2D-Parallel-RicianNet; (k) 3D-DCRNet; (l) 3D-Parallel-RicianNet. |
1a2a4009891a5915f17a8bbca9f8b5ea530209e345d1bdaa350f4d2f3a7092e9 | On this lateral cerebral angiographic image, the abnormal vascular shunt is centered at which dural venous location? | [
"images/c7/c74847b34089fd0fdfea3ebf1347404a55abecd88266b683bf0a3dff553d675b.jpg"
] | {
"A": "Superior sagittal sinus anterior third",
"B": "Cavernous sinus",
"C": "Transverse-sigmoid junction",
"D": "Confluence of sinuses (torcular Herophili)",
"E": "Straight sinus-galenic junction"
} | D | Left occipital artery fed dural arteriovenous fistulas at the confluence (lateral view). |
c3d61e61c9d40a225e3e7034d37f67b6e8d16c733a7143ed90e29fdea44dda6a | Based on the image, which diagnosis is most consistent with the lesion pattern demonstrated? | [
"images/15/152d27beb4f3c90d0e27b308e6a7afa4770ddb61a33dada9a287bb0ee5f3fd91.jpg"
] | {
"A": "Epidural abscess",
"B": "Central spinal cord contusion",
"C": "Syringomyelia with nonhemorrhagic cavitation",
"D": "Anterior spinal artery infarction",
"E": "Subacute combined degeneration"
} | B | Transverse section of a central spinal cord contusion at C7. Hemorrhage is seen preferentially in the central gray matter with largely intact surrounding white matter. Reprinted by permission from SpringerNature: Paraplegia. The disturbance of circulation in traumatic paraplegia in acute and late stages: A pathological... |
0093f714131dacaa5134a682dbd173c2180a72cf10346f224da47b72d9036c3c | On the transverse ultrasound images of the plantar foot, the depicted mass most likely arises from which structure? | [
"images/27/27380fc4b44e56085897f52b054ab2daf433c285202c900501d019ad18fdb872.jpg"
] | {
"A": "Medial plantar aponeurosis",
"B": "Flexor hallucis longus tendon sheath",
"C": "Achilles tendon",
"D": "Plantar digital nerve"
} | A | A 53-year-old man presented with a plantar lump. (a) Transverse greyscale and (b) colour Doppler US images of the sole of his right foot show a heterogeneous nodule arising from the medial plantar aponeurosis (arrow), which shows mild increased internal vascularity on colour Doppler imaging. The nodule was subsequently... |
a71c79a57b5f1256661a4d736783581efc99937bba4d5af39f85976aa31383d1 | On the 3D reconstructed facial image, which dentofacial abnormality is most evident in the patient shown in panel D? | [
"images/d5/d56632a0ac8d4895718ddc69a603ba89419ea01776ba997273e66586ca6b309a.jpg"
] | {
"A": "Marked mandibular protrusion",
"B": "Bilateral condylar hyperplasia",
"C": "Isolated maxillary retrusion",
"D": "Severe mandibular retrusion"
} | D | Upper airway comorbidities via CBCT and 3D reconstruction. (A–C) A patient with concurrent CRS, NDS, and malocclusion. (D) 3D reconstruction of the same patient’s malocclusion, showing severe mandibular retrusion. (E and F) Another patient with malocclusion characterized by mandibular protrusion. |
a43f202e74730113b8400e47db0e517853a95c1ff54c78906dad389706f07bfc | In the frontal and lateral radiographs (1A and 1B), which disc space shows the greatest narrowing? | [
"images/9d/9d8f37450ee6d27ef496d22543edef42182aff68fbadb955221e6d5c4a238e5d.jpg"
] | {
"A": "L5–S1",
"B": "L4–5",
"C": "L1–2",
"D": "L3–4",
"E": "L2–3",
"F": "T12–L1"
} | B | Patient 1. Frontal (A), and lateral (B, C) radiographs reveal severe L4–5 disc space narrowing, erosion and partial collapse of the anterior-superior and anterior-inferior L5 vertebral endplates and to a lesser extent the inferior L4 endplate, and prominent sclerosis of the L5 vertebral body. |
44587f47f2780c82c35b305a4a82fe2aa49e1e63c2b6caf90a31ac33f761d7ad | On these intracranial angiographic and T1-weighted images, the arrowed vascular abnormality is best characterized as which of the following? | [
"images/cf/cff3fb1c68abbf98147025840b5b47a6ffb5b60e4dd9dafd6aa188d7af431ef7.jpg"
] | {
"A": "A fusiform aneurysm of the basilar artery",
"B": "A saccular unruptured aneurysm arising from the left anterior cerebral artery",
"C": "A dissecting vertebral artery aneurysm",
"D": "A cavernous internal carotid artery pseudoaneurysm",
"E": "An arteriovenous malformation centered in the right frontal ... | B | This series includes TOF-MRA scans (A and B) and precontrast (C) and postcontrast (D) T1-weighted 3D TSE sequences showing a 7 × 6 mm unruptured aneurysm in the left anterior cerebral artery (arrows). The delayed postcontrast image (D) reveals circumferential enhancement of the dome of the aneurysm, indicating wall ins... |
44cf52b1683a254a62eecf7243dda1b6cac5dd815fffb855239e10dc690be4a3 | In panel D, which vertebral structures contain the paired arrowed postoperative openings? | [
"images/94/9486d771990a647583b79afb50b3596daa40bdd301751839e3316f4958426b81.jpg"
] | {
"A": "Laminae",
"B": "Pedicles",
"C": "Vertebral bodies",
"D": "Spinous processes",
"E": "Superior articular processes",
"F": "Transverse processes"
} | A | Postoperative CT scan. A – A bilateral translaminar osseous-channel (arrows) was established and the ossified mass (OLF) was completely removed after the p-PELD procedure. A translaminar osseous-channel (arrows) and methyl methacrylate strengthening of T11 were presented on sagittal reconstructed CT scan (B) and corona... |
7746c66e697f16ffd83ed6977714fd0285972d12e2001c21c0521a53b75d23bb | On the displayed planning images, what does the green line represent? | [
"images/c3/c3f890899332d1c48c6b2bc72870ef05965d6cb491ede4e8df9ff328028e5974.jpg"
] | {
"A": "Direction of the ankle mortise widening",
"B": "Orientation of the coronal reconstruction plane",
"C": "Orientation of the sagittal reconstruction plane",
"D": "Proposed fracture line through the distal fibula"
} | B | Reformatting of CT images to create the coronal and axial planes parallel to the ideal syndesmotic screw track which lies perpendicular to the anteroposterior extent of tibial incisura and central through the distal tibiofibular articulation in axial plane, and parallel to the mediolateral extent of the superior joint ... |
60663cdd9c67688d36c2a81f043872f793b4214b3efa308aa1354fec41822130 | In this color fundus image, the abnormal retinal whitening is best localized to which region? | [
"images/a4/a4c4a7289263e2f437c1c849c12f1cc62f945f3e885f31bf1d7f5789b8829da3.jpg"
] | {
"A": "Inferonasal quadrant only",
"B": "Inferior half of the left retina",
"C": "Superior half of the left retina",
"D": "Nasal peripheral retina only",
"E": "Diffuse full-retinal involvement",
"F": "Temporal periphery sparing the macula",
"G": "Optic disc alone"
} | B | Colour photograph of left fundus at presentation, showing acute left hemiretinal artery occlusion and associated retinal oedema. |
a7685e93499a47432d1d886e390b68fdf743757630ecd3d572b4788712684c9d | Based on the visualized anatomy, where is the abnormal sesamoid located relative to the great toe structures? | [
"images/ad/ad3e98514fa09c97d8aae8a23c6d8a545efc56a6247d4357baaf2ca4847ba18c.jpg"
] | {
"A": "Beneath the hallux interphalangeal joint, superficial within the flexor hallucis longus tendon",
"B": "Dorsal to the distal phalanx of the hallux near the nail bed",
"C": "Within the extensor hallucis longus tendon over the proximal phalanx",
"D": "Plantar to the first metatarsal head at the metatarsoph... | A | Magnetic Resonance Imaging. T2- weighted sagittal (A) and coronal (B) and T1- weighted coronal (C) images reveal a sesamoid bone embedded superficially within the flexor hallucis longus tendon (white arrow). STIR weighted sagittal (D) and coronal (E) images reveal hyperintense marrow signals within the subhallucal sesa... |
22f0332907a6356c8999da177edd462b97ee06be3f238f16621e0fd9d2399e7b | Which pair of microscopic findings is demonstrated in this image? | [
"images/2d/2d500a04bcf923e0a8f206efb9dac51e7af6be5bd219c4e8452ed5e924eb7539.jpg"
] | {
"A": "Keratin pearl and foreign-body giant cell",
"B": "Michaelis-Gutmann body and plasma cell",
"C": "Ghost cell and crescentic histiocyte",
"D": "Caseous necrosis and epithelioid histiocyte",
"E": "Psammoma body and foamy macrophage"
} | C | High power view showing ghost cell (arrow head) and crescentic histiocyte (arrow). H&E ×40 objective |
6a309522171fc9f30aff0827379c8c5f78b2475203b80c2cd0ecb662cb63b0e8 | In panel b, where is the visible swelling predominantly located? | [
"images/4f/4f648871045766a9f602d8984d3920117f5c7fd9a269d636349b8990e230d8d7.jpg"
] | {
"A": "Both thighs symmetrically",
"B": "Left lower leg and foot",
"C": "Both lower legs symmetrically",
"D": "Right thigh and gluteal region",
"E": "Right lower leg and foot",
"F": "Left thigh and gluteal region"
} | D | (a) USG image (2D) of fetal thigh showing multiple sonolucent areas in subcutaneous plane (bold arrows). Femur bone is marked with yellow arrow. (b) Clinical image of the new born showing diffuse cystic swelling involving the right thigh and gluteal region. The left lower limb is normal. (c) Contrast enhanced MRI of ri... |
b25cbf947e2e1d21a57a60b6188602ef598a535d37101b1f02e1681b87d43be3 | On the fused axial and sagittal PET/CT images, which anatomic region corresponds to the prominent uptake marked by the blue arrow? | [
"images/97/97c17646ab69f7cbad859daedc9ddac7f46aa8a4b7b946fce1518e181dc8ed7e.jpg"
] | {
"A": "Parotid gland",
"B": "Esophageal lumen",
"C": "Thyroid gland",
"D": "Laryngeal ventricle",
"E": "Sphenoid sinus",
"F": "Nasopharyngeal mucosa"
} | F | A 36-year-old female with a history of right breast carcinoma was referred for 18F- FDG PET/CT scan for staging and maximum intensity projection image (a) showed FDG uptake in nasopharyngeal and oropharyngeal region, bilateral cervical lymph nodes, right breast, right axillary, and right internal mammary lymph nodes wi... |
c50671232e4294e27bf5e21878b09500669808882d275b6e60346b46e3d2282c | Which sonographic description best matches the region behind the bladder in this image? | [
"images/2b/2b7621e8f9eb21d626b275bd70ef57a41534232e357c8f9905e1f2e619560a90.jpg"
] | {
"A": "A heterogeneous calcified mass causing marked shadowing",
"B": "No discrete retrovesical cystic lesion is identified",
"C": "A thick-walled abscess with internal echoes",
"D": "A well-defined posterior cyst with posterior acoustic enhancement"
} | B | US image from postoperative follow-up showing no more cystic structure behind the bladder. |
88a4d9f70d9baa714c9ce653b0ac68b620af34f291959407d292d4af5b50d75e | The torn structure in this surgical field extends into which adjacent muscular component on the medial side of the distal thigh? | [
"images/f3/f3dcbd52dbeb47f953c4222cc741942289f0afce08402d4ecce04542bb3f24e5.jpg"
] | {
"A": "Biceps femoris",
"B": "Vastus medialis obliquus",
"C": "Semitendinosus",
"D": "Tibialis anterior"
} | B | Quadriceps tendon rupture extending into the vastus medialus obliquus muscle as well as the medial and lateral retinacula. |
d7acd4804d34ef4d265e46d5cf212b916f3f056e111b86ba753b3805ec13c831 | Which Sugaya classification best matches the repaired cuff appearance in this image? | [
"images/50/502de26523b2e3af8e5869627de8a6f1c06f8c194de1d4acc0ae952065168ff6.jpg"
] | {
"A": "Grade I",
"B": "Grade V",
"C": "Grade II",
"D": "Grade III",
"E": "Grade IV"
} | D | Healed massive cuff repair with thinning of the tendon (Sugaya grade III) of patient 8. MRI performed 10 months after surgery. |
0c226f1345c568828a36fc2d6a6be3162ed84e1332965c5edc5dd4d15997c087 | In panels A and B, what abnormality is indicated by the arrows at the inferior peripheral cornea? | [
"images/19/19490fff9ee90a9c91c0ff6ee135c459f989adbecf1d8aa6e404265197828400.jpg"
] | {
"A": "Lower-eyelid lacerations",
"B": "Conjunctival hemorrhage",
"C": "Limbal neovascularization",
"D": "Iris transillumination defects",
"E": "Central corneal epithelial defects",
"F": "Peripheral corneal infiltrates"
} | F | Peripheral corneal infiltration (arrows) and decompensated corneal epithelium stained with fluorescein dye in the lower part with bulbar conjunctival injection in both eyes (A: right eye, B: left eye) at the age of 51. Central corneal erosion stained with fluorescein dye in both eyes (C: right eye, D: left eye) eight m... |
2f9e3c4a0d1e37c096a1d0d46b665a4ecbd30e7b25b42ea8e77c8444b8d374de | What is the predominant composition of the lesion shown on the MRI images in panels E through H? | [
"images/19/19d7e13217c52058470e23ece548872729a12b74a51de27d6ac3752737b025c3.jpg"
] | {
"A": "Fluid-containing",
"B": "Predominantly fatty",
"C": "Predominantly calcified",
"D": "Predominantly osseous",
"E": "Predominantly fibrous",
"F": "Predominantly gaseous"
} | A | A 74‐year‐old man with a wear debris pseudotumor after TKA. (A) Anterior film of the right knee showing varus deformity of the prosthetic joint and narrowing of the medial joint compartment. (B) Lateral film showing a soft tissue mass in the posterior region of the right knee. (C, D) Doppler ultrasound showing a cystic... |
6272d775ae1aa0df86a34a74a4e415cc14ee789efc56bad32caa0575d37b78d6 | Which side shows the dominant orbital wall destruction and adjacent intracranial extension from the skull base lesion? | [
"images/be/be6473fdb503f5f9f0f9542e9191ec7d05f05ba2e38ee36879ddddd25be662e3.jpg"
] | {
"A": "Midline only without orbital involvement",
"B": "Left side",
"C": "Bilateral and symmetric",
"D": "Right side"
} | B | (A-D) CECT brain and paranasal sinuses showing infiltrative solid-cystic mixed density lesion epicentred in the base of skull predominantly involving the sphenoid sinus causing its expansion and ballooning. The lesion has caused erosion of the left lateral wall of the sphenoid sinus, left anterior and posterior clinoid... |
c61101ff3ad995f30c563653241b5af350543e0ff808b564ebceff4c264a6c47 | On the elastography image, the arrow indicates a lymph node with which visual feature most strongly suggests increased stiffness? | [
"images/fa/fae2d253ffc9fe01d929da2f9a1e398191d8a8c980641b6d16104a31455a178d.jpg"
] | {
"A": "Complete absence of color overlay in the node",
"B": "A thin echogenic hilum with exclusively yellow color",
"C": "Predominantly anechoic appearance with posterior enhancement",
"D": "Mosaic pattern of green, turquoise, and blue within the node",
"E": "Uniform bright red signal throughout the lesion"
... | D | Near the tumor, elastography scan shows a lymph node (2 cm in diameter, arrow) represented by a mosaic of colors (green, turquoise and blue) suggestive of increased stiffness |
3cb9738e50ac751a7a00505178fe814f0df8c72834939c2a07301b764251ea9e | On the multiphase CT angiographic images, which vascular abnormality is most consistent with the visual findings? | [
"images/9b/9b8b47519cc49cd5f245443895f40ae97d0dc5576ae10c0207a7bca4947cf030.jpg"
] | {
"A": "Right distal M1 middle cerebral artery occlusion",
"B": "Basilar artery tip occlusion",
"C": "Left distal M1 middle cerebral artery occlusion",
"D": "Right A1 anterior cerebral artery occlusion"
} | A | Acute right distal M1 occlusion with baseline NIHSS of 14. Ipsilateral pial vessels cannot be well visualized on single-phase column (a. Phase 1) and collateral score was graded as a 0 (“poor”). Pial vessels start to be seen on second phase (a. Phase 2-3) and were scored as intermediate. Patient showed a significant mi... |
a29a2c07e7bdf3370e9590d6d36cf48061ad7746baf1fe4a307ba4b80bb2f119 | The postoperative change visible in the hand is most consistent with reconstruction involving which interdigital space? | [
"images/bb/bb19d8b70f4dbb01a4f25f31d630c50172d06bff4ab772f241887ba5f7325e81.jpg"
] | {
"A": "First web space between thumb and index finger",
"B": "Second web space between index and middle fingers",
"C": "Fourth web space between ring and little fingers",
"D": "Third web space between middle and ring fingers"
} | D | Nail dystrophy, onycholysis and onychorrhexis of middle, ring and little fingernails in the right hand four months after reconstruction of third web for syndactyly. |
5a442aa34fa52f5d7e47d97637d4c325437a6aedb801c4996705d5db8f49a651 | Which diagnosis is best supported by the visualized gallbladder findings on this T2-weighted MRI? | [
"images/aa/aa29963a2788ea318e1f199f3f844436ba620db91d886fb2b99d3cd02daafbb9.jpg"
] | {
"A": "Gallbladder carcinoma with diffuse mural infiltration",
"B": "Acute calculous cholecystitis",
"C": "Xanthogranulomatous cholecystitis",
"D": "Adenomyomatosis of the gallbladder with Rokitansky-Aschoff sinuses"
} | A | T2-weighted MR imaging revealed homogeneous thickening wall structure with hyposignal intensity. Gallbadder stones were not observed. |
fbdd2934983c639d69a2bdba7585c0db5e467110fb8c15f72116124e57a39a34 | Which surgical instrument is most consistent with the device seen centrally performing the tissue separation in this image? | [
"images/11/11245dcb04b6c5f5c4a59278e6ee62ef6af468d58f12bdc334531cba72a1d690.jpg"
] | {
"A": "Bipolar scissors",
"B": "Maryland dissector",
"C": "Endoscopic clip applier",
"D": "Needle driver",
"E": "Monopolar hook cautery"
} | A | Dissection in the posterior site is seen in the monitor. Sharp dissection is performed with a pair of bipolar scissors in the plane between the breast tissue and pectoral muscle under imaging guidance and the breast tissue is mobilized |
a7e55c85a5cf0468e50c7629d6f4ecb1db83b06cdda74edafaf858b12302f5f4 | Which description best matches the visible pattern of the facial anomaly in this image? | [
"images/c1/c11626035624b28f1184d46109f2722d80bbac487b277dcbff652b75f6a6b91e.jpg"
] | {
"A": "Bilateral complete cleft lip with central prolabium",
"B": "Unilateral cleft lip extending into the alveolus",
"C": "Median cleft of the upper lip",
"D": "Isolated lower lip cleft without alveolar involvement"
} | B | Frontal view showing right-sided cleft lip and alveolus (preoperative). |
11f547fd3fca0ee8891205824c0afc8c4024b92ac9a7786363ee056f4e5861c4 | A region of interest is outlined over the central pelvic structure for stiffness assessment. In which image type is this ROI directly drawn? | [
"images/1f/1f8887918c60142da9cea4dee61510fec00541032117994ad24d9b0f57bd39b5.jpg"
] | {
"A": "Wave image",
"B": "Modulus image",
"C": "Stiffness image",
"D": "T2-weighted image",
"E": "FFE image"
} | E | Demonstrating MRE images in one same slice. A T2W image. B Wave image. C FFE image. D Modulus image. E Stiffness image |
d640a329a4ea79612141fe3ae0ffb7b09920548840c41e873dcedda9eb05d55c | In the operative exposure panel showing bony removal, which side and procedure are depicted to access the lesion? | [
"images/5b/5ba329eb2fb2b2e3efe9602559eb2884fc4ca4f00dd39aa243be4e6dc24da1b2.jpg"
] | {
"A": "Right-side laminectomy",
"B": "Bilateral laminectomy",
"C": "Left facetectomy",
"D": "Left hemilaminectomy",
"E": "Right laminoplasty"
} | A | Therapy processes in the hybrid operating room. (A) The tip of the microcatheter is successfully guided into the proximal parent artery. (B,C) As the arrows show, the aneurysm is located at the lower border of C2 centrum. (D) Right-side laminectomy. (E) Arrow shows dense blood clots around the ruptured aneurysm. (F) Pa... |
375747d3e6aa6716ee0ac2ad8c96293808cd566d63b935352c892813961d4a62 | Which frontal-plane QRS axis is most consistent with the limb leads? | [
"images/1e/1e6255aa98a1818fc3eeab85b2baff90449d683076db23fa3345d7df0077f57f.jpg"
] | {
"A": "Normal axis",
"B": "Right axis deviation",
"C": "Left axis deviation",
"D": "Indeterminate axis from an isoelectric QRS in every limb lead",
"E": "Extreme axis deviation",
"F": "Alternating axis"
} | B | 12-Lead Electrocardiogram
R-wave is low in limb and chest leads. P-wave is high in anterior chest leads. This is evidence of right heart overload and pericardial effusion. |
1a58e2cbb408061d5415c58806be5efa8287e1249dc7033341a87cd3c6dff851 | How does the white-arrowed liver lesion change between panels a and c? | [
"images/d6/d66a61233db6834e8a33ea1daabfe01190c1d8a23d2c5b5c4b1b6b65c40a68f5.jpg"
] | {
"A": "It increases in size.",
"B": "It develops a larger central cavity.",
"C": "It becomes confluent with the adjacent kidney.",
"D": "It remains approximately unchanged in size.",
"E": "It is replaced by a larger calcified mass.",
"F": "It decreases in size."
} | F | A 53-year-old male who had an RTLM and SRLM after chemotherapy. Two liver metastases in segment V sized 32 mm and 12 mm (white and red arrows, respectively) were identified on diffusion-weighted (a) and hepatobiliary phase (b) images of baseline MRI. After chemotherapy, the size of the bigger metastasis decreased to 9 ... |
917a15d080ba03caea9d30462ba5bf319b9f7001b48e08dcb15006c2cb409f73 | In panel B, which structure is targeted by the wire within the white circle? | [
"images/02/02171e10d403d02c03acc55c59ea30cc28460d9ee2266b3a15eef8e910495b63.jpg"
] | {
"A": "The nipple",
"B": "The skin",
"C": "A pectoral muscle",
"D": "An axillary lymph node",
"E": "A breast duct",
"F": "A rib"
} | D | Preoperative wire localization in a 53-year-old woman with right breast tumor and axillary node metastasis. Ultrasound axial image (A) shows the metal wire which appears hyperechoic (white arrow) positioned inside the biopsy-proven pathological node (white circle). Post-procedural medio-lateral oblique (B) right mammog... |
e19828ad76745d3201f32f0f46ed7bd617f49acabf8c7dcc636ff33a986f5b2f | Based on the epithelial abnormalities visible in this cervical specimen, which diagnosis is best supported by the image? | [
"images/29/29ba8fab8df428e3b7b6b32209cb24d36c6ec4c3d097747fcfea82ccffe2bdd4.jpg"
] | {
"A": "CIN 3 / severe dysplasia involving full epithelial thickness",
"B": "CIN 1 / low-grade squamous intraepithelial lesion with HPV effect",
"C": "Invasive squamous cell carcinoma of the cervix",
"D": "Chronic cervicitis without dysplasia",
"E": "Adenocarcinoma in situ"
} | B | Cervical biopsy showing features of both CIN1 and HPV in the form of koilocytotic atypia, bizarre nuclei, and multinucleation. This patient was HPV DNA positive. Colposcopic impression was HSIL. |
1d9dd85a85dcc98c43fd59679a789d3e1f03feba37d95a306f054d0b0ae9b30e | How does vertebral alignment at the treated level change between the upper-right and lower-right images? | [
"images/5d/5d210481673586c5511cd027f581df544e4535af6543d4d04cb5c3fd81a05501.jpg"
] | {
"A": "Anterior translation increases",
"B": "Posterior translation increases",
"C": "Alignment remains unchanged",
"D": "A new vertebral dislocation develops",
"E": "Anterior translation is reduced",
"F": "Posterior translation is reduced"
} | E | AP (left) and lateral (right) erect radiographs of a patient who had an XLIF procedure performed at L4-5. The preoperative imaging (top) shows a grade I spondylolisthesis and the postoperative imaging (bottom) shows complete reduction of the subluxation. The normalised cage position is 0.52. |
c5ad0b895563abfe39a7fd76224ba08eb6caa4f1c8413eea1f0ef46091cbbdbc | On these fluoroscopic aspiration images, the needle tip in each case is positioned adjacent to which anatomic region? | [
"images/2c/2c846da1c2bcd5b4a409c44b2f95e2fa5e91e9f40cf9d1933b141d2bc7cc925e.jpg"
] | {
"A": "Superior pubic ramus near the symphysis",
"B": "Lateral aspect of the femoral head-neck junction",
"C": "Medial aspect of the acetabular roof",
"D": "Lesser trochanter at the iliopsoas insertion",
"E": "Sacroiliac joint space"
} | B | Two examples of aspirations under fluoroscopic guidance – the left half demonstrates a hip with prior arthroplasty, while the right represents a native hip. The needles can be visualized in both pictures on the lateral aspect of the femoral head/neck. |
95c73cca60bdada4a352c7e3ad85ffa0055a21029e8d160e3d36ef33dfd20b76 | On the sagittal CT image, a hyperdense calcified lesion is seen in which paranasal sinus compartment? | [
"images/14/1453482c980ee6761c9b42b307f3456d8d05bfa5303cfd11a510f63cc451d6d2.jpg"
] | {
"A": "Right anterior ethmoidal sinus",
"B": "Right posterior ethmoidal sinus",
"C": "Left frontal sinus",
"D": "Left maxillary sinus",
"E": "Right sphenoid sinus"
} | A | Sagittal CT scan revealed a large calcified dense mass measuring 30 mm × 25 mm × 15 mm in the right anterior ethmoidal sinus. |
271242a8b39ba3a40711dfac1ae0326fac7e3b21c3a7fe82d38c5fa44b3d1d4f | These ankle radiographs most strongly demonstrate a non-united fracture involving which anatomic site and fracture classification? | [
"images/73/73d25b2825f1b775d920d1e86e3c7637df342860e8d4c9b8f93b823ede6495a9.jpg"
] | {
"A": "Vertical fracture of the medial malleolus",
"B": "Transverse infrasyndesmotic fracture of the distal fibula (Weber A)",
"C": "Posterior malleolar fracture of the distal tibia",
"D": "High suprasyndesmotic fracture of the fibula (Weber C)",
"E": "Oblique transsyndesmotic fracture of the distal fibula (... | B | Anterior-posterior radiographs of the five cases of transverse Weber A fractures at non-union. |
5bd5090b10c21b657713d8d77f8bc135088c33e0b300463e21389cc4e42230fb | The fixation hardware seen traversing the centrally located carpal bone is most consistent with treatment of nonunion involving which bone? | [
"images/e2/e28290067f481f3b288e7d12057139a760fbfb56d04d789ce42eab9c94cf3b2e.jpg"
] | {
"A": "Triquetrum",
"B": "Scaphoid",
"C": "Lunate",
"D": "Capitate",
"E": "Pisiform"
} | B |
Coronal and sagittal computed tomography images confirm bony healing of the nonunion.
|
484b44652cd346b637d559306c76c9b2bed7a46d0f47cf0e14b1860891e87a11 | The focal lesion shown is best localized to which segment of the affected coronary artery? | [
"images/fc/fc688aac54ae69876d62b3147b6578fb9b070e45939e6efafe3cffa252174d14.jpg"
] | {
"A": "Proximal to mid right coronary artery",
"B": "Left main bifurcation",
"C": "Distal left anterior descending artery near the apex",
"D": "Distal posterior descending branch",
"E": "Obtuse marginal branch of the circumflex artery"
} | A | An example of mycotic aneurysm of the right coronary artery. Subsequent surgical therapy involved resection of the involved arterial segment and placement of a venous bypass graft |
4b34f39e3278039cda7985029c7045a773113fff6440fab923141396b4cacf2b | Which radiographic description best matches the osseous abnormality seen in this image? | [
"images/69/69554dfbdb7dd81a5684f3db5dd2448a19693016afe540a53bdb409cf5f67057.jpg"
] | {
"A": "Diffuse periosteal reaction along the lateral border of the scapula",
"B": "An anterior shoulder dislocation with a bony Bankart lesion",
"C": "A transverse fracture through the scapular neck with inferior displacement",
"D": "A pedunculated exophytic bony outgrowth attached to the inferior scapula",
... | D | Preoperative X-ray showing the mass attached to the lower end of the scapula. |
22a720dc80c583bff1c5e93a17f10f1e8533a54b0bdc4018c53573ca0a8079a6 | The most abnormal osseous region visible in this image is centered in which location? | [
"images/20/205b62a7da1e82bb009a8d16cf83f0e939669c4f23546452eb54491cb117f2d7.jpg"
] | {
"A": "Lateral distal tibial epiphysis near the ankle",
"B": "Proximal tibial metaphysis just below the knee",
"C": "Talonavicular joint only",
"D": "Mid-diaphysis of the fibula"
} | A | Radiographic presentation of the same patient two years after lengthening procedure. Severe valgus deformity of 85° of the distal tibia in the age of nine y.o., and two years after completing a lengthening procedure of the tibia. Despite multiple efforts to correct axial malignment during lengthening this was not gaine... |
0791b3288ee47322231dfe9f3c99c8237e42c3e52d2009274d3e9bff82751d7c | What is the primary biomechanical effect being demonstrated by the orthotic in this image? | [
"images/74/74ba2cd6ae660c68114a3ee872281a49963263997291ae83922219bcdb56f1a7.jpg"
] | {
"A": "Passive cervical extension to restore sagittal lordotic curvature",
"B": "Flexion of the cervical spine with chin-to-chest positioning",
"C": "Lateral bending of the neck to one side",
"D": "Rotational correction of atlantoaxial malalignment"
} | A | DCTO. A model representation of the Denneroll® device being applied to the region that matches the placement in this case; low placement due to the reduction in the lordosis in the lower cervical spine worsening superiorly. The traction was utilized approximately two times per week by the patient for the 13 months foll... |
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