id stringlengths 64 64 | question stringlengths 27 410 | images listlengths 1 1 | options unknown | answer_idx stringclasses 10
values | caption stringlengths 5 9.26k |
|---|---|---|---|---|---|
d0786b5de3d36b3555377c60f7c9840b4e22e824ab9be2b78f4be62ce197c1e5 | Where is the proximal femoral fracture in panel (a) located? | [
"images/85/85425376ac6ae40f5fda3da51ac74aa3e59258587b4719e122eea2a81e916855.jpg"
] | {
"A": "Left femoral shaft",
"B": "Left femoral neck",
"C": "Right intertrochanteric region",
"D": "Right femoral head",
"E": "Left intertrochanteric region",
"F": "Right femoral shaft"
} | C | (a) Preoperative anteroposterior pelvic radiograph of an intertrochanteric femur fracture with concomitant advanced osteoarthritis of the right hip; (b) anteroposterior pelvic radiograph at 1 year after total hip arthroplasty with a cemented femoral stem and a cemented double-mobility acetabular cup. |
fa920877be5db38d17c893c6ed3a1371738eab389562a6fb5fd50d9c7298d559 | Comparing the preoperative and postoperative images, at which vertebral complex is the corrective osteotomy and instrumentation centered? | [
"images/85/8566cb3f22a0a182baf0c14ee393deb54a9f50b49b7fcbee1cd917d505427ceb.jpg"
] | {
"A": "T11–T12",
"B": "L1–L2",
"C": "T8–T9",
"D": "T6–T7",
"E": "L4–L5"
} | A | A 20–30‐year‐old case with T10
–12 congenital spinal angular kyphosis. (A–C) Preoperative lateral X‐ray and 3D CT scan showed a T10‐L2 congenital kyphosis, with a deformity angle of 88.3°. (D–F) Postoperative lateral X‐ray and 3D CT scan showed DCVO at T11–12 complex, with a deformity angle of 20.0°. (G) Latest follow‐... |
c924e4d103371a90ca1abcc8a70b53d1cc66ecfeb0a4ba881d1886f6cc98cadf | Which interpretation best matches the visual finding in this midcarpal arthroscopic image? | [
"images/2c/2c4de8323d3b0e0c2db6f8ab3e7fa9f4cef788a3208514735e15a40e9a8aaf73.jpg"
] | {
"A": "De Quervain tenosynovitis",
"B": "Kienböck disease with lunate collapse",
"C": "Osteochondral loose body in the radiocarpal joint",
"D": "Isolated synovitis without carpal malalignment",
"E": "Normal smooth apposition of the scaphoid and lunate with intact ligament continuity",
"F": "Pisotriquetral ... | H |
Midcarpal arthroscopy demonstrating type 4 scapholunate instability.
|
78104bbfa8fc647896ae9e8c75a9b5715a7f0a7273cec8c9fb62d25e40935bf5 | The red angular measurement of 5.24° is centered across which intervertebral level? | [
"images/6b/6b80840f71dce44c9e09896862a33967fe112c1b2af27d2739f40f1b96ba9a8a.jpg"
] | {
"A": "L4-L5",
"B": "L3-L4",
"C": "T12-L1",
"D": "L2-L3",
"E": "L5-S1"
} | A | Preoperative sagittal image of lumbar spine before CMIS correction with hyperlordotic cages. |
29c778216169200b3cd1bcab2675f3852319f13c9a8b72669718453d1ff9ab97 | A contrast-enhanced angiographic reconstruction of the abdomen is shown in lateral projection. What is the most conspicuous vascular abnormality visible in this image? | [
"images/57/575641a80cf76df6e08acdb4553f77a1c39278eefea276967a23f0b9d429a729.jpg"
] | {
"A": "Fusiform aneurysmal dilatation of the infrarenal abdominal aorta",
"B": "Dissection flap within the descending thoracic aorta",
"C": "Complete occlusion of the iliac bifurcation",
"D": "Diffuse calcific ectasia of the abdominal aorta",
"E": "Focal narrowing of the abdominal aorta"
} | E | MRA abdomen showing narrowed abdominal aorta
MRA: Magnetic resonance angiography |
c9941dc017761c42dc88045bac3e15e7a39bdb86006f31504af4a61675a65b07 | What is the most appropriate imaging-plane and side description for this study based on the visualized orbital anatomy? | [
"images/1e/1ee172da3eac38e188cc6bad8c5be0f27461dba062aff6df8aaefffae39164d4.jpg"
] | {
"A": "Vertically oriented B-mode echography of the left orbit",
"B": "Coronal MRI of the right orbit",
"C": "Horizontally oriented B-mode echography of the right orbit",
"D": "Axial CT scan of the left orbit"
} | A |
Vertically oriented B-mode echography of the left orbit revealed dilation of the superior orbital vein, seen in cross section above the optic nerve and below the superior rectus.
|
fabc1d3957cf61b0c422bbe92ca6d2d2236f674daa8ab2b2b184a2deb372dfaa | What material is being placed in panel D during the reconstruction? | [
"images/ea/eaf0d27310daf39945108a97af9f7c6bfa4b154ae78169663ec202fd596d3f4e.jpg"
] | {
"A": "Gauze packing",
"B": "Lobulated fat graft",
"C": "Absorbable hemostatic material",
"D": "Vascularized nasoseptal mucosal flap",
"E": "Nasal septal bone flap",
"F": "Synthetic dural substitute"
} | B | Changes in reconstruction strategy/(after) [(C) harvest of nasal septum bone flap; (D–G) process of reconstruction]. (A,B) MRI enhanced in sellar region before operation, and craniopharyngioma was considered before operation. (C) Separation of nasal septum bone flap. (D) Subdural fat packing. (E) Repair of skull base b... |
731c6ae77356f8ed37845f2287b2f4a34f8c0c42e3cf6dbfee4d6095a86ee864 | On the lateral upper airway image, which radiographic sign is best demonstrated by the enlarged soft-tissue structure posterior to the tongue base? | [
"images/f7/f752fdf92f38facec08fbf70ed3ee37bf9b76c9c55b5bb74e8485d8f320f65e3.jpg"
] | {
"A": "Thumb sign",
"B": "Steeple sign",
"C": "Double-arc sign",
"D": "Sail sign"
} | A | (A and B) Swollen epiglottis, termed as ‘thumb sign’ (A and B; arrow), and narrowed vallecula (A and B; arrow head), are consistent with acute epiglottitis. |
846f9e82763c2b225a9beb374e001d2072f61a9fcc1930a59364fc36cb49b3b4 | On the pretreatment images, the abnormality indicated by the arrows is primarily located in which anatomic structure? | [
"images/4c/4cd423883826fd9129a16c180cd2847b0ab2085005457b8cfeea9dca2a254393.jpg"
] | {
"A": "Left inferior pubic ramus",
"B": "Right superior pubic ramus",
"C": "Left acetabular roof",
"D": "Pubic symphysis midline fibrocartilage"
} | A | Axial slice through the pelvis before (
A, C
) and after (
B, D
) androgen deprivation therapy. In (
A, C
), there is restricted diffusion and enhancement (
A
,
arrow
) and edema on T2 (
C
,
arrow
) in the left inferior pubic ramus lesion. In (
B, D
), there is a resolution of the restricted diffusion and enhancement (... |
b7d7f416d111109487019ce14a3d4a6a4f5b7819d446d263e52c0aa0c487e3a7 | Which pair of vertebrae marks the superior and inferior limits of the curved spinal segment being measured in the figure? | [
"images/f1/f17c38cf86d35ecf9d168f2a5e518111a7136e0ce7981d1c246a631d90921888.jpg"
] | {
"A": "A and C",
"B": "B and D",
"C": "A and D",
"D": "B and C"
} | D | Cobb Angle Calculation in the Sagittal Spine. α represents the Cobb Angle. The curved segment has B as its top vertebra and C as its bottom vertebra. Vertebra B’s superior surface tilts to the side of the concavity of the curve, while vertebra A’s inferior surface tilts to the convexity side. The intervertebral space b... |
340c11de706b3a781f571fd50f85148e4c860572e96941df2d918d4584e0a08a | How are the margins of the arrowed finding in panel B best characterized? | [
"images/42/423f7eaf573a16f9a12f5d634cb0da6afeb07e80c24932f9fbd5fdf30a147e00.jpg"
] | {
"A": "Circumscribed",
"B": "Smooth and encapsulated",
"C": "Spiculated",
"D": "Microlobulated",
"E": "Angular",
"F": "Indistinct"
} | F | (Patient No. 8) A 42 -year-old woman with a palpable mass in the right breast and group 3 DCIS of Van Nuys classification. (A) Right mammography shows no detectable lesion. (B) Transverse scan of US demonstrates an indistinct marginated, oval shaped, hypoechoic mass (arrows) in the lower mid portion of right breast, pa... |
8bb18aea3b5c83f063ede5c3123df7d2b9a06a03b33d263a1b1e0f07b500ab0e | The lower histopathology panels best support which combination of vascular marker findings for this lesion? | [
"images/5e/5e8ac00b62b9914c67149c879e7a5c799419a1bf42ba8b5362867e3ff640b2bc.jpg"
] | {
"A": "Prominent lymphatic channels with strong D2-40 and VEGF positivity",
"B": "Scant mature microvessels on CD34 staining with negative VEGF expression",
"C": "Diffuse dense neovascularity on CD34 staining with strong VEGF overexpression",
"D": "Absent CD34-positive vessels with intense membranous EGFR stai... | B | (A-H) Tuberculoma found in apical segment of superior lobe of the right lung of a 39-year-old female. (A) Time density curve. (B-F) (original image, BF, BV, MTT, PS) typeI parametric maps, PS value was lower (6.81). (G) CD34 staining shows a few of more mature microvessels (× 200). (H) VEGF expression is negative (× 40... |
2b50ab39b755f81cd74a95bc3c07f38a6b7ccdac9537a12a7a9c6f10b04e53a4 | This postoperative foot image most clearly shows absence of which digits? | [
"images/18/187b28708022ceee28902229e1ed22c395536d7d97ab07b771336f74ba03de05.jpg"
] | {
"A": "Right second through fourth toes",
"B": "Right third through fifth toes",
"C": "Right first through third toes",
"D": "Right first and second toes only",
"E": "Left first through third toes"
} | C | Despite amputation of the right first to third toes and repeated surgical debridement, the wound demonstrated delayed healing. |
b5745f6d594d77b9376afd826fe2076b0fd871a8cd05b03fb657029c6b7aacb9 | Which gross pathologic pattern is most clearly demonstrated in this pancreatic specimen? | [
"images/2e/2ef176ba980b5d199516c897149814eb5d95df5d5232c7cfce7b57e011ee0cfa.jpg"
] | {
"A": "Multiple cystic lesions scattered through the pancreas",
"B": "Diffuse hemorrhagic necrosis without focal lesions",
"C": "A calcified stone obstructing the main pancreatic duct",
"D": "A solitary well-circumscribed solid pancreatic mass"
} | A | Gross findings of multiple cyst lesions in the pancreas. |
536685c9812abda04a0417edb23689404704235a6249008a5cc92e0a37c781b5 | The white open ring-like structures seen within the darker stained dentin most likely represent which of the following? | [
"images/ad/ad122286a8345ba79b4555030d46fc2698a71fbc74eeb87502aabe156bd30777.jpg"
] | {
"A": "Enamel tufts crossing into dentin from the crown surface",
"B": "Pulp horn extensions filled directly with pressurized tracer",
"C": "Sectioning artifacts caused by loss of the entire dentin matrix",
"D": "Impermeable dentin regions that resist penetration by the blue dye",
"E": "Areas of maximal dye ... | D | Photograph (pattern) of a molar section obtained using the ion diffusion method.33 A liquid containing dark blue dye was introduced into the pulp chamber under pressure. Dark areas of dentin in the region of the tubercles (above the pulp horns) are significantly more permeable than the superficial (unstained) dentin in... |
4aa952d9baa50e1b5c1a075fa08d4447706d5937d1ee0685d466e18eb088ae64 | What is the principal abnormality demonstrated on this fused PET-CT image? | [
"images/3d/3daac2da90e57b30593383e2a410f182d297fe9e671d8003f9d29c80e4240a07.jpg"
] | {
"A": "Large pleural effusion with compressive atelectasis",
"B": "Hypermetabolic mediastinal lymph node conglomerate without lung lesions",
"C": "Multiple moderately FDG-avid pulmonary nodules",
"D": "Diffuse bilateral ground-glass pulmonary opacity"
} | C | A PET-CT revealed multiple moderately hypermetabolic pulmonary nodules in the upper lobes, predominantly of both lungs (solid yellow arrow).
PET-CT: positron emission tomography-computed tomography |
5ab645e866a8ad7df0f09e429aefa9c1bff132812a5f7a05727b381588416650 | In the transesophageal echocardiographic panel, which pair most specifically demonstrates lead-related tricuspid regurgitation by showing an intracardiac device lead crossing the tricuspid valve, with the corresponding color Doppler jet in the adjacent image? | [
"images/df/df91ad66092c5d642acb9b2d5cd07fd386ed5f132e009033190b13713318c0e5.jpg"
] | {
"A": "A and B",
"B": "E and F",
"C": "C and D",
"D": "G and H"
} | D | Causes of tricuspid regurgitation according to sex. Transesophageal echocardiogram—mid-esophageal views: (A): Rheumatic tricuspid regurgitation. (B): Rheumatic tricuspid regurgitation with color Doppler. (C): Atrial secondary tricuspid regurgitation. (D): Atrial secondary tricuspid regurgitation with color Doppler. (E)... |
d77907afada491aefc54b933bb8a0f7c6bda52fce62857240a9099fd2afc1b57 | What is the approximate frontal-plane QRS axis? | [
"images/e5/e5507b9d71d7acb9b406fdf3c6b38c549dbee1836094c76f7746c5ba305c0b93.jpg"
] | {
"A": "Left axis deviation",
"B": "Indeterminate because all limb-lead QRS complexes are isoelectric",
"C": "Extreme axis deviation",
"D": "Indeterminate because of ventricular pacing",
"E": "Right axis deviation",
"F": "Normal axis"
} | F | Electrocardiogram 6 h after the angina, recorded at the secondary hospital. Sinus rhythm, no ST-T changes, no q wave detected. |
9fbd876eef4e98011affd365813481ad88a69b91bffef4174531ff3fc8d573ba | In panel B, what abnormality is indicated by the arrow? | [
"images/a0/a0737fd0f60bdceaf218af822474007b86d74826251cfa8b0cede8f3b7c0b516.jpg"
] | {
"A": "Diffuse thinning of the left ventricular myocardium",
"B": "A defect in the interventricular septum",
"C": "Circumferential fluid around the heart",
"D": "A mass within the left ventricular cavity",
"E": "Asymmetric thickening of the left ventricular myocardium",
"F": "Marked dilation of the left ve... | E | Cardiac magnetic resonance features of different cardiomyopathies. (A) Dilated cardiomyopathy: left ventricle (LV) dilation with thinning of the ventricular walls. (B) Hypertrophic cardiomyopathy: non-dilated LV with asymmetric hypertrophy (arrow). (C) Arrhythmogenic right ventricular (RV) cardiomyopathy: dilation and ... |
4ea3724359fc9ca4cf5fc6c16fbc4f244c1862b68b27a3ab3e5200ea68122a86 | In this operative lower-extremity photograph, which limb demonstrates the more severe destructive soft-tissue injury associated with external fixation hardware? | [
"images/4b/4b271d4fb0b316f4150bc211c4122daa5b92e144795aa5e097852682fab16905.jpg"
] | {
"A": "Right lower limb",
"B": "Both lower limbs are equally injured",
"C": "Neither limb shows major soft-tissue destruction",
"D": "Left lower limb"
} | A | 采用右下肢截肢后废弃肢体制成的组织瓣修复例2患者右下肢毁损性创面的效果。2A.入院时，双侧下肢可见大面积毁损；2B.双侧下肢清创+右下肢骨折外固定术后；2C.右下肢清创后可见右大腿下段以远毁损严重；2D.右下肢截肢前，保留胫前血管及残余皮肤软组织；2E.术中右下肢截肢后肢体近端创面缺损大，并根据右下肢截肢后肢体近端创面大小设计右下肢废弃肢体制成的带蒂组织瓣；2F.术中将组织瓣翻转覆盖于创面后即刻；2G.术后2个月，右下肢组织瓣存活良好；2H.术后2个月，左下肢（正面观）恢复可；2I.术后6个月，双侧下肢（背面观）恢复可
Effects of using tissue flap prepared from the discarded ... |
3733e60520186a26edb9bfb8c13132ff3d2f6e114cfd0c267d403f019424440f | Which digit shows the most evident residual color change compared with the others, despite overall healing? | [
"images/66/6687707f0a085e2e8880046a5a59494451937faf562ab62b5382ecc796aef357.jpg"
] | {
"A": "Little finger",
"B": "Ring finger",
"C": "Middle finger",
"D": "Thumb",
"E": "Index finger"
} | C | Three weeks after necrosectomy—completely healed. |
b9a9c67587a3a78ccd1861f6a5cba18fdc192e469e03f068a9910f5a3dc9cde6 | Which carpal bone is indicated by the white arrowheads in panel C? | [
"images/6f/6f7de90a24130978348b8fbd7e4adb9ea434bf9c548639957db7d2c1dcc73b14.jpg"
] | {
"A": "Triquetrum",
"B": "Trapezium",
"C": "Hamate",
"D": "Scaphoid",
"E": "Capitate",
"F": "Lunate"
} | F | A 28-year-old male patient presented with dorsal wrist pain for eight months. (A) Frontal radiograph of the wrist shows mixed lytic and sclerotic changes in the lunate bone (arrowheads), predominantly at the proximal ulnar aspect of the lunate. (B) Reformatted coronal CT image shows lytic change in the proximal lunate ... |
5c147b2ebe57a073c3a30d0e5bf462d36add5821436bbe6c8a851c9173af4b1c | In this set of mammograms, which panel demonstrates the highest BI-RADS breast density category? | [
"images/4c/4c49c46901f0290b06ab2ba20cff713e4d64501fdcfcfc657b2e80737aa26d58.jpg"
] | {
"A": "Panel (d)",
"B": "Panel (b)",
"C": "Panel (a)",
"D": "Panel (c)"
} | A | MD as assessed by BI-RADS is a qualitative imaging biomarker, as it is visually assessed by physicians. These images show breasts classified by density under BI-RADS as (a) almost entirely fatty, (b) scattered areas of fibroglandular density, (c) heterogeneously dense, and (d) extremely dense. |
761f9af1457e48cbf7499497af68007a9c171231fbf0a981645cfa547f1a5a29 | The follow-up image on the right is most consistent with which interval change compared with the initial study? | [
"images/f8/f86a0c8e266ddb4d83ef564206f91218567a4b18094fc278b0396c05d0999bbf.jpg"
] | {
"A": "Complete radiologic resolution of the previously seen adrenal lesions",
"B": "New bilateral renal masses replacing the adrenal abnormalities",
"C": "Progressive enlargement of the left adrenal lesion only",
"D": "Persistent bilateral adrenal masses with central necrosis"
} | A | (a) CT scan revealed a hyperechoic mass measuring 52 × 45 mm in the anatomical position of the right adrenal gland and a similar but smaller solid lesion measuring 29 × 20 mm in the left adrenal gland. (b) Follow up MRI showed no residual masses. |
248505eb83340b84ac02d03640a8acc979a405aa357093361f63820caf623f54 | Which specific digits are visually shown as mechanically linked during the maneuver? | [
"images/1c/1cde78850a6f99cd63dddddf287885d36f9b4f10fb5a7a04fa071e508ba92c39.jpg"
] | {
"A": "Thumb and ring finger",
"B": "Thumb and little finger",
"C": "Index and ring finger",
"D": "Index and middle finger",
"E": "Thumb and middle finger",
"F": "Thumb and index finger",
"G": "Middle and ring finger",
"H": "Ring and little finger"
} | F | The Linburg-Comstock anomaly results in the inability to flex the distal joint of the thumb without also flexing the distal joint of the index finger. |
4701550f57852c355da2886260d9ab12de90c0b9db45f62b7912b1c9a1b8b7f4 | On this I-123 MIBG study, which interpretation best matches the visualized tracer distribution? | [
"images/6c/6c2dda5e1320a38efa93283df6d5f580c483b8ac45d28c7d27cad7a6f3874321.jpg"
] | {
"A": "Intense focal adrenal uptake consistent with pheochromocytoma",
"B": "Multiple MIBG-avid hepatic metastases",
"C": "Diffuse skeletal uptake indicating widespread osseous metastases",
"D": "Negative examination with only physiologic uptake in the liver and urinary collecting system"
} | D | Iodine-123 meta-iodobenzylguanidine scan showing no abnormal uptake (negative scan). Note is made of physiological uptake in the liver and renal collecting system. |
3ebb4c8a33e3526b93fe14e10a7b9c94532580b153531d5a9a8584b4b85365a1 | What tendon finding is indicated by the red arrows in panel D? | [
"images/b0/b09fb7fafb82257cb580ce8eab3fcfa2f2f3a54c01889ea655ca039690b0ae66.jpg"
] | {
"A": "Complete patellar tendon rupture",
"B": "Recurrent full-thickness quadriceps tendon gap",
"C": "Continuous quadriceps tendon at its patellar attachment",
"D": "Lateral meniscal extrusion",
"E": "Tear of the posterior cruciate ligament",
"F": "Displaced patellar fracture fragment"
} | C | A case study of a 28-year-old male with a QT tear. Section A shows the medial-weighted MR image without fat saturation and Section B with fat saturation at the osseotendinous junction (red arrows). The blue arrows show a partial tear occurring at the proximal patellar tendon. This patient was subjected to surgical trea... |
b1b842ff6916e770a815ed33149bf0d9ea04fc801bb94f56ec2f86f5b0d70dca | What posterior acoustic feature is most apparent deep to the lesion in panel A? | [
"images/59/590c3a446c961e227acebaae58b86edd6d49e65dc8ac358659900367253fc943.jpg"
] | {
"A": "Comet-tail artifact",
"B": "Mirror-image artifact",
"C": "Posterior acoustic enhancement",
"D": "Posterior acoustic shadowing",
"E": "Reverberation artifact",
"F": "Edge shadowing across the entire lesion width"
} | C | The findings of ultrasound sonography and MRI scanning at surgery, or gross and microscopic examination of the resected intraductal fibroadenoma specimen. (A) Ultrasound sonography demonstrated an intracystic well-circumscribed tumour lesion, measuring 22.5 × 21.5 × 11.3 mm in diameter, consisted of a homogeneously sol... |
19f8db3ce971d471d7c6b8c50286693b67c6eee906e41f6324b465dec3ed38a1 | What is the most evident mass effect on the axial brain image in panel (e)? | [
"images/ff/fff527da32c347a65ee562230de1a07b6eb6333e36c3239eff7c6d253125c0af.jpg"
] | {
"A": "Displacement of the ventricular midline structures toward the left",
"B": "Displacement of the ventricular midline structures toward the right",
"C": "Downward displacement of the cerebellar tonsils",
"D": "Bilateral widening of the cerebral sulci",
"E": "Symmetric enlargement of both lateral ventricl... | A | (a) Right eye showing a hazy vitreous humor. (b) Left eye showing an intense inflammation of the anterior chamber, with corneal precipitates. (c) Echographic examination of the vitreous in the right eye. (d) UBM examination of the ciliary body showing vitreous membranes adherent to the pars plana. (e) MR image showing ... |
41d89484d0363b8f8207b48d3703e690eb606c261cf43c183672e7723a90c37b | Which examination maneuver most directly assesses the stabilizing function of the arrowed structure at the thumb metacarpophalangeal joint? | [
"images/cd/cd3f442734abbca3ae8711cfdc79bc9f117276a8b76bf2a24c92409a68af4b33.jpg"
] | {
"A": "Valgus stress testing",
"B": "Active interphalangeal extension against resistance",
"C": "Resisted thumb opposition",
"D": "Varus stress testing",
"E": "Active interphalangeal flexion against resistance",
"F": "Axial compression testing"
} | A | Normal ulnar collateral ligament in the left thumb of a 26-year-old healthy male volunteer. (a) Coronal T1-weighted image, (b) coronal PD FS weighted image, (c) axial T1-weighted image, (d) axial PD FS weighted image showed the homogeneously low-signal intensity of the UCL (arrows). UCL: Ulnar collateral ligament; PD F... |
31870115bf458087ac44264ee0db47eda1b3aa30decfcd354e62a4b64749af99 | Which additional soft-tissue abnormality is visible on the MRI in this severely damaged right shoulder? | [
"images/7f/7f7cd8751bc10074c72745ffb18a10be31fd867165734bb521a12252bad7c2f2.jpg"
] | {
"A": "Rotator cuff tear",
"B": "Isolated acromioclavicular joint separation",
"C": "Biceps tendon dislocation into the joint",
"D": "Labral cyst in the spinoglenoid notch"
} | A | Case 1. Imaging of the right shoulder 4 months after the first visit. (a) An axial computed tomography view demonstrates a destroyed humeral head, displaced bony fragments outside of the greater tuberosity, and destruction of the glenoid. (b) T2-weighted magnetic resonance image (oblique coronal plane) shows the joint ... |
c68f2dbd1fb6ec91db118357e7fdb20bab81642b4f03df42fd88c4ed2039f904 | A gross surgical pathology specimen of colon is shown. Which description best matches the dominant mucosal abnormality visible throughout much of the specimen? | [
"images/68/683a441b6d22f252d7aa2b1dd00b8a708d6785d2c653864b4684c9b52a0406f6.jpg"
] | {
"A": "Diffuse carpeting of innumerable polypoid lesions involving the colonic mucosa",
"B": "Multiple diverticular outpouchings concentrated in the sigmoid colon",
"C": "Segmental transmural fissuring with cobblestoning and skip areas",
"D": "Continuous shallow ulceration with pseudopolyps limited to the rect... | A | Total colectomy specimen demonstrating caecum and ascending colon (below) and descending colon above carpeted with polyps with site of previous anastomosis at centre (above) |
6094b409314f31087f875e120cc20c73af41df484415bc4deff67bbb4788f487 | Which radiographic finding is best shown in panels (a) and (d), before fixation? | [
"images/6f/6f0cea8b587fd8ba15a6f477be714e566baa37ac31095a5ca5539f32004044e5.jpg"
] | {
"A": "Intra-articular fracture of the radial head and proximal ulna",
"B": "Carpal fracture-dislocation without a forearm fracture",
"C": "Displaced distal radial metaphyseal fracture with associated distal ulnar fracture",
"D": "Isolated fracture of the radial shaft with intact distal ulna",
"E": "Transver... | C | X-radiographs from a 14-year-old male with a left-arm distal radial fracture treated by intramedullary nail fixation. Anterior–posterior view (A) before, (B) immediately after, and (C) 6 months after fixation. Lateral view (D) before, (E) immediately after, and (F) 6 months after fixation. |
0b1822fcfda1340229a7b9b293efba0f1c6be04f22de3415ce635507e0465441 | A young trauma patient undergoes multimodality imaging of the thoracic spine. Based on the images, which vertebral level demonstrates the principal injury pattern consisting of anterior wedging on radiograph with a crush fracture and posterior element disruption on CT? | [
"images/48/48c9c58d83b4494d5e050d2cd6fda1b607683e4abeebede82eed513e1a4af906.jpg"
] | {
"A": "T12",
"B": "T6",
"C": "T4",
"D": "T8",
"E": "T10"
} | D | 24 year old male, mountain bike accident. Lumbar and thoracic spine radiographs were obtained and show a T8 fracture with anterior wedging (figure a, lateral radiograph T-spine). CT was performed for further characterisation, a crush fracture of the vertebral body and disruption of the posterior elements was seen (figu... |
a2ea4d64d98f2034433bd3663e739abe6b62e695f69e72157582cd988bf59dd2 | On the multiplanar CT sections, the residual abnormality remaining after surgery is most accurately characterized as which of the following? | [
"images/08/08ddbd8b7f12b71748ca56620863e124bf349a625474930d1426c6aa822faa2c.jpg"
] | {
"A": "A sharply marginated cystic radiolucency causing cortical ballooning",
"B": "A gas-containing cavity within the mandibular marrow space",
"C": "A destructive permeative lesion with cortical breakthrough and soft-tissue mass",
"D": "A diffuse radiopaque sclerotic focus confluent with the native mandibula... | D | Sagittal, coronal and axial sections of Postoperative NCCT Images, showing successful excision and removal of the exophytic bony mass from the lingual aspect of the left angle and body region of mandible. Residual sclerotic bone is evident within the substance of the mandible as a diffuse radiopacity, where the remaini... |
4030a312472e8068cfb61a953fcd863c1789fe1abf84e8ecd2e3e34fa0b90906 | Which imaging finding on the CT portion most likely explains the tendon abnormality seen on MRI? | [
"images/3f/3f65047d0a2564c5c38864f9e70c4b72810f298286e81d2d1bc500439aeab033.jpg"
] | {
"A": "Intra-articular screw penetration into the radiocarpal joint",
"B": "Ulnar styloid nonunion",
"C": "Loss of fracture reduction with dorsal angulation",
"D": "Nonunion of the distal radius",
"E": "Malunion with radial shortening",
"F": "Scapholunate dissociation",
"G": "Volar prominence of the dist... | G |
During surgery, the fracture was anatomically reduced with the plate placed appropriately, although the pronator quadratus was left unrepaired. Since then, she noticed that her right thumb did not move either actively or passively, which was conservatively observed by her attending doctor. One month later, she suddenl... |
900e29109ebf42aea25110a72a5511f3c41c50631331e8ef2eaef13bb204977c | On this endoscopic airway image, where is the lesion most accurately located? | [
"images/00/00afd2833464b4eda14074f47fab0769e6cb4451148c43f8e804c244850fbeca.jpg"
] | {
"A": "At the posterior nasopharyngeal wall",
"B": "On the right true vocal fold",
"C": "Along the left aryepiglottic fold",
"D": "Midline in the subglottic airway"
} | D | On endoscopic examination, a round, well-demarcated lesion was noted midline at the level of the subglottis. The lesion was covered by dilated vessels. |
152cecb834b10a782025a2a554e484459c3da11178c412a7ef3e3e0e97480eb0 | Based on the multimodal ophthalmic images, which laterality and structure are abnormal? | [
"images/ff/ffd94bdf235b6c42b11cf1c8050f3f09e9309b70521b24fa70c25a1cb28748b7.jpg"
] | {
"A": "Left eye fovea",
"B": "Left eye optic disc",
"C": "Bilateral retinal periphery",
"D": "Right eye macula",
"E": "Right eye optic disc"
} | B | Initial fundus examination. Left: normal posterior pole of the right eye. Middle: edematous papilla in the left eye and vitreous opacities. Right: OCT image showing optic disc edema. |
449461324ef58633c89fe2338712177dd1f415fdf9491ae930903d4538f1fc2a | On these serial axial MR images of the face, which structure demonstrates the bilateral abnormality indicated by the arrows? | [
"images/8b/8b15afc9728f35878cb02cefba12a4373d7458556bc5e6e6421d88d5b1f58f54.jpg"
] | {
"A": "Medial pterygoid muscle",
"B": "Parotid duct",
"C": "Buccinator muscle",
"D": "Platysma muscle",
"E": "Masseteric aponeurosis",
"F": "Temporalis tendon"
} | E | Axial MR images show elongated and thickened aponeurosis on the anterior surface (arrows) and inside of both masseter muscles. (A) A section at one-third from the inferior border of zygomatic arch. (B) A section about one half from the lower border of zygomatic arch. (C) A section about three-fourths from the lower bor... |
daef17260ece2faacf0f973c1f5511ba857a6267ea96863ab79991a5a4cad9ad | A crying neonate demonstrates lower facial asymmetry with the angle of the mouth pulled toward the left side, while the remainder of the face appears relatively symmetric. Which side most likely has weakness of the depressor anguli oris muscle? | [
"images/80/80604fd28534eb3e039019652a07347ccf80d05ba1ed57c34a1f2edddb3df0ee.jpg"
] | {
"A": "Right side",
"B": "Bilateral weakness",
"C": "No true weakness is present",
"D": "Left upper face only",
"E": "Left side"
} | A | Asymmetry of Face With Deviation of Mouth Toward Left When the Neonate is Crying |
500cc02ceaa31947aed958c7d660b5718bd5cbf7782a85fa72c9b2ea5a0cc011 | Which of the following best describes the dominant abnormality on this abdominal ultrasound image? | [
"images/1b/1b060486dc50fe0c428a886c3d384a93b36f13e4f46917eabb85e86f62820e3a.jpg"
] | {
"A": "Diffuse pneumoperitoneum with reverberation artifact",
"B": "Multiple septated intraperitoneal fluid collections",
"C": "A solitary simple cyst with posterior acoustic enhancement",
"D": "Solid hypervascular mesenteric mass"
} | B | Ultrasound showing multiloculated intraperitoneal collections. |
85745ee86ef17e3a625dc650d25b59814e18c2d00c67fc32c7483026c6063845 | Which diagnosis is most strongly supported by the combined sagittal and axial MRI appearance? | [
"images/1a/1a59b87883ccff367e917521fab52d5c26cd4a7826dbee953136f01a1f6ab2ab.jpg"
] | {
"A": "Massive L5/S1 disc herniation causing cauda equina compression",
"B": "Epidural abscess centered in the posterior epidural space",
"C": "Degenerative facet arthropathy causing isolated foraminal stenosis",
"D": "Intradural extramedullary tumor at the conus medullaris",
"E": "Lumbar spondylolysis witho... | A | MRI scan example of a disc herniation causing cauda equina compression. The sagittal image on the left shows a large posterior disc herniation at L5/S1 level, and the axial scan on the right at the L5/S1 level shows that the disc herniation fills almost the entire spinal canal, and compresses the cauda equina |
edc1f9e6063a74642687506db15ef9cce2b32c72ea088cd1dfdfe4c189fe8a3d | On the follow-up cervical imaging, which postoperative abnormality is most clearly demonstrated and best explains the planned revision procedure? | [
"images/a1/a1f80ab32338f4aedbb852a795ea2152336877c43c9dc0b5f14f453df3dd2c06.jpg"
] | {
"A": "Diffuse ossification of the posterior longitudinal ligament",
"B": "Right C5-6 intervertebral foraminal narrowing",
"C": "Severe central canal stenosis at C4-5 with cord compression",
"D": "Left C6-7 facet dislocation",
"E": "Atlantoaxial instability with odontoid migration"
} | B | Patient’s conditions 4 months after operation. A-F: The patient reported aggravated numbness and asthenia of both upper limbs; medical examination showed hypermyotonia of the four limbs, right upper limb muscle strength at level IV, left upper limb muscle strength at level III, bilateral lower limb muscle strengths at ... |
577b6a186897c71327340bad13aa5ff5361f4f7d9862e171c2a8a07308f02a53 | In panels d and e, where is the greatest mismatch between the overlaid prostate contours? | [
"images/d4/d442e79e9b0d0e73cf57d806c2826236f36dff8fed1047a95074f98f636d6737.jpg"
] | {
"A": "Anterior boundary",
"B": "The entire boundary equally",
"C": "Right lateral boundary",
"D": "There is no appreciable boundary mismatch",
"E": "Left lateral boundary",
"F": "Posterior boundary"
} | F | Distortion mismatch on anatomical images. 69 year-old patient on active surveillance with MRI showing no distortion on T2 (a) compared to diffusion-weighted imaging ADC maps (b); note collapsed rectum. (d,e) 68 year-old patient on active surveillance, ADC maps (e) show posterior distortion with warping compared to T2 i... |
939c522a9331b9e66df9462eb8fc2f10af015e393df3984661df18b1977d50cb | In panel C, where is the arrowed pigmented ring located? | [
"images/3e/3e9a55e51815e74869f4191b9c7288d36af70292fd43f092b38c016d8ab3e5e9.jpg"
] | {
"A": "Peripheral cornea",
"B": "Iris",
"C": "Conjunctiva",
"D": "Central cornea",
"E": "Lens",
"F": "Sclera"
} | A | Wilson's disease. Brain MRI T2‐weighted images demonstrating the classic “double panda” sign: (A) Giant panda sign (B) Miniature panda. (C) Kayser‐Fleischer (KF) ring which occurs due to deposition of copper in Descemet's membrane. (D) Classic Wilson's face is shown which is characterized by a facetious smile, pseudo‐l... |
ef34538c6bb31ad80cbbc4b06cd1764f6f902a686f979a176ff5b00c402eb404 | Among the first three location-model images, which predicted vertebral level is shown in panel (b)? | [
"images/de/de11c67d9b950fda9487e55168047d9c7c30f5b63d9e7401b1d46e87bb3ed7bc.jpg"
] | {
"A": "L3-L4",
"B": "L2-L3",
"C": "L4-L5",
"D": "L5-S1"
} | C | Grad-CAM visualizations produced for predicting a real case of LDH: a location model (predicted class: L3-L4), b location model (predicted class: L4-L5), c location model (predicted class: L5-S1), d classification model (predicted class: normal), e classification model (predicted class: bulge), and f classification mod... |
b735ec3bd61570070ecf6d3918c93a879e6809793e46acc5c5b0d4a649af0256 | Which diagnosis is best supported by the visual pattern of nonpitting, thickened, elephantiasic skin of the right foot with improvement on follow-up? | [
"images/92/926b8a246804baf20f095fdc59a67a1182f9c35b92d391cf9e61870731b214b8.jpg"
] | {
"A": "Lymphedema from filariasis",
"B": "Diabetic Charcot arthropathy",
"C": "Chronic venous stasis ulceration",
"D": "Graves dermopathy with pretibial myxedema",
"E": "Acute gouty arthritis of the first metatarsophalangeal joint"
} | D | Clinical appearance of Graves dermopathy in the right foot before and after combined immunosuppressive therapy.
Top. The right foot before initiation of combined immunosuppressive therapy shows significant dermopathy and elephantiasis. The arrows point to areas that were most involved. Bottom. After 12 months of combin... |
9223570dfbe6b05811df3cd2885448641eb4b7b2c6550242f178092cd9a2063b | Which imaging-plane combination is demonstrated across the three panels of this spinal study? | [
"images/0e/0eba241adc8522e3fcac38823eebba0468b46b4e1236b7eaf90d6e063405181d.jpg"
] | {
"A": "All three images are coronal views",
"B": "Two coronal views and one sagittal view",
"C": "Two axial views and one coronal view",
"D": "One sagittal view and two coronal views",
"E": "Two sagittal views and one axial view",
"F": "Three axial views at different vertebral levels",
"G": "One axial vi... | E | Vertebral hemangiomas (a,b) sagittal view, (c) axial view |
5cfc7dc8652df04acfb91dc1e7bbb8d5b546d37bb14fa84b2b86519919ffef65 | Which gross description best matches the external surface of this ovarian mass? | [
"images/c5/c5ef6da1fdd7cdc0c0b1893f645b43bc8467f83c4b58cc300af6c81ec30e8e8b.jpg"
] | {
"A": "Smooth gray-white surface without papillary excrescences",
"B": "Multiloculated cystic surface with numerous papillary fronds",
"C": "Friable yellow-green surface covered by purulent exudate",
"D": "Irregular black hemorrhagic surface with necrotic debris"
} | A | Gross finding of ovarian mass measuring 21.5×15×10. The exterior surface of the ovary had a smooth grey-white appearance without papillations. |
59004505242622588c27ea70a46080b03989172ee02c636d213942ea482469ee | Which adjacent pelvic organ is still directly invaded by the rectal malignancy after chemoradiotherapy, as seen on the T2-weighted images? | [
"images/cf/cf72c87f312d6b18aacd2beeacb7e8892a81acf2b82d5b2156254a473bdb6201.jpg"
] | {
"A": "Iliac bone",
"B": "Sigmoid colon",
"C": "Urinary bladder",
"D": "Uterus",
"E": "Vagina",
"F": "Prostate",
"G": "Seminal vesicle"
} | C | In (a and b), the primary tumor is delineated with a dotted line: a proximal rectal cancer massive extramural growth with EMVI (arrowhead in a) and invasion of the bladder (black arrow in a). After CRT on T2-weighted images (c, d), there is a decrease in volume, but obvious residual tumor is visible, still invading the... |
e35edffbe89913d8e88bf814bb7b54e5871a72a2cd68b30bf2e4f3420362c7d5 | What is the predominant distribution of the pulmonary opacities in radiograph a? | [
"images/e4/e4fcbc086f239dfe56063f50e96eff14e8b2633e8aecbc3a9f0568dbdf00e718.jpg"
] | {
"A": "Bilateral, multifocal air-space opacities",
"B": "Bilateral pleural-based nodules",
"C": "Isolated left lower-lobe opacity",
"D": "Isolated right apical opacity",
"E": "A solitary perihilar mass",
"F": "Unilateral, diffuse air-space opacity"
} | A | A 30-year-old woman with a history of melanoma undergoing HDIL-2 therapy presented with dyspnea. Chest radiograph (a) shows bilateral diffuse air-space opacities. Bilateral costophrenic angles are spared. Axial chest CT image (b) demonstrates bilateral ground-glass opacities and air bronchograms (arrows). The heart is ... |
6930f4a06132e1553ad8254e8795a5fbcb13dad97f05936fdbe01c45f98b3b7a | On the orbital MRI, which diagnosis is most strongly supported by the appearance of a poorly circumscribed serpentine mass involving the right conal-extraconal and preseptal spaces, with associated remodeling abnormalities of the ipsilateral sphenoid wing? | [
"images/91/917f5592dd2fdafa981edc33d68397c12a40c10d9a62b145a8a6a9390dc114cf.jpg"
] | {
"A": "Right orbital cellulitis with subperiosteal abscess",
"B": "Right orbital optic pathway plexiform neurofibroma",
"C": "Right optic nerve sheath meningioma",
"D": "Left orbital venolymphatic malformation",
"E": "Right cavernous hemangioma"
} | B | 28-year-old female patient with NF-1. MRI was performed for pre-surgical planning. Coronal STIR (a) and axial T2W (b) images show poorly circumscribed, serpentine masses (asterisks) within the right orbital conal-extraconal and preseptal compartments. Findings are typical of an OPNF. There is associated dural ectasia o... |
2622094b726d828411927fb37e4248b5d0ef184854ba131bb56903ec5cefddc1 | Which spinal region is predominantly involved by the arrow-marked lesions across the four displayed MR images? | [
"images/90/900b9c75ee59e5042debfcc4f583bc6a62697f07f0419c53e9b9adeb61d994eb.jpg"
] | {
"A": "Conus medullaris exclusively",
"B": "Cervical spinal cord with some cervicothoracic extension",
"C": "Lumbosacral cord and cauda equina",
"D": "Upper thoracic cord only",
"E": "Lumbar epidural space"
} | B | Sagittal T2‐weighted spinal MRI scans showing syrinxes in all 4 patients (red arrows). |
d2b3b622206eb4a784b2e96962b1b16c3c7f48ad01c735d2c760ba5fd8453a9c | Which description best characterizes the ST segments in the mid-precordial leads? | [
"images/bd/bd0e9fd3e852c3a022ee144431762e5e5d81fafddd252addcae37384cb40b581.jpg"
] | {
"A": "Approximately isoelectric",
"B": "Markedly elevated",
"C": "Obscured by continuous atrial flutter waves",
"D": "Alternating between elevation and depression",
"E": "Markedly depressed",
"F": "Progressively elevated from beat to beat"
} | A | Electrocardiogram at the time of discharge shows isoelectric ST segment in the mid-precordial leads. |
3812a5a3b01b895142c2070cf70e8473d7374718bb84514441a56314282625ba | Which myocardial regions are suggested by the distribution of ST-segment elevation on this ECG? | [
"images/63/634585c1ffae73b7f1def234ca74d002642ff4b58b205432a1a2ec57e98a5ad7.jpg"
] | {
"A": "Inferior and high lateral only",
"B": "Anterior and inferior",
"C": "High lateral only",
"D": "Inferior only",
"E": "Anterior and high lateral only",
"F": "Septal only"
} | B | The electrocardiogram (ECG) before percutaneous intervention (PCI) shows an anterior-inferior ST-elevation myocardial infarction (STEMI). The ECG shows ST elevation in leads II, III, aVF, and V3–V5. |
864f5da226363747ed1311102f81ba86b097926971549ca4bf1f5582fb6ad604 | In panels J and K, where are the prominent pale fundus lesions located relative to the optic discs? | [
"images/b5/b52c7e2a8fe706fdc8c28c1805407b956f96193193b2a94af4405fbd152bd020.jpg"
] | {
"A": "Centered on the optic discs in both eyes",
"B": "Temporal to the optic discs in both eyes",
"C": "Nasal to the optic discs in both eyes",
"D": "Superior to the optic discs in both eyes",
"E": "Inferior to the optic discs in both eyes",
"F": "Nasal in the right eye and temporal in the left eye"
} | B | Scalp defects, fundus changes, and neuroimaging in patients with COL18A1 and LAMA1 mutations. (A,E) Alopecia areata appears in the midline of the occipital region of patients with COL18A1 mutations. (I,M) Alopecia areata appears in the midline of the parietal region (in the center of hair whorl) in patients with LAMA1 ... |
04e6c889a5d9eaf7d323fe25862c6cf68cc61819354e94d615f52eba15542f2e | What abnormality of the optic disc is visible in panel (b)? | [
"images/86/86351155d38aa579f7d526ae361438bd3e36d45029bbd0c575688fb06636826d.jpg"
] | {
"A": "Deep enlargement of the optic cup",
"B": "A white fibrous membrane obscuring the disc",
"C": "A sharply demarcated excavation of the disc",
"D": "Disc swelling with blurred margins",
"E": "A pigmented mass covering the disc",
"F": "Disc pallor with sharply defined margins"
} | D | (a) Fluorescein angiography: optic disc edema and hyperfluorescent dots in the posterior pole, (b) Signs of retinal vasculitis (hemorrhages) and optic disc edema extended mainly to the nasal area of the posterior pole, (c) SD-OCT: increased papillomacular bundle edema compared to the initially documented (Fig. 1b) (d) ... |
9a7826a25cd8d91bc99a55f0010af7cfb4b24fd0584fd53a05b6848623cc7b19 | In the multiparametric MRI figure, one row differs from the others by showing a sagittal rather than axial appearance of the anatomy, with an elongated profile and inferior boundary visible. Which sequence is most likely depicted in that row? | [
"images/21/21c06c971179ef6ddd0d7d5fb3319b7f2bbef0fca7cb5481415f7e63e91f707c.jpg"
] | {
"A": "MR spectroscopy map",
"B": "Contrast-enhanced T1-weighted image",
"C": "Diffusion trace image",
"D": "Susceptibility-weighted imaging",
"E": "FLAIR",
"F": "Time-of-flight MR angiography",
"G": "T1-weighted image without contrast",
"H": "Proton density image"
} | B | Grad-CAM heatmap. (A-C) shows the input image and its corresponding Grad-CAM heatmap for the T2WI, ADC maps and CE-T1WI respectively for the same patient. |
33697c7de159e3434dd5c3f76ca0c6c391e2c35fd000d082aa8fffc376bbd9a1 | On the fused cross-sectional images, which pair of sites corresponds to the arrow-marked lesions lacking radiotracer uptake? | [
"images/11/11074a531f1b0c9d36084c52961203cf8692a7fb70ac54f3f6fb8719fdfcc640.jpg"
] | {
"A": "Left superior pubic ramus and right iliac wing",
"B": "Left iliac crest and right acetabulum",
"C": "Bilateral acetabula",
"D": "Right iliac crest and left acetabulum",
"E": "Left sacral ala and right femoral head"
} | B | Negative 123I-MIBG and 18F-MFBG scans (concurrent) of 7-y-old patient with relapsed refractory neuroblastoma (stage IV disease) after chemoimmunotherapy. 123I-MIBG scan was performed to evaluate extent of disease. Patient showed no 123I-MIBG uptake (A; whole-body and fused images) with concordant lack of uptake on 18F-... |
1d632cb34ed9fdc173049ad68360d365a58b06c5331082b960d81c138c34fa2e | On this fluoroscopic image, which cardiac implanted device is most clearly demonstrated? | [
"images/36/36a3d08a77896ae54cb55658b30356c85f47107dc4a0886325ff430c29ce66e5.jpg"
] | {
"A": "Leadless right ventricular pacemaker",
"B": "Subcutaneous implantable cardioverter-defibrillator",
"C": "Cardiac resynchronization device with coronary sinus lead",
"D": "Dual-chamber transvenous pacemaker with right atrial and right ventricular leads"
} | A | Aveir DR leadless pacemaker system after implantation (right anterior oblique projection 30°), ©Clemens Steinwender, MD. |
79d731b85f522b84f188be7746cd37eeff51af547d9d55b605695346ec510f5a | How are the T waves oriented in leads V4–V6? | [
"images/97/97ee5bf14c76af3481fcc069c5c878aeb87a2a16dffbd7758ee9f57fc00e67b8.jpg"
] | {
"A": "Biphasic, initially positive then negative",
"B": "Predominantly upright",
"C": "Biphasic, initially negative then positive",
"D": "Absent",
"E": "Predominantly inverted",
"F": "Alternating in polarity from beat to beat"
} | B | The ECG after detraining, with resolution of the T-wave inversion in leads II, aVF, V2-V6 |
7d875886e7b8c94c79a32c1371bb0baaef5e62c76ac06299845d772fee11622c | What is the most likely principal histopathologic abnormality shown in this colonic mucosal section? | [
"images/db/db85eeaf706c05a8c42f8ac5849b40a7526a5ba77bb93c062c64a2eb165341f7.jpg"
] | {
"A": "Colitis with crypt luminal abscess formation",
"B": "Ischemic colitis with transmural necrosis",
"C": "Hyperplastic polyp with serrated architecture",
"D": "Invasive adenocarcinoma with desmoplastic stroma"
} | A | Colitis with intraluminal abscesses. |
5a6312ab4d872d4052c19dccdcb570c0838ca83367390a43b4239e5a852c436d | In panel A, how is the lesion's interface with the surrounding tissue best characterized? | [
"images/53/534224025593167d280e23975b43dae1f2c6b8d39a8e7094ccd9081110f9a280.jpg"
] | {
"A": "Composed of multiple discrete nodules separated by fibrous septa",
"B": "Connected to the surface epithelium by an invasive component",
"C": "Well-circumscribed by a fibrous capsule",
"D": "Infiltrative, with irregular tongues extending into surrounding tissue",
"E": "Surrounded by a prominent lymphoi... | C | (A) Microscopic examination shows a well capsulated retroperitoneal mass (H&E staining, ×40). (B) Microscopic examination shows poorly differentiated squamous cell carcinoma (H&E staining, ×400). (C) Immunohistochemical staining of p63 shows strong nuclear positivity (×200). |
27895f51540b03054bf1ea7bd91d89b248763527ba471d7bfdb5274a16968bbb | In the fused PET/CT view of the lower extremity, the abnormal uptake localizes most precisely to which anatomic structure? | [
"images/7d/7dd6f158637cc3435449192f748753f47203d726d1aa4e6d9f8eb66dcf5fc055.jpg"
] | {
"A": "Right patella",
"B": "Right proximal tibia",
"C": "Right distal femoral condyle",
"D": "Right popliteal fossa soft tissues",
"E": "Left tibial plateau",
"F": "Left proximal tibial metaphysis",
"G": "Right proximal fibula",
"H": "Right tibial shaft mid-diaphysis"
} | B | (A) Biodistribution of [68Ga]Ga-DOTA-UBI29-41 in the whole-body PET/CT image in maximum intensity projection (MIP). The arrow indicates the increased uptake of the radiopharmaceutical in the right knee. (B) The arrow indicates the lesion with purulent secretion in the proximal portion of the right leg. (C) Fusion of th... |
bc299d54828132e6be86a4416888e8860901d20994f3bc2a34fcd186f6e015b8 | Breast MRI demonstrates a solitary enhancing lesion in which location? | [
"images/e2/e2a2d39d0d2579674ae3ea2a729e793636ea91e5e4e01cfa913f145dc5e169f8.jpg"
] | {
"A": "Right retroareolar region",
"B": "Left central subareolar breast",
"C": "Right upper outer quadrant",
"D": "Left inferior internal quadrant",
"E": "Left upper outer quadrant with axillary tail extension"
} | D | A grade III triple-negative invasive ductal carcinoma in the left inner lower breast quadrant, 2.5 × 2.1 × 1.5 cm3 in size, no lymphovascular invasion, negative incisal margin, and no metastasis in sentinel lymph nodes. Preoperative MRI showed a mass in left inferior internal breast quadrant, demonstrating isointense s... |
7e09acaba0180bb83f63dfea3f567759deb28e9cb6f55bb52245075325887452 | This radiograph of a malformed neonate most specifically demonstrates union at which anatomic site? | [
"images/0a/0a6c093e296bb3fa1b71d1c40b12b813a45881eeacbe5bce95859e1bde6b9875.jpg"
] | {
"A": "Lower extremities",
"B": "Cervical vertebrae only",
"C": "Abdominal wall",
"D": "Pelvis only",
"E": "Thoracic cage",
"F": "Sacrum and lower spine",
"G": "Cranium"
} | G | Radiograph of the conjoined twins shows fused cranium. |
929a280c9450d9c7e30f3ff7e4ab9e0300b7d07855f3c3fd5cb251852e63449c | What is the best interpretation of the measured extrahepatic bile duct in panel D? | [
"images/06/06c0f332105054bac20e482c77b2b81bc54f5895653521598145c814cf68724f.jpg"
] | {
"A": "Absent",
"B": "Completely occluded",
"C": "Ruptured",
"D": "Mildly dilated",
"E": "Clearly filled by a large stone",
"F": "Markedly dilated"
} | D | Radiological studies. (A) Ultrasound showing the left hepatic lobe heterogeneous area. (B) CT scan with contrast showing a lesion in the left lobe of the liver demonstrates areas of internal enhancement and a mildly distended gall bladder. (C) MRCP showing a lesion in the left hepatic lobe measuring up to 5 cm. (D) MRC... |
6ccd91ecbe07a51e8c6ad7ef926c360d036ff61ef19774d491ff55dd5ba84e92 | The bony structure being removed in this image lies between the frontal sinus and which adjacent compartment? | [
"images/0b/0bfd5bd198faa4a28038135567d482a760c48db8f4a4e57f7a46e102020f090b.jpg"
] | {
"A": "Middle ear cavity",
"B": "Nasal septum",
"C": "Maxillary sinus",
"D": "Anterior cranial fossa"
} | D |
Removal of remaining posterior wall of frontal sinus procedures cranialization. (Reprinted with permission from Donald16 Chap. 26, Fig. 36D, page 392.) |
fdec616b87a71a34107b896829e0ef03f5a7e08fb9bb4f0caf95c2708aa5dee6 | Which of the following is the most accurate estimate of the size and laterality of the visible toe lesion? | [
"images/75/750f2f39a92c35d9b1bc3c6d8dd7316eca854e4680797bf8bbcfd88244766238.jpg"
] | {
"A": "Approximately 1 cm lesion on the left foot",
"B": "Approximately 3 cm lesion on the right foot",
"C": "Approximately 2.5 cm lesion on the plantar left heel",
"D": "Approximately 5 mm lesion on the right foot",
"E": "Multiple subcentimeter lesions on both feet"
} | A | Preoperative clinical view. 72-year-old female patients visited our hospital with chief complaint of 1 cm sized round and protuberance skin lesion which had a indeterminated margin on dorsolateral aspect of third toe on left foot. |
c4b8e24272000456e8309f3973bf9395a6c312a064718b59172370b540204172 | Which vessel gives rise to the accessory left hepatic artery marked 2? | [
"images/dc/dc80834ea7be46c446e428f4d688d11af9efb62c43fad1e3aff20834deade4a5.jpg"
] | {
"A": "Splenic artery",
"B": "Left gastric artery",
"C": "Right hepatic artery",
"D": "Gastroduodenal artery",
"E": "Common hepatic artery",
"F": "Superior mesenteric artery"
} | B | DSA of celiac trunk (C) shows an aberrant origin of the right gastric artery (7), arising from the right hepatic artery (6), gives rise to an aberrant supraduodenal artery (8) supplying the proximal duodenum and wrapping around the duodenal clips (D). S, splenic artery; 1, left gastric artery; 2, accessory left hepatic... |
82f76316c8f7259c634ee50cb7a5f2bb8c95a1a767962c4e787875374021583e | A cone-beam CT of an anterior tooth is shown in axial and sagittal sections. Which root canal configuration is best demonstrated by this tooth? | [
"images/0b/0bdf90baffbb6eb55036b7a5d56210bb9f7c49966689bb15b5aaa1ddd0d116a9.jpg"
] | {
"A": "Two canals merging into one and redividing apically (2-1-2)",
"B": "One canal dividing into two apical exits (1-2)",
"C": "Three canals that merge into one apical exit (1-3-1)",
"D": "Two separate canals with two separate foramina (2-2)",
"E": "Single canal from chamber to apex (1-1)"
} | C | CBCT showing three canals or Ahmed 1-3-1 configuration. (a) Axial section. (b) Sagittal section.
CBCT - Cone beam computed tomography |
fff4bc1532ff08de9b3fd8b00fd97f46bd6d72ff8da95e20c796b989125d29fd | Which set of leads most clearly demonstrates the abnormal T-wave inversion on this 12-lead ECG? | [
"images/9f/9ff7b615fb91ed61e77dc7d1bd283efacf3c5a6c108dd34145449eb99b34f55c.jpg"
] | {
"A": "I, aVL, V5, V6",
"B": "V1, V2, V3",
"C": "aVR only",
"D": "II, III, aVF"
} | D | Case 6. Figure 2. Twelve lead ECG. Inverted T-waves in inferior leads and ventricular ectopy present |
5b05bba3a62ee3c2cb80a3b9576e7b13f3bd99c9414431039ec0e23bb93da7a9 | The marked angle is formed between the patellar transverse axis and which of the following structures? | [
"images/3b/3b88ff40099c20aa4f3c6a8b88869ed95bd4ad951384e00c1f1cf9cc27c259d9.jpg"
] | {
"A": "Quadriceps tendon axis",
"B": "Posterior femoral condylar line",
"C": "Lateral patellar facet tangent",
"D": "Medial trochlear facet tangent"
} | C | The lateral patellar facet angle is the angle formed by the patellar transverse axis and the lateral patellar facet tangent |
03f5fa2a109e452fbec3dfd445b79f6360f9825dca4572a24c3ce7256d0ad670 | In panel A, how does perfusion in the region indicated by the solid arrow compare with the corresponding hypermetabolic region on PET/CT? | [
"images/87/87041efbd45ef80d1140af7130f45979c05b1500938e15e0adb7c5383d024c1e.jpg"
] | {
"A": "Perfusion is present in the hypermetabolic region",
"B": "Perfusion is confined to a rim around the hypermetabolic region",
"C": "The hypermetabolic region lies entirely outside the perfusion field",
"D": "Perfusion is present only in the opposite lung",
"E": "The hypermetabolic region is obscured by ... | A | (A–C) Axial (A), left sagittal (B), and coronal (C) slices from computed tomography (CT) (left), 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT (center), and lung perfusion single-photon-emission CT (SPECT)/CT (right). Note normal or increased lung perfusion in most hypermetabolic areas detected... |
cceccfa5c4627d6eec9090dedff44957b1fb827e0787e3bba90f85be7f1f1b7e | Which side and pole of the kidney are involved by the mass seen on this transverse contrast-enhanced CT image? | [
"images/56/56556b357aa03169e3ace1612b2e2e76ee11aa458ed06742875fd5a6a7f5baf9.jpg"
] | {
"A": "Right kidney, upper pole",
"B": "Left kidney, upper pole",
"C": "Left kidney, lower pole",
"D": "Right kidney, lower pole"
} | B | Contrast-enhanced abdominal computed tomography transverse plane image from a 53-year-old male patient, showing a large mass with heterogeneous enhancement in the upper pole of the left kidney. |
d2f9d40ce827fe297d4bba8e1603df1026e11adda9fb7b2e83bc81c3cca62468 | Based on the location and appearance of the marked lesion on this axial CT image, which diagnosis is most consistent with the visualized abnormality? | [
"images/65/652ac6407584a85becf84330420076dc631310ddcdee5f2500b61a0ea39e6370.jpg"
] | {
"A": "Lumbar hernia",
"B": "Obturator hernia",
"C": "Hiatal hernia",
"D": "Parastomal hernia",
"E": "Spigelian hernia",
"F": "Umbilical hernia",
"G": "Direct inguinal hernia",
"H": "Internal mesenteric hernia",
"I": "Perineal hernia",
"J": "Femoral hernia"
} | F | CT scan axial view of the umbilical hernia(blue arrow). |
6479ca7d62851bb0a064f3c0bab5028c97b954ac48591e505924c990cdc8847c | In panel A, what do the fine dark interrupted lines around the central cornea most likely represent? | [
"images/10/10320b86eca4cd79a0a4d53de5c061f41617c0910d8107447ba87cb44410bab6.jpg"
] | {
"A": "Corneal nerve fibers",
"B": "Eyelashes adherent to the cornea",
"C": "Iris synechiae",
"D": "Corneal sutures",
"E": "Corneal blood vessels",
"F": "Conjunctival folds"
} | D | Sample Cases. Case 7 (A–C): Subconjunctival bevacizumab was administered to treat newly formed corneal vessels in the right eye of Case 7. A 19-year-old man with CorNV caused by an alkali burn (lime) had undergone anterior deep lamellar keratoplasty of the central cornea 20 days before presentation. The newly formed su... |
3396d5db5f3e55ac5bff5b18c4d67c215ea56ff4b5213d672d2bcebf7e5f6f21 | In panel c, what globe abnormality is indicated by the yellow arrow? | [
"images/22/220a6639337a36d8cc877965718ff71c2d7c4f0adcb5b98177f90ce88466d3f8.jpg"
] | {
"A": "Anterior chamber narrowing",
"B": "Retinal detachment",
"C": "Globe rupture",
"D": "Posterior scleral flattening",
"E": "Anterior lens dislocation",
"F": "Vitreous hemorrhage"
} | D | (a, b) Disc oedema in both eyes with peripapillary haemorrhages and exudates. (c) T1-weighted contrast-enhanced MRI of the brain suggestive of nodular appearance of right optic nerve (red arrow) and posterior scleral flattening of left globe. (yellow arrow). (d) Contrast-enhanced CT of the abdomen depicting circumferen... |
815a8618ec10d21e7429cf48d01f57816acc3ddefd31456acf6547c469eceb6e | On this lateral videofluoroscopic swallowing image, which numbered landmark corresponds to the pit of the valleculae, located just anterior to the epiglottic base and superior to the hyoid region? | [
"images/e3/e3fe24899dbe9dfdfa377e78be3d7b2a24275daf7c7169ade8aac1f0a74c6f27.jpg"
] | {
"A": "#6",
"B": "#10",
"C": "#8",
"D": "#9"
} | B | Coordinates mapping anatomical landmarks are here used to characterize the actions of muscles underlying pharyngeal swallowing. Coordinates #1-5 map the interactions of the mandible, cranial base, and vertebrae as skeletal levers that suspend muscles of deglutition. The distal attachments of muscles that mobilize swall... |
ae63f0080fdbf7333dea8fa6fa28fb339918b2cb559eff725bd2385bad8dd9f0 | Review the composite figure with axial and coronal MRI, intraoperative ultrasound, and gross specimen. From which site does the depicted mass most likely arise? | [
"images/59/5943668f0032962485c21270195ef563f81cd690dbb3f3702289f0698fab4ed6.jpg"
] | {
"A": "Lower pole of the right kidney",
"B": "Right adrenal gland",
"C": "Upper pole of the right kidney",
"D": "Upper pole of the left kidney"
} | C | Magnetic resonance imaging (MRI), intraoperative echography, and gross image of the tumor
Magnetic resonance imaging showing a 5.8 × 4.0 × 5.6 cm tumor originating from the upper pole of the right kidney. A: T2-weighted imaging (WI), transverse section; B: T2WI, coronal section; C: intraoperative echogram showing a wel... |
e46981285ae3a3f1469ad1ca2e87ba3e238ac4449ba96573ed1fb9e94cdad0db | The abnormal bright punctate/linear echoes highlighted within the placenta on this sonographic image most likely represent which finding? | [
"images/5a/5a964a378b7d27ffd701dd3ea5456d72ce10e9849a7460614fae7035687e6f3b.jpg"
] | {
"A": "Amniotic bands",
"B": "Umbilical cord calcification",
"C": "Intervillous thrombi",
"D": "Placental calcifications",
"E": "Subchorionic fibrin deposition only"
} | D | (A) Image showing placental calcification and lobulation (grade 3 placenta) in a case of 26-year-old primigravida at a gestational age of 33 weeks and 6 days. Red arrows show the placental calcification and blue arrows show lobulations. (B) Image showing grade 3 placental calcification in a 31-year-old primigravida at ... |
022cbd243113dec6ae6116bb273c03e2a7063b40bc3a7150716b992c8c5e78e0 | When comparing the FDG PET/CT with the radioiodine SPECT/CT, which site is metabolically active on FDG imaging but shows absent radioiodine concentration, indicating dedifferentiated disease? | [
"images/50/501386158c1921d93fea9b9c268aa6aea3373bbf93502436d5a03379af0dcd89.jpg"
] | {
"A": "L3 vertebral lesion",
"B": "Left lateral orbital lesion",
"C": "Urinary bladder",
"D": "Pelvic bone lesions",
"E": "Cervical vertebral lesion at C2",
"F": "Multiple rib lesions",
"G": "Calvarial lesion",
"H": "Left kidney"
} | E | [18F]-Fluorodeoxyglucose (FDG)-positron emission tomography-computed tomography (PET/CT), maximum intensity projection (MIP) image (
A
) and sagittal fused image (
B
) demonstrating hypermetabolic multiple lytic skeletal lesions at the calvarium, left orbit (red arrow), C2 vertebra, multiple ribs, L3 vertebra (blue arr... |
a47a88ca70cde270a19571be2ca5a3eddbd0834b6956b13ad4490af84bd61f23 | Which pairing of labeled structures is most consistent with the anatomy seen in this left knee arthroscopic view obtained through the anterolateral portal? | [
"images/b2/b2d89fbe95eaa86a765d8afb561254e106163dcc15abc7588eb7e296bcddf9ac.jpg"
] | {
"A": "A = medial collateral ligament; B = posterior cruciate ligament",
"B": "A = posterior cruciate ligament; B = anterior cruciate ligament",
"C": "A = anterior cruciate ligament; B = posterior cruciate ligament",
"D": "A = anterior horn of lateral meniscus; B = ligamentum mucosum",
"E": "A = ligamentum m... | C | Arthroscopic view of the intercondylar notch of a left knee viewed from the anterolateral portal. The anterior cruciate ligament (A) and posterior cruciate ligament (B), as well as the ligamentum mucosum, are assessed as step 5 of step-by-step diagnostic arthroscopy. The anterior cruciate ligament should be assessed fo... |
7b5566ab5aeeff2ff5cddc25d3c2c8bf7d831950302fcb102764ad31dad42916 | In panel B, which marked position corresponds most closely to the foveal center? | [
"images/39/396e8d716eecdbad63fd59e838414aa9af4473ea05e50a3264df2eeaeab573ba.jpg"
] | {
"A": "The fifth marker from the left",
"B": "The second marker from the left",
"C": "The midpoint between the fourth and fifth markers",
"D": "The fourth marker from the left",
"E": "The third marker from the left",
"F": "The first marker from the left"
} | B | Directional OCT and AOSLO accurately characterizes parafoveal transition zones.
Numbered arrows indicate the approximately corresponding areas, allowing for minor variations in eye fixation and rotation between imaging sessions. A: 3 × 3mm en face Bioptigen spectral domain optical coherence tomography (SDOCT) of the co... |
54596f91636783b8f1c1764218d3fc110242e755993d44d97db15d6690cc1cad | Where is the rounded low-attenuation lesion in panel B located relative to the stomach? | [
"images/b9/b9068f65b11c0b41611237a9f139879f15f278f6a9b46a70f6f41c89b589757d.jpg"
] | {
"A": "Along the greater curvature",
"B": "At the gastroesophageal junction",
"C": "Along the lesser curvature",
"D": "Within the esophageal lumen",
"E": "Within the duodenal bulb",
"F": "Along the posterior wall of the rectum"
} | A | (A) Esophagogastroduodenoscopy reveals gastric submucosal lesion with normal overlying mucosa. (B) Abdominal computed tomography shows a 5.5-cm cystic lesion, located along the greater curvature side of the stomach, during the arterial phase. (C) An unilocular cyst is readily seen below the mucosa when the lesion is bi... |
dabd8f0d17ddf153ff665350a5f3e677bbc724cc84572adb7593e81b3e8e101b | In panel B, which location best describes the abnormality indicated by the orange arrow on the fused image? | [
"images/1a/1a7454840de2e925cd1e130319b9a8da40bfde6332026b0263f0363cf8dcd873.jpg"
] | {
"A": "Anterior abdominal wall",
"B": "Subcutaneous tissue of the flank",
"C": "Right renal cortex",
"D": "Right hepatic lobe",
"E": "Para-aortic retroperitoneum",
"F": "Vertebral body"
} | E | 18F-FDG PET/CT images before and after chemotherapy. Before the patient received chemotherapy, the whole-body maximum intensity projection (A) showed multiple hypermetabolic lesions around the abdominal aorta, spleen, left psoas major, left diaphragm foot and left pelvic cavity. And the transverse images (B,C) showed t... |
bd04abbf41c1e4b1d6d53e836e297316494e6459ff767f7c0299abad26fa0083 | In panel A, what relationship is shown between the CD20-positive and CD3-positive cells? | [
"images/e6/e610f18d36ed30dd66a20a446b2cc9e11cfae44e1c2ebb5c1fdfffa06ef3ac41.jpg"
] | {
"A": "CD20-positive cells are surrounded by CD3-positive lymphocytes",
"B": "CD3-positive cells are absent, while CD20-positive cells form the infiltrate",
"C": "The two cell populations are present in separate, non-overlapping regions",
"D": "CD3-positive cells are surrounded by CD20-positive lymphocytes",
... | A | The patient's skin lesion detected pathologically and metabolically. (A) The first skin biopsy after the first course of epcoritamab therapy (on day 30). The pathological finding showed lymphocyte infiltration in subcutaneous tissue. CD20+ lymphoma cells were surrounded by CD3+ lymphocytes. (B) On day 26 after the thir... |
7056338261897aeb015076181433f33283809ca224710e757a7b046c62988d91 | Which tendon transfer is most consistent with the corrected appearance seen in this postoperative foot image? | [
"images/57/57397f1fd05d9764e769a613ce2b1b2c892937706021d66ccd92b2eb83d4a8d6.jpg"
] | {
"A": "Tibialis anterior transfer",
"B": "Peroneus longus transfer",
"C": "Abductor digiti minimus transfer",
"D": "Flexor hallucis longus transfer"
} | C | Results 3 years after the operation. Internal rotation of the plantar is well corrected by the transfer of the abductor digiti minimus. |
e65fd47f75a0addfa04114b98f3df72603a4151b9c3966f17fb8c9eb5f0908ec | The prominently dilated bowel loop in the upper abdomen is most consistent with which portion of the gastrointestinal tract based on its radiographic appearance? | [
"images/7a/7a6db2d4bb23730aa8621050320143d898ed80315c6b6674a205ace76a3fb1ec.jpg"
] | {
"A": "Colon",
"B": "Distal ileum",
"C": "Jejunum",
"D": "Stomach"
} | A | Abdominal radiograph showing a distended colonic loop of the bowel. |
2fc1bce73a5526b9ab9e18cdeaf70f7309fe6d33b0a491d604e66e0fb3080e48 | Which structure is visible as a small metallic density adjacent to the lateral aspect of the proximal tibia, consistent with reconstructive fixation? | [
"images/21/21e669cfca058708c6c67ab11dd2ba6f5fec376063851a76675da3a9a0b821b4.jpg"
] | {
"A": "Suture anchor",
"B": "Intramedullary tibial nail",
"C": "External fixation pin",
"D": "Interference screw in the femur"
} | A | Anteroposterior radiography on last follow-up appointment showing resected proximal fibula and reconstruction of soft tissues with suture anchors (patient 2) |
5a23803459a28be04ad067a0f8d8569dfb6638d2692bb48b6805265e89bb61ba | The measured distance displayed on the image most directly corresponds to which airway parameter? | [
"images/2d/2d653b7cc52e01d8f5619f18c39a5e281d565a78f81ca46295175da67c063243.jpg"
] | {
"A": "Skin-to-hyoid distance",
"B": "Skin-to-vocal cord distance",
"C": "Pretracheal soft tissue thickness at the level of the thyroid isthmus",
"D": "Skin-to-epiglottis distance",
"E": "Tongue base thickness"
} | D | Distance from the skin to the epiglottis. Example measurement from skin to anterior aspect of the epiglottis (star). |
67cf969fff666e645f4c469abd141ae6fc3d836f969f15c195f39d40af7785fd | In this 68Ga-DOTATATE PET/CT figure, the lesion indicated by the green arrow is best classified as which of the following? | [
"images/a6/a6c13da1183f35aadc8d71c450e15d4761d7feeaa56f3928604da3660ead30bb.jpg"
] | {
"A": "Physiologic urinary tracer activity",
"B": "Bone metastasis",
"C": "Hepatic metastasis",
"D": "Primary pancreatic mass",
"E": "Regional nodal metastasis"
} | B | The central MIP image (B) provides an overview of disease distribution enabling an immediate impression of possible primary sites including, in this case of a 68Ga-DOTATATE PET/CT, the pancreas (red arrow), regional nodes (blue arrow), hepatic (purple arrow), and bone (green arrow) metastases, which can be secondarily ... |
ffd4072b4c23d662a65faf46a32bc817f37b3567f14d99028422efd628096fec | Which microscopic feature is visible in the day 4 high-magnification section (row F)? | [
"images/d5/d5058176df897b4a00c8c49ff743aef820266b2f8660850cc4ef6b3b27d49ac4.jpg"
] | {
"A": "A bronchial lumen surrounded by cartilage plates",
"B": "A large pulmonary artery occluded by thrombus",
"C": "Alveolar spaces separated by thin tissue septa",
"D": "Complete replacement of lung tissue by tumor",
"E": "Alveolar spaces uniformly filled with dense fibrous tissue",
"F": "A pleural surf... | C | Multiscale analyses of extracorporeal lung maintenance and integrity. A, Photographic appearance. B, Thermographic appearance. C, Radiographic appearance. D, Bronchoscopic evaluation of extracorporeal lungs throughout 4 days of normothermic support, including aerated regions (dotted lines), and areas of local consolida... |
46a71b61ec11d701971a53ad4b8349b4a29cadcfc4b2f1cd3b15f1f263643e39 | On this sagittal spinal CT, which vertebral level demonstrates the compression fracture? | [
"images/c1/c15ce306a2a6dbc5a02b47ff722ddaf2a8bf0aa66ebfe868ff0d70719d52a4b4.jpg"
] | {
"A": "T11",
"B": "L3",
"C": "T8",
"D": "L1",
"E": "S1"
} | A | Sagittal CT scan revealed compression fracture of T11 thoracic vertebra. |
b0c69a8fe9145be445be56ad96cc13d730ef366da0b9e4cfb3453dfb99fc9b5e | Which orientation best describes the mass on the grayscale ultrasound image in panel C? | [
"images/b9/b92547972ab821b6203fa1896163458febe7554fbf2ce231909246669a21e6ce.jpg"
] | {
"A": "Nonparallel to the skin, taller than wide",
"B": "Radially oriented along a duct",
"C": "Curvilinear along the skin surface",
"D": "Concentric around the nipple",
"E": "Parallel to the skin, wider than tall",
"F": "Parallel to the pectoralis muscle within the chest wall"
} | A | A 37-year-old woman who underwent excisional biopsy for fibroadenoma after tattoo localization in left breast. (A,B) During the follow-up, after benign mass excision, there was a newly developed mass in tattooed area. On follow-up mammography 2 years after the surgery, a new isodense mass with an oval-shaped and circum... |
356d3fd0e2eab8d4e17e7d895a7d06d74dd15bf4d3c9117887fe1e87b310d811 | Inspection of the repolarization pattern on this ECG most strongly supports which of the following statements? | [
"images/f8/f8fbfbe16826f3fc88c5e1cb52c32efc573b20fd011d2b69701a9482c68eebad.jpg"
] | {
"A": "T-wave amplitude appears normal without striking ischemic or hyperacute change",
"B": "There is marked T-wave inversion in the anterior precordial leads",
"C": "Biphasic T waves are present in the inferior leads",
"D": "There are diffuse giant peaked T waves consistent with hyperkalemia"
} | A | Admission 12-lead electrocardiogram on presentation to the emergency room showed sinus rhythm with intrinsic atrioventricular conduction as well as normal T-wave amplitude. |
eeb91b7edb3b338368419d4b3422fdc4cdff6e587b4eed444f4d803a0f71c190 | Which imaging finding is best demonstrated by these echocardiographic views of a pacemaker lead? | [
"images/df/df92e1ede0b02dcc3da209c111b3db119b93d0e2b7d51c110c569b0129aeac98.jpg"
] | {
"A": "Coronary sinus lead positioned in a lateral cardiac vein",
"B": "Lead passing from the right atrium through a patent foramen ovale into the left atrium",
"C": "Lead perforation through the right ventricular free wall into the pericardial space",
"D": "Lead advanced retrograde through the aortic valve in... | F | Pacing lead coursing from right ventricle through the interventricular septum into left ventricle. |
59c6881f6ea4e7da22ccda20b2a68e9406f3432d342abbd4349009197586b80d | What is the most accurate description of the location of the implanted marker seen on this image? | [
"images/66/66c510a7afd52d9888e098bedc9fb821320e078c79f7ff7b831f46e00d8d03ff.jpg"
] | {
"A": "Within the L5-S1 neural foramen",
"B": "Along the anterior margin of the L5 vertebral body",
"C": "Centered in the sacral canal",
"D": "In the posterior interspinous region at L4-L5",
"E": "Within the L4-L5 intervertebral disc space"
} | D | The lateral X-ray image reveals the radiographic marker of the BacJac implanted at L4-L5 interspinous area. |
37d741e0d7f9df140683e2c286730c5f2a9d571caa29866017d7bcb12f0da51c | How are the margins of the breast mass best characterized on the mammographic images in panels A and B? | [
"images/06/06f8589d83b5329e1b9d8953e489435472553a38ef95e66b25cc02328b47fc37.jpg"
] | {
"A": "Obscured",
"B": "Angular",
"C": "Circumscribed",
"D": "Indistinct",
"E": "Spiculated",
"F": "Microlobulated"
} | C | Case 1. Incidentally detected nodular pseudoangiomatous stromal hyperplasia in a patient with mastalgia. Craniocaudal and mediolateral oblique images of left breast (
A, B
) show an oval equal density lesion with circumscribed margins in upper outer quadrant, showing no significant enhancement on recombined postcontras... |
2de52db877dde321fb0d7d1be7b93a1e75b491f6cef54435c78750ebd3fbd1dd | In the hippocampal photomicrographs, which panel shows the stimulation electrode placed in the associational-commissural (AC) pathway? | [
"images/ab/abdd3ef3dcf6fa511c92c82c93eb315b16d4048883cabfb3be2ae844d644f3ca.jpg"
] | {
"A": "Panel i",
"B": "Panel ii",
"C": "Panel iv",
"D": "Panel iii"
} | D | Nissl-stained photomicrographs of hippocampal slices showing the position of the electrodes. White arrowheads point to the position of the stimulation electrode in the MFs (i) and of the recording electrode in the stratum lucidum of area CA3 (ii). In iii, the arrowhead shows the stimulation electrode position in the AC... |
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