Classification, Staging and Syndromes

Altman surgical classification of sacrococcygeal teratoma

Type I: primarily external – best prognosis 47% Type II: Dumbell shape with equal external and internal component 34% Type III: mainly internal within abdomen and pelvis 9% Type IV: internal completely 10%, worst prognosis

Chondral injury classification

grade 0: normal grade 1: softening grade 2: partial thickness defect, <50% cartilage depth grade 3: partial thickness defect, >50% cartilage depth grade 4: full thickness defect with or without underlying bone changes

Weinstabi classification of achilles injury

Type I: inflammatory response Type II: degenerative changes Type III: partial tear Type IV: complete tear

Sangeorzan classification of navicular body fractures

Type I Coronal fracture, no dislocation Type II Dorsolateral or plantar medial fracture with medial forefoot displacement Type III Comminuted fracture with lateral forefoot displacement

Sanders classification of calcaneal fractures

Two categories Based on number of fracture lines Type I non displaced, no matter how many fracture lins Type II single displaced fracture line – 2 part Type III two displaced fracture lines – 3 part Type IV comminuted Based on position of main fracture line A: lateral 1/3 of joint B: middle 1/3 of…

Hawkins classification of talar neck fractures

Type 1 Non-displaced Type 2 Displaced with posterior subtalar joint disruption Type 3 Displaced with disruption of both ankle and posterior subtalar joints Type 4 Displaced with disruption of ankle, posterior subtalar and talonavicular joints

Weber classification of malleolar fractures

Type A fracture below level of tibial plafond Type B fracture at level of tibial plafond Type C fracture above level of tibial plafond

Ideberg classification of intraarticular glenoid fractures

Kuhn classification of acromion fractures

Thompson classification of scapula fractures

Zdravkovic and Damholt classification of scapula fractures

Classification of acromioclavicular joint injury

Neer classification of distal clavicle fractures

Allman classification of clavicle fractures

5th edition WHO classification of pediatric bone tumors

Osteogenic tumors Subungual exostosisBizarre parosteal osteochondromatous proliferationOsteoblastomaOsteoid osteomaChondromesenchymal hamartoma of chest wallOsteosarcoma Chondrogenic tumors ChondroblastomaOsteochondromaChondromyxoid fibromaEnchondroma and enchondromatosisChondrosarcomaMesenchymal chondrosarcoma Other tumors Vascular tumors of boneAneurysmal bone cystGiant cell tumorNon ossifying fibromaNotochordal tumorsSimple bone cystAdamantinomaOsteofibrous dysplasiaFibrous dysplasia

5th edition WHO classification of pediatric soft tissue tumors

Adipocytic tumors LipomatosisLipoblastoma/lipoblastomatosisLiposarcoma Fibroblastic and myofibroblastic tumors FasciitisFibrodysplasia ossificans progressivaFibroma of tendon sheathGardner fibromaFibrous hamartoma of infancyLipofibromatosisInclusion body infantile digital fibromatosisJuvenile hyaline fibrzomatosisFibromatosis colliCalcifying aponeurotic fibromaSinonasal angiofibromaPlantar/palmar fibromatosisDesmoid fibromatosisInfantile fibrosarcomaGiant cell fibroblastomaLow grade fibromyxoid sarcomaInflammatory myofibroblastic tumor  Fibrohistiocytic tumors Fibrous histiocytomaPlexiform fibrohistiocytic tumorTenosynovial giant cell tumor  Vascular tumors Capillary malformationsVenous malformationsArteriovenous malformationsIntramuscular vascular anomaliesLymphatic anomaliesCongenital…

5th edition WHO classification of pediatric leukemias and lymphomas

In the fifth edition, WHO classifies pediatric tumors separately from adult tumors. Myeloid neoplasms Myeloproliferative neoplasms Chronic myeloid leukemia, BCR::ABL1 positive Myelodysplastic/myeloproliferative neoplasms Juvenile myelomonocytic leukemia Myelodysplastic syndromes Refractory cytopenia of childhoodMyelodysplastic syndromes with excess blasts Myeloid neoplasms with germline predisposition Myeloid proliferations associated with Down syndrome Acute myeloid leukemia and related neoplasms Acute myeloid…

Garden classification of hip fractures

Stage 1 Undisplaced, incomplete, including impaction in valgus Stage 2 Complete fracture, no displacementStage 3 Complete fracture, varus angulationStage 4 Completely displaced

AJCC staging of malignant bone tumors

StageGrade SizeMetastasisIALow< 8 cmNone IBLow > 8 cmNone IIAHigh< 8 cmNone IIBHigh > 8 cmNone IIIAny Any Skip metastasisIVAAny Any Pulmonary metastasisIVBAnyAny Non-pulmonary metastasis

7th edition AJCC TNM staging of adrenocortical carcinoma

TXPrimary tumor cannot be assessedT0No evidence of primary tumor T1Tumor 5 cm or less in greatest dimension, no extra-adrenal invasionT2Tumor greater than 5 cm, no extra-adrenal invasionT3Tumor of any size with local invasion, but not invading adjacent organsT4Tumor of any size with invasion of adjacent organsNXRegional lymph nodes cannot be assessedN0No regional lymph node metastasis N1Metastasis in…

FIGO staging of ovarian carcinoma

#foamed #foamrad #elearnrad #drbabu #kuwait #rad #radiology #radiologist #radres

8th edition TNM anal cancer staging

Stage I T1 – tumor not more than 2 cm in greatest dimension N0 – no regional lymph nodes M0 – no distant metastasesStage IIa T2 – tumor more than 2 cm but not more than 5 cm in greatest dimension N0 – no regional lymph nodes M0 – no distant metastasesStage IIbT3 – tumor more than…

8th edition TNM esophageal cancer staging

TT1aInvasion of lamina propria or muscular mucosaT1bInvasion of submucosaT2Invasion of muscularis propriaT3Invasion of adventitiaT4aResectable tumor invading pleura, pericardium or diaphragmT4bUnresectable tumor invading aorta, airway, vertebrae etcNN0No lymph nodes N1One to two regional lymph nodes N2Three to six regional lymph nodesN3Seven or more regional lymph nodes MM0No distant metastasisM1Distant metastasis Define unresectable? Tumor contact more than 90 degreesLoss of…

O-RADS MRI risk stratification and management system

O-RADS MRI scoreRisk categoryPositive predictive value for malignancyRemarks0Incomplete evaluation–1Normal ovaries-No ovarian lesionSimple cyst < or equal to 3 cm in premenopausal womenHemorrhagic cyst < or equal to 3 cm in premenopausal womenCorpus luteum with or without hemorrhage < or equal to 3 cm in premenopausal women2Almost certainly benign< 0.5%Cyst: unilocular, any type of fluid content.…

Grading of proximal interphalangeal joint instability

Grade 1 Distal avulsion of volar plate from base of middle phalanx.Hyperextension of PIP joint. (swan-neck deformity)Proximal avulsion of checkreins less common and can cause pseudoboutonniere deformityGrade 2 Volar plate injury extends to collateral ligaments.Dorsal subluxation produces more instability. Volar plate tilting with detachment of collateral ligamentGrade 3Fracture-dislocation of distal attachment of volar plate. Stable…

Sakakibara arthroscopic classification of medial plica

Acord-like elevation in synovial wallBshelf-like without covering anterior medial femoral condyleClarge and shelf-like, covers anterior medial femoral condyleDcentral defect or fenestrated

Types of Morel-Lavallee lesion

Ifluid-like serohematic effusionIIsubacute hematoma IIIchronic, organizing hematoma IVperifascial dissection, closed fatty tissue lacerationVperifascial pseudonodular lesionVIinfection with or without thick capsular septations and sinus tract

Jackson and Feagin grading of muscle contusion

Mild active or passive range of motion limited to less than 1/3 of normal. 6 days of disability.Moderate active motion limited to 1/3 to 2/3 of normal range due to muscle spasms. 56 days of disabilitySevereactive motion limited to more than 2/3 of normal range of motion. More than 60 days of disability

Grading of muscle strain

1minimal disruption of musculotendinous unit (MTU). muscle spasm or cramp2partial tear with some intact MTU fibres. discomfort during sports or training, but resolves with rest3Acomplete rupture of MTU3Bavulsion fracture at tendon origin or insertion

Arthroscopic/imaging classification of shoulder impingement

Type 1: rotator cuff degeneration or tendinosis without visible tears on either surfaceType 2: rotator cuff degeneration or tendinosis with partial-thickness tears of either articular or bursal surfacesType 3: complete-thickness rotator cuff tears of varying sizes, complexity, and functional compromise

Waldenstrom’s staging of Legg-Calve-Perthe disease

Initial stageincreased head-socket distance, subchondral plate thinning, dense epiphysisFragmentation stagesubchondral fracture, inhomogeneous dense epiphysis which is porous, metaphyseal cystsReparative stagenormal bone in areas of resorption, removal of sclerotic bone. epiphysis is more homogeneousGrowth stagere-ossification. normal femoral shape is approachedDefinitive stagefinal shape determined with joint congruency or incongruency

Herring classification of Legg-Calve-Perthes disease

Alateral pillar is not involvedB<50% of lateral pillar is affectedC>50% of lateral pillar is affected What is lateral pillar? Lateral 15 to 30% of epiphysis is called the lateral pillar

Salter-Thompson classification of Legg-Calve-Perthes disease

Aless than 50% of epiphysis involvedBfracture of >50% of span of epiphysis

Catterall classification of Legg-Calve-Perthes disease

Iinvolvement of anterior epiphysis without metaphyseal reaction, sequestrum or subchondral fracture line. < 25% epiphysis is involvedIImore extensive or severe involvement of anterior epiphysis, preservation of medial and lateral segments. Sequestrum present, with anterolateral metaphyseal reaction. Subchondral fracture line that doesn’t extend to the apex of femoral epiphysis. Less than half of epiphysis is involved.…

Mitchell staging system for avascular necrosis

Class Aosteonecrotic lesion shows signal similar to fat – high on T1, intermediate on T2Class Bhips show signal of blood or hemorrhage (high on both T1 and T2)Class Chips show signal of fluid (low on T1, high on T2)Class Dhips show signal of fibrous tissue (low on T1 and T2) Peripheral band of low signal…

Neer classification of shoulder impingement syndrome

Stage 1: tendon edema and hemorrhageStage 2: fibrosis and tendinitis Stage 3: partial or complete tear of rotator cuff. Associated anterior acromial spurring, or greater tuberosity excrescence. Burial thickening, fibrosis. Greater tuberosity sclerosis. 

Snyder classification of complete rotator cuff tears

0tear lacks full thickness communication between bursal and articular surfaces Ismall complete tear (puncture)IImoderate < 2 cm tear involving one tendon without retractionIIIlarge 3-4 cm complete tear involving entire tendon with minimal retraction of torn edgeIVmassive tear involving two or more cuff tendons, associated retraction and scarring of remaining tendon ends. tears irreparable

Grading of partial rotator cuff tears (depth)

1< 3 mm deep23 – 6 mm deep, < 50 % of cuff thickness involved3high grade partial tear > 6 mm deep, > 50 % cuff thickness involved

Snyder grading of partial rotator cuff tears

0NormalIminimal superficial bursal or synovial irritation or mild capsular fraying in small localized area (< 1 cm)IIfraying and failure of some rotator cuff fibres with synovial bursal or capsular injury (< 2 cm)IIIfraying and fragmentation of tendon fibres usually involving whole surface of a cuff tendon, mostly supraspinatus (< 3 cm)IVsevere tear with tendon fraying,…

Snyder classification of acromial thickness

Classification of acromial thickness assessed at posterior margin of acromioclavicular joint Type A: thin, less than 8 mm Type B: 8 to 12 mmType C: thick, more than 12 mm

Mirizzi syndrome

Common bile duct narrowing and fibrosis due to chronic gallstone diseaseStone usually impacted in gall bladder neck, cystic duct or cystic duct remnantFistula can develop between gall bladder or cystic duct and common duct, stone may partially or totally pass into common ductStricture commonly in upper and middle common ductDifficult to distinguish obstruction and thickening…

FIGO staging of endometrial carcinoma

Stage ITumor confined to corpus uteri Ia – tumor extending to <50% of myometrial depth Ib – tumor extending to >50% of myometrial depthStage IITumor invades cervical stroma, but does not extend beyond the uterusStage IIILocal and/or regional spread of the tumor IIIa – tumor invades serosa of corpus uteri and/or adnexa IIIb – vaginal…

8th edition TNM pancreatic cancer staging

T staging  TXPrimary tumor cannot be assessedT0No evidence of primary tumorTisCarcinoma in situT1Tumor < or = 2 cm in greatest dimensionT2Tumor > 2 cm, but < or = 4 cm in greatest dimensionT3Tumor > 4 cm in greatest dimensionT4Tumor involves the celiac axis, superior mesenteric artery and/or common hepatic artery N staging  NX Regional lymph nodes…

8th edition TNM prostate cancer staging

T – primary tumor (clinical staging) TXPrimary tumor cannot be assessedT0No evidence of primary tumorT1Clinically inapparent tumor that is not palpable  T1a – tumor incidental histological finding in 5% or less of tissue resected T1b – tumor incidental histological finding in more than 5% of tissue resected T1c – tumor identified by needle biopsyT2Tumor that…

de Morsier syndrome

HypopituitarismOptic nerve hypoplasiaAbsence of septum pellucidum

Classification of adult scoliosis

Aebi et. al classified adult scoliosis into three types TypeFeaturesIPrimary degenerative scoliosisDevelops after skeletal maturityMinimal structural deformitiesAdvanced degenerative changesLumbar spine most commonAsymmetric degeneration of disc and facet joints with osteoporotic fracturesIIProgressive idiopathic deformityDevelops before skeletal maturitySymptomatic in adult lifeCervical, thoracic or lumbarIIISecondary degenerative scoliosisSecondary to pelvic obliquity, hip pathology or lumbosacral transitional anomalySecondary to metabolic…

8th edition TNM colorectal cancer staging

StageTumor extentDukes5-year survivalIT1 – invades submucosa T2 – invades muscularis propria No nodal involvement, no distant metastasisA85-95%IIT3 – invades outside muscularis propria T4a – invades visceral peritoneum T4b – invades other organs No nodal involvement, no distant metastasisB60-80%IIIN1 – 1 to 3 lymph nodes N2 – more than 3 lymph nodesC30-60%IVaM1a – distant metastasis to…

8th edition AJCC gastric cancer staging

T staging TXPrimary tumor cannot be assessedT0No evidence of primary tumorTisCarcinoma in situ: intraepithelial tumor without invasion of the lamina propria, high-grade dysplasiaT1Tumor invades lamina propria, muscularis mucosa or submucosaT1aTumor invades lamina propria or muscularis mucosaT1bTumor invades the submucosaT2Tumor invades the muscularis propriaT3Tumor penetrates the subserosal connective tissueT4Tumor invades the serosa or adjacent structuresT4aTumor invades…

Erdheim-Chester disease

Rare form of histiocytosisMean age 55 – 60 yearsM:F = 3:1Skeletal involvement 95%Cardiovascular involvement 50%Retroperitoneal fibrosis 30%CNS involvementDiabetes insipidusExophthalmos Imaging  Bilateral, symmetrical cortical/medullary sclerosis of major long bone metadiaphyses with epiphyseal sparingBone scintigraphy, PET-CT show increased uptake

8th edition TNM lung cancer staging

T staging TxTumor in sputum/bronchial washings but not seen in imaging or bronchoscopyT0No evidence of tumorTisCarcinoma in situT1≤3 cm surrounded by lung/visceral pleura, not involving main bronchusT1a(mi)Minimally invasive carcinomaT1a≤1 cmT1b>1 to ≤2 cmT1c>2 to ≤3 cmT2>3 to ≤5 cm or involvement of main bronchus without carina, regardless of distance from carina or invasion of visceral…

Endoleak classification

TypeFeaturesIsecondary to inadequate seal at the EVAR anchor site; occurs in up to 10% of case, almost never resolves and usually requires treatment to reseal the defectIIthe sac fills retrogradely via branch vessels arising from the lumbar, inferior mesenteric or internal iliac arteries and occurs in up to 25% of casesIIImechanical failure due to defect…

International neuroblastoma staging system

StageDescription1localized tumor confined to area of origin; complete gross resection with or without microscopic residual disease; identifiable ipsilateral and contralateral lymph nodes negative macroscopically2Alocalized tumor with incomplete gross excision; identifiable ipsilateral and contralateral lymph nodes negative microscopically2Bunilateral tumor with complete or incomplete gross resection with positive ipsilateral regional lymph nodes; contralateral lymph nodes negative microscopically3tumor…

Salter-Harris classification of fractures

TypeFindingI5%isolated to growth plate with epiphyseal separationno adjacent bone fracturefracture line passes through hypertrophic layer of physisII75%fracture splits growth plate, extends into metaphysis, separating a small fragment of bonesecondary to shearing or avulsive forcesseen in children 10-16 years of ageIII10%fracture line passes through epiphysis, then horizontally across growth platemost common in distal tibia in children…

Graf angles in developmental dysplasia of hip

TypeAlpha angleBeta angleBony roofOssific rimCartilage roofInterpretationI a >60<55good sharpcovers femoral headmatureI b>60>55good usually bluntcovers headmatureII a 50-59>55deficientroundedcovers head< 3 months of age (physiological ossification delay)II b50-59>55deficient roundedcovers head> 3 months of ageII c43-49<77deficientrounded/flatcovers headII d43-49>77severely deficientrounded/flatcompressed on point of dislocationIII a<43>77poor flatdisplaced up echo poordislocatedIII b<43>77poor flat displaced up reflectivedislocatedIV<43>77poor flat interposeddislocated

Radiographic grading of Vesicoureteric Reflux

GradeFindingIureter and upper collecting system without dilatationIImild dilatation of ureter and renal pelvis with minimal blunting of fornicesIIImoderate dilatation of ureter and renal pelvis with minimal blunting of fornicesIVmoderate dilatation and tortuosity of ureter with moderate dilatation of renal pelvis and calyces, obliteration of sharp angle of fornices, but maintenance of papillary impression in majority…

Ultrasound classification of pelvicalyceal dilatation

TypeFinding0collecting system hardly visible, normalIjust renal pelvis visible, calyces not seen. pelvic diameter <7 mm, considered normalIIaxial renal pelvis diameter <10 mm, some calyces visible but with normal forniceal and papillar shape / configurationIIImarked dilatation of calyces and pelvis, pelvic axial width >10 mm with flattened papilla and rounded fornices, but without parenchymal narrowingIVgross dilatation…

Modified Stocker Congenital Pulmonary Airway Malformations Classification

Type Description 0 Incompatible with life 1 Commonest (>65%) Several large intercommunicating cysts (up to 10 cm) Mediastinal shift common 2 10-15% Smaller than other types Small evenly sized cysts (up to 2 cm) Other associated congenital abnormalities 3 8% cases Large solid appearing lesion with microcysts (<5 mm) Causes mediastinal shift Poor prognosis 4 10-15% Large cysts, indistinguishable from type 1 

9th AJCC cervical cancer staging

T category FIGO stage T criteria TX  Primary tumor cannot be assessed T0  No evidence of primary tumor T1 I Carcinoma is strictly confined to cervix (extension to corpus should be disregarded) T1a IA Invasive carcinoma that can be diagnosed by microscopy with maximum depth of invasion ≤5 mm T1a1 IA1 Measured stromal invasion ≤3 mm T1a2 IA2 Measured stromal invasion >3 mm and ≤5 mm T1b IB Invasive carcinoma with measured deepest invasion >5 mm; lesion limited…

West syndrome

Triad of myoclonic seizureshypsarrhythmic electroencephalogramdevelopmental delay

Turner syndrome

monosomy 45, XO1 in 3000-5000skeletal growth arrest at 15 years Cardia coarctationaortic stenosisidiopathic hypertensionlymphangiectasia, generalized hydros head and neck webbed neckhigh palatelow irregular nuchal line nuchal cystic hygroma endocrine thyromegalypigmented nevi, keloid formationsexual infantilismprimary amenorrheaabsent secondary sex characteristicsraised urinary gonadotrophins chest wide spaced nipplesshield shaped chestthin narrow ribs with pseudonotchingthin lateral clavicle margins abdomen horseshoe…

Bonnevie-Ullrich syndrome

infantile form of Turner syndromecongenital webbed neckwidely separated nippleshand and feet lymphedema

Williams syndrome

idiopathic hypercalcemia of infancyneonatal hypercalcemia MSK osteosclerosisdense broad zone of provisional calcificationbone islands in spongiosadense vertebral end platesradiolucent metaphyseal bandscraniosynostosis Cardio supravalvular aortic stenosisaortic hypoplasiavalvular pulmonary artery stenosisASDVSD Abdomen colonic diverticulabladder diverticula

Joubert syndrome

total aplasia of cerebellar vermisfailure of formation of decussation of superior cerebellar peduncleslack of pyramidal decussationsother anomalies of midbrain crossing tracts and their nucleiassociated anomalies: renal cysts, ocular abnormalities, liver fibrosis, hypothalamic hamartomas, polymicrogyria clinical presentation tachypneaabnormal eye movementsataxiaoccasionally clinically normal MRI cleft within vermissmall midbrainsuperior peduncles enlargedmolar tooth appearance: seen on axial images, due…

Cotswold’s modification of Ann Arbor staging of Hodgkin’s disease

StageClassificationIinvolvement of single lymph node region (I) or a single extralymphatic organ or site (IE)IIinvolvement of two or more lymph node regions on the same side of the diaphragm (II) or on one or more lymph node regions plus an extralymphatic site (IIE)IIIinvolvement of lymph node regions on both sides of the diaphragm (III) (spleen…

Harborview high-risk criteria for cervical spine injury

Computed tomography is indicated in any of the following criteria presence of significant head injurypresence of focal neurological deficit(s)presence of pelvic or multiple extremity fracturescombined impact of accident >50 km/hdeath at the scene of motor vehicle accidentaccident involved fall from a height of 3 meter or more Harborview high-risk criteria

Wells clinical prediction rule for pulmonary embolism

CriteriaPointsprevious pulmonary embolism or deep venous thrombosis1.5heart rate > 100 beats per min1.5surgery or immobilization < 4 weeks1.5hemoptysis1active cancer 1clinical signs of deep venous thrombosis3alternative diagnosis less likely than pulmonary embolism3 Pulmonary embolism is likely if > 4 points

Facet joint osteoarthritis grading

Weishaupt et al. refined grading of Pathria et al. to grade facet joint osteoarthritis on CT and MRI Grading Grade 0 normal facet joint space (2-4 mm width) Grade 1 narrowing of joint space (<2 mm) and/or small osteophytes and/or mild hypertrophy of articular processes Grade 2 narrowing of joint space and/or moderate osteophytes and/or…

Carney complex

autosomal dominantmyxoma (heart, breast, skin)abnormal skin pigmentationendocrine abnormalities: primary pigmented nodular adrenocortical disease leading to ACTH- independent Cushing’s syndrome

KDIGO Acute Kidney Injury Staging

Using serum creatinine as reference, Kidney Disease Improving Global Outcomes (KDIGO) criteria has been endorsed by NKF Kidney Disease Outcomes Quality Initiative. Serum creatinine is the most practical and common method of assessing acute kidney injury Stage 1 1.5 – 1.9 times baseline serum creatinine or Increase in serum creatinine >= 0.3 mg/dl (>= 26.5…

Spondylolisthesis types

Grading of meniscal tears

Bigliani classification of acromion morphology

Cystic duct insertion variants

Extensor compartments of wrist

Uterine anomalies

Hematoma signals on an MRI

Schatzker classification of tibial plateau fractures

ACR BI-RADS

5th edition, 2013 reporting system was introduced to standardize reporting of breast lesions. The original ACR reporting document can be downloaded here. Categories Category 0 – Incomplete need additional imaging for evaluation / prior images for comparisonrecall the patient for the above information Category 1 – Negative needs only routine mammographic screeningno likelihood of cancer…

ACR TI-RADS

A system introduced to standardize reporting of thyroid nodules on an ultrasound. Five ultrasound features are evaluated with points awarded to each feature. Compositioncystic or almost completely cystic – 0spongiform – 0mixed cystic and solid – 1 solid or almost completely solid – 2Echogenicityanechoic – 0 hyperechoic or isoechoic – 1hypoechoic – 2 very hypoechoic…

Bosniak classification of renal cysts

New York criteria for radiological grading of sacroiliitis

Devised in 1966, it was modified in 1984 to enable the diagnosis of ankylosing spondylitis. To date, it is the most used classification in radiography. Studies have shown that, it could take up to 9 years after disease onset for radiographic changes to appear. MRI is a no brainer in picking up disease way before…

Sarteschi grading of varicocele

Numerous classifications are around for grading varioceles. One of the most popular ones used is using gray scale and color doppler ultrasound to classify severity of varicoceles Classification Grade 1 No 2D evidence of scrotal varicosity Prolonged reflux in inguinal vessels only during Valsalva Grade 2 Small varicosity reaching superior pole of testis, increasing in…

St. James’s university hospital classification of perianal fistulas

An MR imaging based classification was proposed to augment the surgical classification offered by Park primarily to facilitate radiologists to provide accurate detailed descriptive reports that will influence the management of these fistulas. Classification Grade 1: simple linear intersphincteric fistula Grade 2: intersphincteric fistula with an abscess or secondary track Grade 3: transsphincteric fistula Grade 4: transsphincteric…

Park classification of perianal fistulas

Park et al described perianal fistulas in the coronal plane according to course of fistula and relation to internal and external sphincters. This was based on surgical findings of 400 patients referred to St Mark’s Hospital surgery in London, England. Classification Intersphincteric Transsphincteric Suprasphincteric Extrasphincteric Key inferences External sphincter is the key landmark for this…

Steinberg staging of avascular necrosis

At and about the time when Ficat and Arlet in the late 70s brought out their system of classification, Steinberg and colleagues proposed a system which also incorporates quantitative assessment of femoral head involvement. This is primarily useful in standardizing reporting of direct comparison between series of studies of the same patient. Staging Stage 0 normal or…

Ficat and Arlet staging of hip avascular necrosis

Professor R.P. Ficat and professor J. Arlet in the late 70s devised a staging system for idiopathic bone necrosis of femoral head based on two fundamental concepts: a standard radiograph shows only the shadow of the mineralized portion of the bone. bone necrosis is the end result of severe and prolonged ischemia. Staging Stage 0…

Carotid stenosis grading

A standardized systematic approach is essential for grading carotid stenosis using doppler ultrasound. It involves taking multiple parameters into consideration: B mode imaging: vessel diameter, vessel area plaque characterization assessing color flow documenting hemodynamic flow velocities at and beyond stenosis understanding collateral flow status Low degree stenosis (0% to 40%) [NASCET] B-mode imaging is relevant.…

WHO classification of endometrial stromal tumors

2014 revision of the 2003 WHO classification is the one currently in place that classifies these rare uterine mesenchymal neoplasms incorporating molecular findings Classification Endometrial stromal nodule (ESN) Low-grade endometrial stromal sarcoma (LGESS) High-grade endometrial stromal sarcoma (HGESS) Undifferentiated uterine sarcoma (UUS) Read more Ali, Rola H., and Marjan Rouzbahman. “Endometrial stromal tumours revisited: an…

AAST liver injury scale

N.B. advance one grade for multiple injuries up to grade III 1994 revision Moore et al. AAST 

AAST spleen injury scale

N.B. advance one grade for multiple injuries up to grade III 1994 revision Moore et al. AAST. 

AAST lung injury scale

N.B.  Increase one grade for bilateral injuries up to grade III. Hemothorax is scored under thoracic vascular injury scale. 

AAST cervical vascular injury scale

N.B.  Increase one grade for multiple grade III or IV injuries involving more than 50% vessel circumference. Decrease one grade for less than 25% vessel circumference disruption for grade IV or V.

Modified Fisher grading – subarachnoid hemorrhage

In 2006, Frontera et al. modified the Fisher scale and compared it with the original scale to see which was a better predictor. They studied 1355 patients and concluded the modified scale better predicts symptomatic vasospasm after subarachnoid hemorrhage.

Fisher grading – subarachnoid hemorrhage

#Fisher grading #SAH #subarachnoid #hemorrhage #foamed #ct

Glasgow Coma Scale

4 steps of assessment Check for factors interfering with communication, ability to respond and other injuries. Observe eye opening, content of speech and movements of right and left sides. Stimulate – spoken or shouted interest, pressure on finger tip, trapezius or supraorbita notch Assign according to highest response obtained. EYE OPENING VERBAL RESPONSE BEST MOTOR RESPONSE…