FMGE Radiology Syllabus

Radiology syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Radiology in FMGE, not a summary of it.

1. 1

   Introduction to Radiology

   2 topics

   • History of radiology
     • Evolution of imaging techniques and modalities
   • Basics of radiological physics
     • X-ray production
     • Interactions of X-rays with matter
     • Radiation safety
2. 2

   Radiological Anatomy

   3 topics

   • Radiological anatomy of the chest
     • Normal radiographic anatomy of the lungs
     • Normal radiographic anatomy of the mediastinum
     • Normal radiographic anatomy of the pleura
   • Radiological anatomy of the abdomen
     • Normal radiographic anatomy of the gastrointestinal tract
     • Normal radiographic anatomy of the liver
     • Normal radiographic anatomy of the spleen
     • Normal radiographic anatomy of the pancreas
     • Normal radiographic anatomy of the kidneys
     • Normal radiographic anatomy of the urinary tract
   • Radiological anatomy of the musculoskeletal system
     • Normal radiographic anatomy of the bones
     • Normal radiographic anatomy of the joints
     • Normal radiographic anatomy of the soft tissues
3. 3

   Diagnostic Radiography

   3 topics

   • Chest Radiography
     • Technique
     • Positioning (Posteroanterior, Lateral, and Oblique Views)
     • Interpretation of Common Findings (Pneumonia, Pneumothorax, Pleural Effusion)
   • Abdominal Radiography
     • Technique
     • Positioning (Supine, Upright, and Decubitus Views)
     • Interpretation of Common Findings (Intestinal Obstruction, Bowel Perforation, Renal Calculi)
   • Skeletal Radiography
     • Technique
     • Positioning (Anteroposterior, Lateral, and Oblique Views)
     • Interpretation of Common Findings (Fractures, Dislocations, Osteoarthritis)
4. 4

   Fluoroscopy

   2 topics

   • Upper gastrointestinal (GI) series
     • Technique
     • Indications
     • Interpretation of barium swallow studies for evaluation of esophageal and gastric pathology
   • Barium enema
     • Technique
     • Indications
     • Interpretation of barium enema studies for evaluation of colorectal pathology
5. 5

   Computed Tomography (CT)

   3 topics

   • Principles of CT imaging
     • Generation of CT images
     • Contrast enhancement
     • Multiplanar reconstruction
   • CT of the head
     • Indications
     • Protocols (non-contrast, contrast-enhanced)
     • Interpretation of findings (intracranial hemorrhage, brain tumors, stroke)
   • CT of the chest and abdomen
     • Indications
     • Protocols (contrast-enhanced, multiphase)
     • Interpretation of findings (pulmonary embolism, solid organ injuries, abdominal masses)
6. 6

   Magnetic Resonance Imaging (MRI)

   3 topics

   • Principles of MRI imaging
     • Generation of MRI images
     • Tissue contrast
     • Pulse sequences (T1-weighted, T2-weighted, diffusion-weighted)
   • MRI of the brain and spine
     • Indications
     • Protocols (with and without contrast)
     • Interpretation of findings (brain tumors, spinal cord compression, multiple sclerosis)
   • MRI of the musculoskeletal system
     • Indications
     • Protocols (with and without contrast)
     • Interpretation of findings (ligamentous injuries, soft tissue tumors, osteomyelitis)
7. 7

   Ultrasound Imaging

   3 topics

   • Principles of ultrasound imaging
     • Generation of ultrasound images
     • Transducer types
     • Doppler imaging
   • Abdominal ultrasound
     • Indications
     • Techniques (transabdominal, transvaginal)
     • Interpretation of findings (liver cysts, gallstones, renal calculi)
   • Obstetric ultrasound
     • Indications
     • Techniques (transabdominal, transvaginal)
     • Interpretation of findings (fetal anatomy, placental abnormalities)
8. 8

   Principles of nuclear medicine imaging

   3 topics

   • Radiopharmaceuticals
   • Gamma cameras
   • Single-photon emission computed tomography (SPECT)
9. 9

   Interventional Radiology

   2 topics

   • Image-guided procedures
     • Percutaneous biopsies
     • Drainages
     • Catheter-based interventions
   • Minimally invasive therapies
     • Radiofrequency ablation (RFA) for tumor treatment
     • Microwave ablation for tumor treatment
     • Cryoablation for tumor treatment
10. 10

    Radiation Oncology

    2 topics

    • Principles of radiation therapy
      • External beam radiation therapy (EBRT)
      • Brachytherapy
      • Intensity-modulated radiation therapy (IMRT)
    • Planning and delivery of radiation therapy
      • Treatment planning techniques (CT simulation, treatment planning software)
      • Radiation delivery methods (linear accelerators, gamma knife)

Radiology flashcards for FMGE

21 of 56 cards from the Radiology deck — real questions with worked answers.

1. Who is credited with discovering X-rays in 1895, and what name did he give them?

   Wilhelm Conrad Roentgen discovered them on 8 November 1895; he called them 'X-rays' because their nature was unknown (X = unknown). The first human radiograph was of his wife's hand. He won the first Nobel Prize in Physics (1901).

2. What did Marie and Pierre Curie contribute to the history of radiology?

   They discovered the radioactive elements polonium and radium (1898), founding the field of radioactivity that underpins nuclear medicine and radiation therapy. Marie Curie won Nobel Prizes in both Physics (1903) and Chemistry (1911).

3. In radiological physics, how are diagnostic X-rays produced in an X-ray tube?

   A heated cathode filament emits electrons (thermionic emission); these are accelerated across a high-voltage gap to strike a tungsten anode (target). The sudden deceleration produces bremsstrahlung X-rays, plus characteristic radiation from inner-shell electron transitions.

4. What is the difference between bremsstrahlung and characteristic X-radiation?

   Bremsstrahlung ('braking radiation') is produced when electrons decelerate near the nucleus, giving a continuous energy spectrum. Characteristic radiation occurs when an inner-shell electron is ejected and an outer electron fills the vacancy, emitting photons of discrete, element-specific energies.

5. What is the role of kVp versus mAs in producing an X-ray image?

   kVp (kilovoltage peak) controls the energy/penetrating power and contrast of the beam (higher kVp = more penetration, lower contrast). mAs (milliampere-seconds) controls the quantity of X-rays produced, governing image density/brightness and patient dose.

6. Name the five basic radiographic densities seen on a plain radiograph from least to most radiopaque.

   Air (most radiolucent/black) < fat < soft tissue/water < bone (calcium) < metal/contrast (most radiopaque/white).

7. What is the photoelectric effect and why is it important in diagnostic radiology?

   An incoming photon is completely absorbed by an inner-shell electron, which is ejected. Absorption is proportional to Z^3 (atomic number) and inversely to energy^3, so it produces the high subject contrast between bone (high Z calcium) and soft tissue at diagnostic energies.

8. State the inverse square law as it applies to radiation intensity.

   Radiation intensity is inversely proportional to the square of the distance from the source: I1/I2 = (d2/d1)^2. Doubling the distance reduces intensity to one quarter.

9. What are the three cardinal principles of radiation protection (ALARA)?

   Time, Distance, and Shielding — minimize exposure time, maximize distance from the source, and use shielding (e.g., lead). ALARA = As Low As Reasonably Achievable.

10. On a normal frontal chest radiograph, which structures form the right and left mediastinal (cardiac) borders?

    Right border (top to bottom): SVC and right atrium. Left border (top to bottom): aortic knob, main pulmonary artery, left atrial appendage, and left ventricle.

11. What is the normal cardiothoracic ratio on a PA chest radiograph, and when is it abnormal?

    The cardiothoracic ratio (max transverse cardiac width / max internal thoracic width) is normally less than 0.5 (50%) on a PA film. A ratio greater than 0.5 suggests cardiomegaly.

12. Why is a PA chest radiograph preferred over an AP view?

    In a PA (postero-anterior) view the heart is closer to the detector, minimizing magnification, and the scapulae are rotated off the lung fields. AP views (used for portable/supine patients) magnify the heart and can falsely suggest cardiomegaly.

13. What is the 'silhouette sign' on a chest radiograph and what does it localize?

    Loss of a normal anatomical border (silhouette) occurs when an adjacent opacity of the same density obliterates it. E.g., loss of the right heart border indicates right middle lobe disease; loss of the left hemidiaphragm border indicates left lower lobe disease.

14. On an abdominal radiograph, what feature distinguishes small bowel from large bowel?

    Small bowel shows valvulae conniventes (plicae) that cross the entire lumen and is typically central; large bowel shows haustra that only partially cross the lumen and lies peripherally. Small bowel diameter >3 cm is abnormal.

15. What are the upper limits of normal bowel diameter on an abdominal radiograph (the '3-6-9 rule')?

    Small bowel up to 3 cm, large bowel (colon) up to 6 cm, and caecum up to 9 cm. Exceeding these suggests obstruction or dilatation.

16. In musculoskeletal radiology, define the radiographic terms epiphysis, metaphysis, and diaphysis.

    Diaphysis is the central shaft; metaphysis is the flared region between shaft and growth plate; epiphysis is the end of the bone (beyond the physis/growth plate) that forms the joint surface and contains the secondary ossification centre.

17. What is the difference between cortical and trabecular (cancellous) bone on a radiograph?

    Cortical (compact) bone is the dense outer layer appearing as a smooth white line; trabecular (cancellous/spongy) bone is the inner meshwork appearing as a finer reticulated pattern, found mainly in the metaphysis and epiphysis.

18. What are the standard projections for a routine chest radiograph?

    The standard is a PA erect view taken in full inspiration, often with a left lateral view. Additional views include AP (portable/supine), lateral decubitus (for small effusions), and expiratory films (for pneumothorax).

19. List the systematic 'ABCDE' approach to reading a chest radiograph.

    A = Airway (trachea, carina), B = Breathing (lung fields, pleura), C = Cardiac (heart size, mediastinum), D = Diaphragm (costophrenic angles, free air below), E = Everything Else (bones, soft tissues, devices). Plus checking adequacy: rotation, inspiration, penetration.

20. What radiographic signs indicate adequate inspiration and no rotation on a chest film?

    Adequate inspiration: 8-10 posterior (or 5-6 anterior) ribs visible above the diaphragm. No rotation: the medial ends of both clavicles are equidistant from the spinous processes.

21. What is the radiographic sign of free intraperitoneal air (pneumoperitoneum) on an erect abdominal/chest film?

    Air seen under the diaphragm on an erect chest/abdominal radiograph. On a supine film, Rigler's sign (air on both sides of the bowel wall) and the football sign indicate free air, suggesting a perforated viscus.

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