MBBS 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 MBBS, 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 MBBS

21 of 51 cards from the Radiology deck — real questions with worked answers.

1. Who discovered X-rays, and in what year, marking the birth of radiology?

   Wilhelm Conrad Röntgen discovered X-rays on 8 November 1895. He named them "X" rays because their nature was unknown, and he received the first Nobel Prize in Physics (1901) for the discovery.

2. What was the subject of the first medical X-ray image ever taken?

   The hand of Röntgen's wife, Anna Bertha Ludwig, taken in 1895, showing her bones and wedding ring.

3. Define an X-ray in terms of electromagnetic radiation and typical photon energy used in diagnostic radiology.

   X-rays are high-energy electromagnetic radiation (photons) with very short wavelength. Diagnostic X-rays typically have photon energies in the range of about $20$–$150\ \text{keV}$.

4. What are the two mechanisms by which X-rays are produced at the anode of an X-ray tube?

   1) Bremsstrahlung (braking radiation) — electrons decelerate near the nucleus, producing a continuous spectrum. 2) Characteristic radiation — incoming electrons eject inner-shell electrons; outer electrons fill the vacancy, emitting discrete-energy photons.

5. State the inverse square law for X-ray intensity and give its formula.

   X-ray intensity is inversely proportional to the square of the distance from the source: $$I \propto \frac{1}{d^{2}}$$ Doubling the distance reduces intensity to one quarter.

6. Name the five basic radiographic densities seen on a plain film, from most radiolucent (black) to most radiopaque (white).

   From black to white: 1) Air/gas, 2) Fat, 3) Soft tissue/water, 4) Bone/calcium, 5) Metal (and contrast media).

7. What physical process is primarily responsible for image contrast in diagnostic X-ray imaging?

   The photoelectric effect — its probability is strongly dependent on atomic number (approximately $\propto Z^{3}$) and inversely on photon energy, producing the differential absorption that creates contrast between tissues.

8. In an X-ray tube, what is the function of the cathode (filament) versus the anode (target)?

   The cathode (heated tungsten filament) emits electrons by thermionic emission. The anode (tungsten target) is struck by these accelerated electrons to produce X-rays. Tungsten is used for its high atomic number and high melting point.

9. Differentiate kVp and mAs in radiography and state what each primarily controls.

   kVp (kilovoltage peak) controls the energy/penetrating power and affects image contrast. mAs (milliampere-seconds) controls the quantity (number) of X-ray photons and thus film density/brightness and patient dose.

10. What is the silhouette sign on a chest radiograph and what does its presence indicate?

    The silhouette sign is loss of a normal anatomical border (e.g., the heart or diaphragm) when an adjacent structure of the same radiographic density (fluid/consolidation) lies in contact with it. It helps localize pathology to a specific lobe.

11. On a normal PA chest radiograph, how do you assess adequate inspiration by counting ribs?

    Adequate inspiration is present when the diaphragm is at the level of the anterior 6th rib (or posterior 8th–10th rib) in the midclavicular line.

12. What forms the right and left heart borders on a frontal chest radiograph?

    Right border: superior vena cava (upper) and right atrium (lower). Left border (top to bottom): aortic knob, main pulmonary artery, left atrial appendage, and left ventricle.

13. Why is a PA (posteroanterior) erect projection preferred over an AP projection for routine chest radiography?

    In PA the heart is closer to the detector, minimizing magnification of the cardiac silhouette, and the scapulae are rotated off the lung fields. The erect position also allows detection of air-fluid levels and free subdiaphragmatic air.

14. How is the cardiothoracic ratio (CTR) measured, and what value suggests cardiomegaly on a PA film?

    $$\text{CTR} = \frac{\text{maximum transverse cardiac diameter}}{\text{maximum internal thoracic (chest) diameter}}$$ A CTR greater than $0.5$ on an adequately inspired PA film suggests cardiomegaly.

15. What radiographic sign indicates pneumoperitoneum (free air) on an erect chest or abdominal film?

    Free gas under the diaphragm (subdiaphragmatic free air), typically more visible on the right side beneath the dome of the diaphragm; it indicates a perforated hollow viscus until proven otherwise.

16. Distinguish the small bowel from the large bowel on a plain abdominal radiograph.

    Small bowel: central location, valvulae conniventes (plicae circulares) crossing the full lumen width, diameter normally up to ~3 cm. Large bowel: peripheral, haustra that do not cross the full lumen, may contain faeces, diameter up to ~6 cm (caecum up to ~9 cm).

17. What are the upper limits of normal bowel diameter used in the "3/6/9 rule" for the abdomen?

    3 cm for small bowel, 6 cm for large (colon), and 9 cm for the caecum. Diameters exceeding these suggest obstruction or dilatation.

18. Differentiate small bowel obstruction from large bowel obstruction on an abdominal radiograph.

    Small bowel obstruction: central dilated loops with valvulae conniventes, multiple air-fluid levels, little/no colonic gas. Large bowel obstruction: peripheral dilated loops with haustra, dilated colon, with a competent ileocaecal valve sparing small bowel.

19. What is the long bone structure terminology: define epiphysis, physis, metaphysis, and diaphysis.

    Epiphysis: end of the bone, at the joint. Physis: the growth plate (cartilaginous, lucent in children). Metaphysis: the flared region adjacent to the growth plate. Diaphysis: the central shaft of the long bone.

20. What is the systematic ABCS approach to reading a musculoskeletal/skeletal radiograph?

    A — Alignment (bone alignment and joints). B — Bone density and texture (cortex, trabeculae). C — Cartilage and joint spaces. S — Soft tissues (swelling, effusion, foreign bodies).

21. What is a Salter-Harris classification used for, and what does Type II describe?

    It classifies growth plate (physeal) fractures in children. Type II — the most common — is a fracture through the physis extending into the metaphysis (the fracture line exits through the metaphysis). Mnemonic SALTR: S=Slipped, A=Above, L=Lower, T=Through, R=Rammed.

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