UPSC-CMS 2018 — Radiology

Q: Radiologic views used for fracture Mandible (body and Ramus) are all EXCEPT:

Submentovertex. ***Submentovertex*** - The **Submentovertex (SMV) view** is primarily used to assess the **zygomatic arches**, base of the skull, and sphenoid sinuses, not typically for mandibular body or ramus fractures. - While it can provide some information about the medial aspects of the mandible, it offers **limited structural detail** crucial for diagnosing fractures in the body and ramus. *Lower occlusal* - **Lower occlusal films** are useful for visualizing the **anterior mandible**, including the symphysis and parasymphysis regions, and the lingual aspect of the body. - They can provide detailed views of these specific areas but are not the primary view for comprehensive assessment of the entire body or ramus. *Lateral obliques* - **Lateral oblique views** are highly effective for visualizing the **body, angle, and ramus** of the mandible, providing a good representation of these regions without superimposition from the contralateral side. - This projection allows for assessment of fracture displacement and angulation in the lateral and postero-lateral aspects of the mandible. *Orthopantomogram* - An **Orthopantomogram (OPG)**, also known as a panoramic radiograph, provides a comprehensive view of the **entire mandible** and maxilla on a single film. - It is an excellent screening tool for identifying fractures in the **condyle, ramus, angle, body, and symphysis** of the mandible due to its broad coverage. [Practice more Radiology PYQs on OnCourse]

Q: Indications of computed tomography after head injury include all EXCEPT:

Mild head injury in a 50 year old man. ***Mild head injury in a 50-year-old man*** - This is not an absolute indication for CT scanning after head injury, especially if the patient is **neurologically intact** (GCS 15) and has no other high-risk features. - While age **> 65 years** is considered a risk factor in some guidelines (Canadian CT Head Rule), age 50 alone does not warrant CT in mild head injury (GCS 13-15) without additional warning signs. - CT would be indicated if this patient had **other risk factors** such as loss of consciousness, amnesia, vomiting, anticoagulation use, or dangerous mechanism of injury. *Open depressed fracture* - This is a **high-risk feature** indicating a severe head injury and potential for **intracranial injury** or infection, requiring immediate imaging. - CT is essential to assess the extent of **bone depression**, foreign bodies, and associated brain injury. *Glasgow Coma Scale 30 minutes* - **Post-traumatic amnesia (PTA)** lasting longer than 30 minutes is a recognized risk factor for **intracranial injury**, even in patients with otherwise normal GCS scores. - It indicates a more significant impact on brain function and warrants a CT scan to rule out **structural lesions** per NICE and Canadian CT Head Rules. [Practice more Radiology PYQs on OnCourse]

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Radiologic views used for fracture Mandible (body and Ramus) are all EXCEPT:

Indications of computed tomography after head injury include all EXCEPT: