Mirel’s scoring system rates 4 criteria from 1 to 3 with maximum possible score of 12 to assess the risk of pathological fracture due to metastases and also serves as a guide for considering prophylactic fixation. The parameters of the criteria can be remembered using the mnemonic MIREL’S. M –…
Tag: Radiology
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Appearance and Fusion of Ossification Centers
Upper end of humerus Mnemonic: HGL – 1,3,5 a. Head – by 1 year b. Greater tuberosity – by 3 years c. Lesser tuberosity – by 5 years All 3 centers fuse together by 6 years (1 year after the last center appears) Upper end of femur Mnemonic: HGL –…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Mnemonic Approach to Elbow Xray – FOOL
Mnemonic: FOOLa. Fat padsb. Overt findings and outlinesc. Ossification centersd. Lines Fat pads The elbow joint has anterior and posterior fat pads which are extra-synovial but within the articular capsule. These are present as a radiolucent (black) line (compared to bone and surrounding soft tissues) in lateral X-rays. Normal finding:…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Lines and Angles in Orthopedics
Slipped Capital Femoral Epiphysis (SCFE) Southwick’s angle: Epiphyseal-shaft angle on lateral radiograph <30 degrees: mild 30-60 degrees: moderate >60 degrees: severe Klein’s line: Line drawn along superior border of femoral neck (AP x-ray) In SCFE: will intersect less of the femoral head or not at all Developmental Dysplasia of Hip…
Emergency Medicine 
Ottawa Foot, Ankle and Knee rules – Mnemonic
Ottawa Ankle and Foot Rules Mnemonic: 44-55-66-PM Patients need an X-ray only if: 4: Unable to do 4 steps immediately AND4: Unable to do 4 steps at Emergency Department OR 5: Has pain at the base of 5th metatarsal5: Has pain at the 5caphoid (Navicular) OR 6: Tenderness in 6…
Emergency Medicine 
Pulmonary Embolism : Chest X-ray Signs
1. Classic presentation is normal X-ray in patient with dyspnea and hypoxia 2. Atelectasis or parenchymal abnormality (68%) 3. Elevated hemidiaphragm 4. Pleural effusion (Felson’s sign – pleural effusion on left > right) 5. Hampton’s hump: peripheral pleural based wedge-shaped density above the diaphragm due to pulmonary infarct 6. Westermark’s…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Rib Notching
Normal Rib Notching A small notch near the costo-vertebral joint is normal, so pathologic rib notching is more likely if the notching is more lateral. Types of Pathological Rib Notching 1. Superior rib notching 2. Inferior rib notching (more common) Inferior Rib Notching (Roesler’s sign) Mechanism: Enlargement of one or…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Silhouette and Cervico-thoracic sign
Synonyms: Obscured margin sign, Loss of outline sign Silhouette refers to the shadow and derived it’s origin from shadow papercuts done by Etienne de Silhouette. Principle of Silhouette sign On a normal Chest X-ray the well-defined borders of the heart and the domes of the diaphragm are visualised because the adjacent…