An attending physician is teaching a group of residents about the pathophysiological mechanisms that produce classic radiographic signs. Match each specific imaging description with its most likely corresponding clinical diagnosis.
- Visualization of both the mucosal and serosal surfaces of the bowel wall on a supine abdominal radiographPneumoperitoneum
- Prominent central pulmonary artery with focal peripheral oligemia on a chest radiographPulmonary embolism
- Nodular, thickened mucosal indentations projecting into the colonic lumen on an abdominal radiographIschemic colitis
- Bilateral erosion of the inferior margins of the posterior 3rd to 8th ribs on a chest radiographCoarctation of the aorta
Answer
The correct pairings match the Rigler sign with pneumoperitoneum, the Westermark sign with pulmonary embolism, the thumbprint sign with ischemic colitis, and inferior rib notching with coarctation of the aorta.
Each imaging descriptor directly translates to a specific pathophysiological process: free intraperitoneal air outlines the bowel serosa (pneumoperitoneum); acute vascular occlusion creates distal oligemia (pulmonary embolism); submucosal edema creates nodular luminal projections (ischemic colitis); and tortuous collateral arteries erode adjacent bone (coarctation of the aorta).
Step-by-Step Solution
Key Concept
Identifying pathophysiological mechanisms underlying classic radiologic signs