Quick reference for radiological findings in X-ray films.

1. Radiological
Differential
Diagnosis
by Mohammed Musa
1st
edition

2. Contents:
Chest Imaging Differential Diagnoses .................................................... Page 3
Cardiac Imaging Differential Diagnoses ................................................. Page 8
Gastrointestinal Imaging Differential Diagnoses .................................... Page 12
Urinary Imaging Differential Diagnoses ................................................. Page 18
• Pelvocalyceal Differential Diagnoses ............................................ Page 20
• Ureteral Differential Diagnoses ..................................................... Page 20
• Bladder Differential Diagnoses ..................................................... Page 22
Musculoskeletal Imaging Differential Diagnoses .................................. Page 23
Radiological Differential Diagnosis =====( 2 )============= By Mohammed Musa

3. Chest Imaging
Differential Diagnoses
Acute Airspace Disease
1. Pulmonary edema
2. Pneumonia
3. Aspiration
4. Hemorrhage
Anterior Mediastinal Masses
1. Thymoma
2. Teratoma
3. Substernal thyroid
4. Lymphoma
Opacified Hemithorax
1. Atelectasis
2. Effusion
3. Pneumonia
4. Post-pneumonectomy
Chronic Airspace Disease
1. Alveolar cell ca
2. Alveolar sarcoid
3. Lymphoma
4. Alveolar proteinosis
Large Cavitary Lung Lesions
1. Abscess
2. Carcinoma
3. TB
Bibasilar Interstitial Disease
1. Bronchiectasis
2. Aspiration
3. DIP
Radiological Differential Diagnosis =====( 3 )============= By Mohammed Musa

4. 4. Asbestosis
5. Sarcoidosis
6. Scleroderma
Micronodular Lung Disease
1. Mets
2. Sarcoid
3. Pneumoconiosis
4. Miliary TB
Pulmonary Fibrosis
1. Pneumoconiosis
2. Interstitial Pneumonia
3. Granulomatous disease
4. Neoplastic disease
5. Idiopathic fibrosis
6. Collagen vascular disease
Small Cavitary Lung Lesions
1. Septic emboli
2. Rheumatoid nodules
3. Squamous or transitional cell mets
4. Wegener’s Granulomatosis
Lymphangitic Spread to the Lungs
1. Lung ca
2. Breast ca
3. Stomach ca
4. Pancreas ca
5. Laryngeal ca
6. Cervical ca
Multiple Lung Nodules
1. Mets
2. Wegener’s granulomatosis
3. Rheumatoid nodules
4. AVMs
5. Septic emboli
Radiological Differential Diagnosis =====( 4 )============= By Mohammed Musa

5. Shifting Infiltrates
1. Loeffler’s syndrome
2. ABPA
3. Asthma
4. Polyarteritis
5. Viral pneumonia
Unilateral Hyperlucent Lung
1. Swyer James syndrome
2. Pulmonary embolism
3. Pneumothorax
4. Obstructive emphysema
Rapidly Clearing Airspace Disease
1. Pneumococcal pneumonia
2. Hemorrhage
3. Pulmonary edema
4. Aspiration
Cavitating Pneumonia
1. Staph
2. Strep
3. TB
4. Gram negative (klebsiella)
Middle Mediastinal Masses
1. Lymphadenopathy
2. Aneurysms
3. Esophageal duplication
4. Bronchogenic cysts
Masses with Air Bronchograms
1. Lymphoma
2. Alveolar cell ca
3. Pseudolymphoma (Maltoma)
Cavities Containing Masses
1. Aspergillosis
2. Cavitating bronchogenic ca
3. Hydatid cyst
Radiological Differential Diagnosis =====( 5 )============= By Mohammed Musa

6. 4. Tuberculosis
Infiltrates with Effusion
1. Staph pneumonia
2. Strep pneumonia
3. TB
4. Pulmonary infarct
“Mass”+ ipsilateral adenopathy
1. Bronchogenic ca
2. Lymphoma
3. TB
Solitary Pulmonary Nodule
1. Bronchogenic ca
2. Hamartoma
3. Histoplasmoma
4. TB granuloma
5. Bronchial adenoma
6. Solitary met
7. Round pneumonia
8. Rounded atelectasis
Pleural Effusion
1. CHF
2. Mets
3. Pancreatitis
4. Pulmonary embolism
5. Trauma
6. Empyema
7. Collagen vascular
8. Ovarian tumor (Meig’s Syndrome)
9. Chylothorax
Multiple Small Calcifications
1. Histoplasmosis
2. Silicosis
3. Chicken pox pneumonia
4. Pulmonary ossification 2° MS
5. Alveolar microlithiasis
Radiological Differential Diagnosis =====( 6 )============= By Mohammed Musa

7. Posterior Mediastinal Masses
1. Neurogenic tumors
2. Lymphadenopathy
3. Extramedullary hematopoiesis
Mediastinal Adenopathy
1. Bronchogenic ca
2. Lymphoma
3. TB
4. Mets
5. Sarcoid
Lung Disease & Rib Destruction
1. Bronchogenic ca, i.e. Pancoast tumor
2. Actinomycosis
3. Blastomycosis
4. Multiple myeloma
Pleural Calcification
1. Old TB empyema
2. Asbestos exposure
3. Hemothorax
“Masses” in Cardiophrenic Angle
1. Sequestration
2. Diaphragmatic hernia
3. Pericardial cyst
Unilateral Pulmonary Edema
1. Aspiration
2. Disease in other lung, e.g. COPD
3. Postural
4. Rapid expansion of PTX
Reverse Pulmonary Edema
1. Eosinophilic lung disease, e.g. Loeffler’s
2. Sarcoid
3. Pulmonary contusions
Radiological Differential Diagnosis =====( 7 )============= By Mohammed Musa

8. Cardiac Imaging
Differential Diagnoses
Cyanosis with decreased Vasculature:
1. Tetralogy
2. Truncus-type IV
3. Tricuspid atresia
4. Transposition
5. Ebstein’s anomaly
CHF in the Newborn:
1. Hypoplastic Left Heart Syndrome
2. Coarctation of the aorta
3. Cong. aortic stenosis
4. Mitral stenosis
5. Cor triatriatum
6. Pulmonary venous obstruction as in:
◦ Stenosis of the pulmonary veins
◦ TAPVR from below diaphragm
Cardiomegaly with Normal Vasculature:
1. Viral myocarditis
2. Endocardial fibroelastosis
3. Aberrant coronary artery (from PA L to R shunt)
4. Cystic medial necrosis of coronary arteries
5. Diabetic mother
Cyanosis with Increased Vasculature:
1. Transposition
2. Truncus types I,II,III
3. TAPVR
4. Tricuspid atresia
5. Single ventricle
Radiological Differential Diagnosis =====( 8 )============= By Mohammed Musa

9. Causes of Enlarged Left Atrium:
1. CHF
2. Mitral stenosis
3. Mitral regurgitation
4. Prolapsed mitral valve
5. Papillary muscle dysfunction
6. Left atrial myxoma
Causes of an Enlarged Main Pulmonary Artery:
1. L to R shunt
2. Pulmonary arterial hypertension
3. Pulmonic stenosis
4. Idiopathic dilatation of pulmonary artery
Causes of Prominence of the Thoracic Aorta:
1. Hypertension (entire)
2. Atherosclerosis (entire)
3. Aortic insufficiency (entire)
4. Aortic stenosis (ascending)
5. Aneurysm (ascending or entire)
6. Coarctation of the aorta (ascending)
7. Aortitis (ascending or entire)
Types of Left-to-Right Shunts:
1. Atrial Septal defect
2. Ventricular Septal Defect
3. Patent ductus arteriosus
4. Anomalous pulmonary venous return
5. AV communis
6. Anomalous origin of left coronary artery from pulmonary artery
Causes of Increased Flow Vascularity:
1. Left-to-right shunts
2. Atrial septal defect
3. Ventricular septal defect
4. Patent ductus arteriosus
5. Total anomalous pulmonary venous return
6. AV communis
7. High-output states
Radiological Differential Diagnosis =====( 9 )============= By Mohammed Musa

10. Causes of Pulmonary Arterial Hypertension:
1. Primary or idiopathic
2. Secondary to
3. Lung disease – COPD, fibrosis
4. Pulm. arterial dz – arteritis, multiple emboli
5. Chronic hypoxia – hi altitude
Causes of Pulmonary Venous Hypertension:
1. Coarctation of aorta
2. Aortic stenosis
3. Hypoplastic Left Heart syndrome
4. Mitral stenosis-acquired or congenital
5. Left atrial myxoma
6. Cor triatriatum
7. TAPVR from below diaphragm
8. CHF
Causes of Congestive Heart Failure:
1. Coronary artery disease
2. Hypertension
3. Cardiomyopathy
4. Valvular lesions – AS, MS
5. Left-to-right shunts
6. Fluid overload
Causes of Marked Enlargement of Cardiac Silhouette:
1. Cardiomyopathy
2. Pericardial Effusion
3. Multiple valve disease
Causes of Cardiomyopathy:
1. Alcoholism
2. Coronary artery disease
3. Collagen-vascular disease
4. Myocarditis – e.g. rheumatic
5. Amyloidosis
6. Nutritional – e.g. Beriberi
Radiological Differential Diagnosis =====( 10 )============= By Mohammed Musa

11. Causes of Pericardial Effusion:
1. Viral pericarditis
2. Collagen-vascular disease, e.g. lupus
3. Uremia
4. TB
5. Trauma
6. Post myocardial infarction
7. Mets
Radiological Differential Diagnosis =====( 11 )============= By Mohammed Musa

12. Gastrointestinal Imaging
Differential Diagnoses
Multiple Esophageal Ulcers
1. Reflux
2. Infectious-HSV, Candida
3. Drug induced
4. Barrett’s
Solitary Esophageal Ulcer
1. HIV
2. CMV
Distal Esophageal Stricture
1. Peptic strictures
2. Barrett’s
3. Carcinoma-Gastric,esophageal
4. Achalasia
Mid-esophageal stricture
1. Barrett’s
2. Radiation
3. Ingestion of corrosives
4. Metastases to mediastinum
Esophageal Mucosal Nodularity
1. Reflux
2. Candida
3. Glycogenic Acanthosis
4. Barrett’s
Long esophageal stricture
1. Lye
2. NG Tube (prolonged use)
3. Radiation
Radiological Differential Diagnosis =====( 12 )============= By Mohammed Musa

13. Thickened esophageal folds
1. Varices
2. Varicoid carcinoma
3. Reflux esophagitis
4. Lymphoma
Solitary esophageal mass
1. Leiomyoma
2. Fibrovascular polyp
3. Inflammatory esophagogastric polyp
4. Papilloma
5. Carcinoma
Gastric ulcers, no mass
1. H. Pylori
2. Aspirin
3. Crohn’s
4. Zollinger-Ellison syndrome
Target lesions in GI tract
1. Hematogenous metastases-Breast, lung
2. Kaposi’s Sarcoma
3. Melanoma
Thickened Gastric Folds
1. Gastritis-Hypertrophic, H. Pylori
2. Menetrier’s disease
3. Zollinger Ellison syndrome
4. Varices
5. Lymphoma
Gastric Non-distensibility
1. Carcinoma-Primary, metastatic
2. Lymphoma
3. Atrophic gastritis
4. Scarring from PUD
5. Linitis Plastica of the Stomach
Radiological Differential Diagnosis =====( 13 )============= By Mohammed Musa

14. Linitis Plastica
1. Pancreatic tumor
2. Lymphoma
3. Amyloid
4. Sarcoid/Syphilis
5. TB
6. Ingested Corrosives
7. CA of stomach
Gastric outlet obstruction
1. Peptic ulcer disease-Acute or chronic
2. Carcinoma-Primary, Metastatic (pancreatic)
3. Gastric volvulus
4. Antral diaphragm/web
5. Pyloric stenosis in children
Gastric dilatation
1. Diabetes
2. Electrolyte/acid-base imbalance
3. Neuromuscular disorder
4. Abdominal surgery
5. Abdominal trauma
Widening of retrogastric space
1. Pancreatic mass
2. Retroperitoneal mass
3. Exophytic posterior wall gastric tumor
4. Aortic aneurysm
Antral Pad Sign
1. Pancreatic cancer
2. Pancreatic pseudocyst
3. Gallbladder (normal or distended)
Diseases that cross the pylorus
1. Lymphoma
2. Carcinoma
3. Crohn’s Disease
4. Peptic ulcer disease
5. TB
Radiological Differential Diagnosis =====( 14 )============= By Mohammed Musa

15. 6. Eosinophilic Gastroenteritis
Multiple Duodenal Filling Defects
1. Brunner’s gland hyperplasia
2. Polyps
3. Adenomatous, hyperplastic
4. Lymphoma
Thickened Duodenal Folds
1. Duodenitis
2. Chronic Renal Failure
3. Pancreatitis
4. Zollinger-Ellison Syndrome
5. Varices
6. Lymphoma
Duodenal-Biliary fistula
1. Prior sphincterotomy
2. Cholecystitis
3. Gallbladder carcinoma
4. Duodenal carcinoma
Duodenal Obstruction
1. Congenital duodenal atresia/stenosis
2. Annular pancreas
3. Midgut volvulus
4. Carcinoma
5. SMA syndrome
6. Intramural hematoma
Widening of duodenal sweep
1. Pancreatic Disease-Pancreatitis, pseudocyst, tumor
2. Lymphadenopathy
3. Aortic Aneurysm
4. Choledochal cyst
Dilated small bowel, No fold thickening
1. Scleroderma
2. Sprue
3. Small Bowel Obstruction
Radiological Differential Diagnosis =====( 15 )============= By Mohammed Musa

16. Multiple small bowel masses
1. Polyposis (Peutz-Jeghers)
2. Lymphoma
3. Metastases
Separation of small bowel loops
1. Thickening of bowel wall
2. Carcinoid
3. Crohn’s Disease
4. Ascites
5. Peritoneal metastases
6. Retractile mesenteritis
Multiple Colonic Filling Defects
1. Polyps (polyposis)
2. Pseudopolyps (UC)
3. Lymphoma
4. Cystic Pneumatosis
Smooth Colonic Stricture
1. Ulcerative Colitis
2. Crohn’s Disease
3. Radiation
4. Ischemia
Ileocecal disease
1. Crohn’s Disease
2. Lymphoma
3. TB
4. Cancer (colon adenocarcinoma, carcinoid)
Coned Cecum
1. Amebiasis
2. Crohn’s Disease
3. TB
Cecal Filling defect
1. Appendicitis/Mucocele
2. Crohn’s Disease
3. Cecal neoplasm
Radiological Differential Diagnosis =====( 16 )============= By Mohammed Musa

17. 4. Ileocolic intussusception
5. Lymphoma
Double tracking of Colon
1. Crohn’s Disease
2. Diverticulitis
3. Adenocarcinoma
Colon Thumbprinting
1. Ulcerative Colitis
2. Ischemia
3. Hemorrhage
4. Lymphoma
Smooth Colon
1. Ulcerative colitis
2. Cathartic Colon
3. Post ischemic
4. Post radiation
Widened Presacral space
1. Ulcerative colitis
2. Pelvic lipomatosis
3. Crohn’s Disease
4. Rectal tumor
5. Sacral tumor
Rectal Narrowing
1. Ulcerative Colitis
2. Pelvic Lipomatosis
3. Lymphogranuloma Venereum (LGV)
4. Solitary Rectal Ulcer Syndrome
5. Radiation
Radiological Differential Diagnosis =====( 17 )============= By Mohammed Musa

18. Urinary Imaging
Differential Diagnoses
Non-visualized kidney
1. Renal agenesis
2. Renal ectopia
3. Nonfunctioning kidney
Displaced kidney
1. Horseshoe kidney/pelvic kidney
2. Hepatomegaly/splenomegaly
3. Adrenal mass-downward
4. Bochdalek hernia-upward
Unilateral small kidney
1. Renal Ischemia/Renal Artery Stenosis/ Fibromuscular hyperplasia
2. Renal Infarction-Usually due to embolism
3. Postinflammatory/Post-obstructive atrophy
4. Radiation
5. Reflux atrophy
Bilateral small smooth kidneys
1. Bilateral atherosclerosis/embolism
2. Chronic Medical Renal Disease
• Chronic glomerulonephritis
• Hypertension
• Analgesic nephropathy
Unilateral large, smooth kidney
1. Ureteral obstruction
2. Renal duplication
3. Pyelonephritis
4. Acute Renal Vein Thrombosis
5. Acute Arterial Occlusion
Radiological Differential Diagnosis =====( 18 )============= By Mohammed Musa

19. Bilateral large smooth kidneys
1. Diabetes
2. Acute Glomerulonephritis
3. Collagen vascular diseases-SLE, Goodpasture’s, Wegener’s
4. Vasculitis-Polyarteritis nodosa
5. Malignancy-Lymphoma/Leukemia
6. Duplicated collecting systems
Bilateral Renal Enlargement with masses
1. PCKD
2. Lymphoma
3. Von Hippel-Lindau disease
4. Tuberous Sclerosis
Increasingly dense unilateral nephrogram
1. Obstruction
2. Renal vein thrombosis
3. Renal artery stenosis
Persistent bilateral nephrogram
1. Hypotension/shock
2. ATN
3. Acute glomerulonephritis
Medullary Nephrocalcinosis
1. Renal tubular acidosis
2. Medullary sponge kidney
3. Hypercalcemia
• Sarcoidosis
• Milk-alkali syndrome
• Hyperparathyroidism
• Vitamin D intoxication
Radiological Differential Diagnosis =====( 19 )============= By Mohammed Musa

20. Pelvocalyceal Differential Diagnoses:
Papillary Necrosis
1. NSAIDS
2. Sickle Cell Disease
3. Analgesic nephropathy
4. Infection (Tb)
5. Diabetes
*Mnemonic spells NSAID
Renal sinus mass effect
1. Parapelvic cyst
2. Renal sinus lipomatosis
3. Vascular abnormalities
4. Solid tumors of renal sinus
Clubbing or destruction of renal calyces
1. Papillary necrosis
2. TB
3. Chronic pyelonephritis
4. Hydronephrosis
5. Congenital megacalyces
Extra-calyceal contrast
1. TB
2. Papillary necrosis
3. Calyceal Diverticulum
4. Medullary Sponge Kidney
5. Post-obstructive
Ureteral Differential Diagnoses:
Lateral proximal ureteral deviation
1. Lymphadenopathy
2. Psoas hypertrophy
3. Aortic aneurysm
4. Retroperitoneal mass
Radiological Differential Diagnosis =====( 20 )============= By Mohammed Musa

21. Medial deviation of proximal or mid ureter
1. Renal or Retroperitoneal mass
2. Retrocaval ureter
3. Retroperitoneal Fibrosis
Medial displacement distal ureters
1. Pelvic lymphadenopathy
2. Pelvic lipomatosis
3. Iliopsoas muscle hypertrophy
4. Bilateral iliac artery aneurysm
5. S/P AP resection
Intraluminal filling defects renal pelvis/calyces/ureters
1. Calculus
2. Blood clot
3. TCC
4. Sloughed Papilla
5. Fungus ball
6. Air bubble (if post-instrumentation)
Ureteral filling defects
1. Tumor-TCC
2. Infection-TB, Schistosomiasis
3. Response to infection-Ureteritis cystica
4. Leukoplakia
5. Malacoplakia
Obstruction of the ureter
1. Calculus
2. Adjacent inflammatory disease
3. Malignancy
4. Ureterocele
5. Retroperitoneal fibrosis
6. Stricture
• Congenital
• Acquired (Instrumentation)
• Infection (TB, Schisto)
• Radiation
Radiological Differential Diagnosis =====( 21 )============= By Mohammed Musa

22. Ureteral Calcification
1. TB
2. Schistosomiasis
3. Calculi (Steinstrasse)
Bladder Differential Diagnoses:
Small urinary bladder
1. Transitional cell CA
2. Cystitis
3. Pelvic hematoma
4. Pelvic lipomatosis
5. TB/schistosomiasis
Enlarged urinary bladder
1. Bladder outlet obstruction
2. Neurogenic bladder
3. Diabetes
4. Absent abdominal wall musculature
Urinary bladder filling defect
1. Calculus
2. Blood clot
3. Neoplasm
4. Prostatic enlargement
5. Ureterocele
Air in urinary bladder
1. Emphysematous cystitis
2. Iatrogenic
3. Bladder fistula from diverticulitis, Crohn’s
Bladder Calcification
1. Schistosomiasis
2. TB
3. Cystitis
4. Bladder Calculus
5. Bladder neoplasm
Radiological Differential Diagnosis =====( 22 )============= By Mohammed Musa

23. Musculoskeletal Imaging
Differential Diagnoses
Diffuse Increase in Bone Density
1. Secondary to malignancy - metastases
2. Non-malignant disease - Paget's Disease
3. Myelofibrosis
4. Myelosclerosis - Sickle Cell Disease
5. Fluorosis
6. Mastocytosis
7. Osteopetrosis
8. Hypervitaminosis D
Diffuse Decrease in Bone Density
1. Osteoporosis-Multiple myeloma, Steroid administration
2. Osteomalacia
3. Hyperparathyroidism
4. Paralysis
5. Osteogenesis imperfecta
Focal lytic lesion
1. Primary malignancy -Myeloma
2. Secondary malignancy -Metastases
3. Eosinophilic granuloma
4. Brown tumors
Round Cell Lesions
1. Ewing’s sarcoma
2. Osteomyelitis
3. Multiple myeloma
4. Lymphoma and leukemia
5. Neuroblastoma
Radiological Differential Diagnosis =====( 23 )============= By Mohammed Musa

24. Expansile Lesion
1. 1° malignancy - Multiple myeloma
2. 2° malignancy - Mets
3. Non-malignant – Aneurysmal bone cyst
4. Fibrous dysplasia
5. Brown tumor
6. Enchondroma
Expansile Lesion of Rib
1. Primary malignancy – Plasmacytoma
2. Secondary malignancy – Mets
3. Non-malignant – Fibrous dysplasia
4. Chondrosarcoma
5. Enchondroma
6. Eosinophilic granuloma
7. Neurofibromatosis
Soap-Bubbly Lesion
1. Metastases, esp. kidney, thyroid, lung
2. Giant Cell Tumor
3. Plasmacytoma
4. Chondrosarcoma
Lesions with Associated Soft Tissue Masses
1. Multiple myeloma
2. Metastases
3. Osteomyelitis
4. Primary malignancies of bone, e.g. osteosarcoma
Sclerotic Cortical lesions
1. Osteoid osteoma
2. Brodie’s abscess
3. Healing stress fracture
Short Thumb
1. Myositis ossificans progressiva
2. Fanconi’s syndrome
3. Holt-Oram Syndrome
Radiological Differential Diagnosis =====( 24 )============= By Mohammed Musa

25. Short 4th Metacarpal
1. Turner’s syndrome
2. Pseudohypoparathyroidism
Clinodactyly
1. Down’s syndrome
2. Otopalatodigital syndrome
3. Cornelia de Lange syndrome
Polydactyly
1. Isolated anomaly
2. Ellis-Van Creveld syndrome
3. Carpenter’s syndrome
Syndactyly
1. Carpenter’s syndrome
2. Apert’s syndrome
3. Poland’s syndrome
Erosion - Distal Clavicle
1. Rheumatoid Arthritis
2. Hyperparathyroidism
3. Scleroderma
Acetabulo Protrusio
1. Paget’s disease
2. RA
3. Osteomalacia
4. Osteoporosis
5. Mucopolysaccharidosis
Acro-osteolysis
1. Thermal injury, burns, frostbite
2. Scleroderma
3. Hyperparathyroidism
4. Psoriasis
5. Raynaud’s disease
6. Leprosy
Radiological Differential Diagnosis =====( 25 )============= By Mohammed Musa

26. Avascular Necrosis
1. Idiopathic (Legg-Calve-Perthe’s Disease)
2. Steroid administration
3. Sickle cell anemia
4. Arteritis - collagen-vascular disease
5. Trauma
6. Gaucher’s
7. Pancreatitis
8. Fat embolism
Hypertrophic Osteoarthropathy
1. Carcinoma of the lung
2. Mesothelioma
3. Chronic lung infection (TB)
4. Chronic liver disease, e.g. cirrhosis
5. Ulcerative colitis
Lesions That Affect The Spine
1. Osteoblastoma
2. Chordoma
3. Aneurysmal bone cysts
4. Metastases
Lesions That Affect The Pelvis
1. Chondrosarcoma
2. Plasmacytoma
3. Chordoma
Posterior Scalloping
1. Neurofibromatosis
2. Achondroplasia
3. Spinal cord tumor (ependymoma)
Anterior Scalloping
1. Aortic aneurysm
2. TB
3. Neurofibroma
Radiological Differential Diagnosis =====( 26 )============= By Mohammed Musa

27. Lucent Metaphyseal Bands
1. Normal
2. Leukemia
3. Neuroblastoma
4. TORCH infection
Dense Metaphyseal Bands
1. Normal
2. Lead poisoning
3. Treated leukemia
4. Healing rickets
Bone Within a Bone
1. Osteopetrosis
2. Paget’s disease
3. Thorotrast
Chondrocalcinosis
1. Pseudogout
2. Gout
3. DJD
4. Hyperparathyroidism
5. Hemochromatosis
6. Wilson’s Disease
Intramedullary Calcification
1. Enchondroma
2. Bone infarct
3. Chondrosarcoma
Thinned Ribs (Ribbon-Ribs)
1. Neurofibromatosis
2. Osteogenesis imperfecta
3. Trisomy 18
4. Gorham’s Disease
Wide Ribs
1. Achondroplasia
2. Fibrous dysplasia
3. Rickets (rosary)
Radiological Differential Diagnosis =====( 27 )============= By Mohammed Musa

28. 4. Thalassemia
5. Mucopolysaccharidosis, esp. Hunter’s and Hurler’s
6. Gaucher’s disease
Wormian Bones
1. Normal
2. Hypothyroidism
3. Down’s Syndrome
4. Cleidocranial dysostosis
5. Osteogenesis imperfecta
Ankylosis of SI Joints
1. Ankylosing spondylitis
2. Psoriasis
3. Reiter’s syndrome
4. Inflammatory bowel disease
5. TB
Radiological Differential Diagnosis =====( 28 )============= By Mohammed Musa