Radiology High Yield Golden Points For USMLE & PGMEE Exams

Radiology High Yield Golden Points For USMLE & PGMEE Exams

Common radiological findings are not just tested in USMLE but also in PG Entrance Exams across India including AIIPG, NEET, PGI & DNB. In USMLE exams, they are commonly asked in the form of vignettes. On the other hand, Indian PG Exams often tend to ask them as an isolated Multiple Choice Question.  Here we provide you high yield points, which have been repeatedly asked in USMLE as well PGMEE Exams. You may use them as a memory note or compile them in your flashcards.

Fruit Signs in Radiology

Apple Core Lesion : Seen in Colorectal Carcinoma and Synovial Osteochondromatosis.

Apple Peal Appearance: Seen in Illeal Atresia.

Banana Sign : Seen in Anencephaly.

Banana Fracture: Seen in Paget Disease of Bone.

Lemon Sign: Seen in Spina Bifida, Chiari II Malformation, Encephalocele and Dandy Walker Syndrome.

Strawberry Gallbladder: Seen in Cholesterosis.

Strawberry Skull: Seen in Edward Syndrome ( Trisomy 18)

Bubbles in Radiology

Single Bubble Sign: Seen in Pyloric Stenosis

Double Bubble Sign: Seen in Duodenal Atresia and Annular Pancreas

Triple Bubble Sign: Seen in Illeal/Jejunal Atresia

Soap Bubble Appearance on X-ray Abdomen: Seen in Meconium Illeus.

Soap Bubble Appearance on X-ray Bone: Seen in Osteoclastoma (Giant Cell Tumor)

Soap Bubble Appearance on Lymphangiography: Hodgin’s Disease


Calcifications in Radiology

Bracket Calcification: Seen in Meningioma and Pericallosal Lipoma (Lipoma of Corpus Callosum)

Coin Shadow Calcification: Seen in Epidermoid Carcinoma

Calcified Basal Ganglia: Seen in Idiopathic ( /Ageing Factors),  Hypoparathyroidism ( 2nd most common cause), Lead/CO Poisoning, Wilsons Disease, Neurocysticercosis

Egg Shell Calcification: Seen in Silicosis, Sarcoidosis and Radiotherapy following Lymphoma.

Sun Burnt Calcification: Seen in Insulinoma

Post Pneumonia Calcification: Particularly seen in Chicken Pox.


Calcifications Particularly Seen in CT Scan of Head

Bracket Calcification: Pericallosal Lipma

Sun Ray Calcification: Seen in Meningioma.

Soap Bubble Calcification: Seen in Neuroparagonimosis

Rice Grain Calcification:  Seen in Neurocysticercosis (NCC)

Ribbon Shaped Calcification: Seen in Oligodendroglioma


Animal Signs in Radiology

Bird of Prey Sign: Seen in Sigmoid Volvulus.

Bird Beak Sign: Seen in Achalasia Cardia

Bull’s Eye Sign: Seen in Intussusception.

Cobra Head Appearance: Seen in Ureterocele.

Bat Wing Opacities: Seen in Pulmonary Edema, Aspiration Pneumonia , Pneumocystis Pneumonia (PCP) and Primary Alveolar Proteinosis.

Fox Sign: Seen in Acute Pancreatitis


Miscellaneous Signs and Findings

Cupola Sign: Seen in Pneumoperitoneum

Meniscus/ Crescent Sign: Seen in Fungal Ball/ Aspergilloma

Honeycombing of  Lung: Seen in Sarcoidosis, Tuberculosis, Interstitial Lung Disease(ILD), Pneumoconiosis and Histiocytosis.

Jug Handle Appearance:  Seen in Pulmonary Hypertension.

Pruned Tree Appearance:  Seen in Pulmonary Hypertension.

Onion Peel Appearance: Seen in Ewing Sarcoma

Notching of Ribs (Classical Notching / Inferior Surface Notching ): Seen in Coarctation of Aorta.

Notching of Ribs (Superior Surface Notching) : Seen in Hyperparathyroidism and Neurofibromatosis.

Notching of Ribs (Unilateral Notching ) : Seen in Blalock Tssusing Shunt and Coarctation of Subclavian Artery.




  • Radiology Made Easy 2nd Edition – Arpan K. Banarjee
  • Radiology in Medical Practice 5th Edition – ABM Abdullah
  • Textbook of Radiology and Imaging 7th Edition – David Sutton, MD
  • USMLE Practice Test Items for Multiple-Choice Questions,  – updated February 2017