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Radiology High Yield Golden Points For USMLE & PGMEE Exams


Radiology is a high yield subject to learn while preparing for any competitive post graduate entrance exams across the world. Radiology is not just a single subject as it cannot be isolated from other clinical disciplines like Medicine, Surgery and Pathology. 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(MCQ).

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. To make it less bulky, we have categorized the points as fruits, bubbles, animals etc.


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.

These are some the Radiology buzz words and key points collected from multiple sources. You may help us and our readers expand this list by adding such points in comments below. We hope these points will be helpful during the course of your preparation.



  • 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, http://www.usmle.org/practice-materials/index.html  – updated February 2017
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