Anatomy for the Royal College of Radiologists Fellowship. Malcolm Sperrin

4.31 Frontal radiograph of the shoulder

       4.32 Longitudinal view from an ultrasound of a paediatric lumbar spine

       4.33 Upper limb and cervical spine arterial angiogram

       4.34 Transverse view from an ultrasound of a paediatric lumbar spine

       4.35 Frontal radiograph—peg view

       4.36 Coronal CT of the wrist

       4.37 Sagittal T2-weighted sequence from an MRI of the cervico-thoracic spine

Preface

      Studying for the anatomy exam is tough but worthwhile, as a good understanding of anatomy forms a key part of the day-to-day life of a radiologist. Whilst you will previously have studied anatomy at medical school or in some cases for surgical exams, you have to approach radiological anatomy in a slightly different way, as it requires you to visualise three-dimensional structures on two-dimensional images. It is also important to be able to recognise structures on the range of imaging modalities that you will encounter in clinical practice, including plain radiographs, ultrasound, fluoroscopy and cross-sectional studies.

      We have written this book to try to make the process of learning anatomy as smooth as possible, by providing you with a resource to test your progress and provide advice for revision and sitting the examination. We have written the book specifically with the Royal College of Radiologists Part 1 examination in mind, although the questions and comments are more broadly applicable to other radiology anatomy examinations. We were prompted to write this book because, when we sat the examination ourselves in the past two years, we noticed that some resources featuring exam-style questions were below the level of difficulty that we experienced. We wanted to prepare a text that reflected some of the more difficult questions that you may encounter. Don’t be discouraged as you go through the book if you find it particularly challenging–the exam will have a mix of straightforward and difficult questions!

      The main difference between our questions and the examination is that the FRCR Part 1 will only have one question per image. We have chosen to test five structures on each image, as we felt this would be a more efficient way to give you as much practice as possible as you work through the book. It also emphasises the point that the structures that you are asked to identify in the exam may be at the periphery of an image, or may be shown from a slightly unusual perspective.

      In addition to the questions and answers, we have written comments sections designed to provide further clarification on why we gave certain answers where there might be ambiguity. These sections also describe the anatomy depicted in the questions, to help you to understand how the structures relate to each other and assist with problem-solving in the exam. You will also notice words highlighted in bold–these are structures that we feel could legitimately be examined, and that we would advise you to be able to recognise (although not necessarily on the image provided). The exam tips are taken from our experiences, and include advice we were given during preparation for the Part 1, and reflections from our own experience.

      Although we have made every effort to make sure we have been as accurate as possible, the text may still contain mistakes, so please do not rely on this book for clinical decision making. If you do notice any mistakes, we would be grateful to receive your feedback, so that we can improve any future editions of the book. Finally, we would advise that you read the guidance provided on the Royal College of Radiologists website, particularly in case any changes in format or content have arisen since the publication of this book.

      Thanks for reading, and good luck!

Author biographies

      Andrew G Murchison

      Andrew grew up in Edinburgh and studied medicine at the University of Oxford. He was awarded the top first for the BA in medical sciences, and graduated with distinction. He completed core medical training and is currently an academic clinical fellow in clinical radiology. He is married with a young son, and lives in Oxford.

      Mitchell Chen

      Mitch is an academic clinical fellow in radiology at the Oxford University Hospitals NHS Foundation Trust, where he researches on novel imaging modalities alongside his clinical training. He graduated from Oxford University, with a bachelor’s degree in medicine and surgery, a master’s degree in engineering science and a DPhil. In addition to his work, he has passions for long distance running and travelling.

      Thomas Frederick Barge

      Having graduated in medicine from the University of Oxford in 2011, Tom completed his foundation training in the Oxford deanery. He then moved to New Zealand where he worked in acute medicine, ED and ICU, before returning to start radiology training in Oxford. He is a keen cyclist.

      Shyamal Saujani

      Dr Shyamal Saujani is a third year radiology registrar in the Oxford training programme. He undertook his undergraduate medical training at the Universities of Exeter and Plymouth, before embarking on an intercalated degree in anatomy at King’s College University, London. In his spare time he enjoys cooking, spending time with his family and travelling around the country following his favourite football club.

      Christopher Sparks

      Upon completion of his undergraduate studies and the Foundation Programme in Liverpool, Chris worked in a variety of medical specialties in New Zealand before returning to the UK for Core Medical Training and, subsequently, the Clinical Radiology training programme in Oxford. Outside of work Chris enjoys running, skiing, travelling and the search for the perfect British pub.

      Radoslaw Adam Rippel

      Radoslaw Rippel is a Clinical Radiology registrar in Oxford Deanery and University College London Medical School alumnus. His previous work includes publications on use of nanoparticles, tissue engineering and endovascular robotics. Clinically his main interests are musculoskeletal radiology and ultrasound guided intervention. In his spare time Radoslaw enjoys motorsports, cycling and running. Recently he has welcomed a baby girl however, and so spare time has become a thing of the past.

      Malcolm Sperrin

      Malcolm was born in Cuba of diplomatic parents in 1963, and attended The Harvey Grammar School in Folkestone leaving there in 1981 to study Physics with Maths at Reading University. His first job was working on Artificial Intelligence and then with the UK Atomic Energy Authority on reactor fault analysis. This experience placed him in a good position to provide insight into both the Chernobyl and Fukushima incidents.

      After further study at Reading University, Malcolm joined Medical Physics at the Churchill Hospital in Oxford with responsibility for non-ionising radiation. In 1995, Malcolm moved to the Princess Margaret Hospital in Swindon acting as Deputy Head of Department and then, in 2002, he moved to The Royal Berkshire Hospital in Reading taking on the role of Departmental Director.

      Malcolm