RANZCR key conditions assessment

The RANZCR key conditions assessment is an assessment mandated by the Royal Australian and New Zealand College of Radiologists (RANZCR) for first year radiology trainees prior to starting after-hours work and on-call duties.

The assessment is conducted locally by the training site, where clinical supervisors select a minimum of 16 cases from the key conditions categories (see below) as a "mock list" to assess a trainee's competency in radiological diagnosis. These represent conditions which may be life threatening if undiagnosed over a period of 12 hours, and are typically encountered in emergency and trauma.

Trainees are given both formal and informal teaching sessions prior to undertaking the assessment, which usually occurs between four to six months after the commencement of training.

Conditions

Around 100 conditions are listed in the RANZCR Clinical Radiology Curriculum Learning Outcomes ² which divides them into the following categories:

Brain

• brain oedema
• raised intracranial pressure
• brain herniations and complications
• skull fractures and complications
• diffuse axonal/shearing injury
• parenchymal/intracerebral haemorrhage (traumatic and non-traumatic)
• epidural haematoma
• subdural haematoma
• subarachnoid haemorrhage
• non-accidental injury (NAI) / abusive head trauma
• global hypoxia, ischaemia and infarction
• acute vessel thromboembolic occlusion with an associated stroke syndrome
• micro-haemorrhage
• border-zone/watershed infarction
• diffuse anoxic/hypoxic injury
• intracranial venous thrombosis including venous sinus thrombosis and associated haemorrhage and/or venous infarction
• brain abscess
• subdural empyema
• hydrocephalus (communicating and non-communicating)

Head and neck

• tonsillar and peritonsillar abscess
• epiglottitis
• croup
• retropharyngeal abscess
• inhaled and swallowed foreign bodies

Spine

• vertebral fractures including occipital condyle, Jefferson, odontoid, hangman's, burst, Chance/distraction, compression, hyperflexion, hyperextension, and apophyseal ring
• spinal fracture-dislocation
• atlanto-axial dislocation
• epidural haematoma
• spinal cord compression
• spinal cord injury including contusion, haemorrhage and transection
• discitis/osteomyelitis including pyogenic, tuberculous, granulomatous, chronic recurrent multifocal
• facet septic arthritis

Cardiothoracic

• chest wall trauma
• traumatic aortic injury
• rib fractures including flail chest
• pneumothorax including non-traumatic
• haemothorax including non-traumatic
• oesophageal rupture / Boerhaave syndrome
• non-accidental injury (NAI)
• inhaled and swallowed foreign bodies
• atelectasis including lobar collapse
• pneumonia (lobar/bronchopneumonia) including community-acquired, institutional/nosocomial, aspiration, and neonatal
• bacterial infections including pneumococcal, staphylococcal, klebsiella, MRSA, legionella, nocardia, and actinomycosis
• lung abscess
• acute respiratory distress syndrome (ARDS)
• pulmonary vascular congestion and oedema
• pulmonary thrombosis and thromboembolism including acute and chronic
• cardiac failure (left and right)
• thoracic aortic atherosclerosis including penetrating ulcer
• thoracic aortic aneurysm including rupture
• thoracic aortic intramural haematoma and aortic dissection

Abdominal and pelvic

• gastrointestinal haemorrhage
• oesophageal obstruction including stenosis, achalasia, web, ring, and motility disorders
• swallowed foreign bodies
• pyloric stenosis
• stomach trauma
• small bowel obstruction
• small intestinal malrotation
• small intestinal intussusception
• small intestinal volvulus
• small intestinal trauma
• intestinal ischaemia including ischaemic colitis
• large bowel obstruction
• necrotising enterocolitis
• volvulus including caecal and sigmoid
• diverticular disease and complications including diverticulitis
• appendicitis
• cholecystitis including acute calculous, acute acalculous, chronic, xanthogranulomatous, emphysematous, and empyema
• cholangitis including primary, sclerosing, recurrent pyogenic, and autoimmune (IgG4)
• hepatic trauma
• pancreatitis including acute and chronic, including pseudocysts and other complications
• pyelonephritis including acute and chronic, xanthogranulomatous and emphysematous
• renal trauma including renovascular injury and urinoma
• renal infarct
• urolithiasis and nephrocalcinosis
• cystitis
• renal collecting system trauma
• scrotal/testicular trauma including haematocele
• torsion including testis and testicular appendage, and segmental infarction
• adrenal trauma
• splenic rupture including traumatic, spontaneous and delayed
• splenic infarct
• ascites
• trauma including mesenteric injury, haemoperitoneum and diaphragmatic rupture
• pneumoperitoneum
• mesenteric adenitis
• intra-abdominal abscess
• retroperitoneal trauma
• abdominal aortic atherosclerosis, aneurysm, pseudoaneurysm, dissection, and rupture
• aorto-iliac occlusion

Musculoskeletal

• fracture including greenstick, bowing, Salter-Harris, buckle/torus, pathological, delayed union, and non-union with assessment of stability
• subluxation and dislocation including assessment of stability
• fracture-dislocation including Monteggia, Galeazzi, Lisfranc injuries with assessment of stability
• non-accidental injury (NAI)
• osteomyelitis including acute and chronic
• septic arthritis

Obstetrics and gynaecology

• haematometrocolpos
• tubo-ovarian abscess
• ovarian / acute adnexal torsion
• ovarian cyst rupture
• anembryonic pregnancy and miscarriage
• ectopic pregnancy (tubal, interstitial, cervical, caesarean section scar, abdominal, heterotopic pregnancy)

The Royal Melbourne Hospital playlists

The radiology department at The Royal Melbourne Hospital, in conjunction with Radiopaedia, has developed a series of playlists covering the essentials of emergency radiology, aimed primarily at junior radiology registrars ³.

Body

• body trauma 1
• body trauma 2
• abdominal CT
• abdominal ultrasound
• abdominal x-ray

Chest

• chest trauma
• lungs and pleura
• heart and mediastinum

Central nervous system

• CNS haemorrhage
• CNS ischaemia
• CNS infection and malignancy
• CNS MRI emergencies

Head and neck

• head and neck

Musculoskeletal

• upper limb trauma
• lower limb trauma
• musculoskeletal infection and arthritis
• spinal trauma and infection

Obstetrics and gynaecology

• obstetrics and gynaecology

Paediatrics

• paediatrics

Vascular

• vascular and interventional radiology
• aortic syndromes

See also

• Trauma Radiology Course
• Emergency Radiology Course
• Abdominal Emergency Radiology Course
• Trauma CT Brain Learning Pathway
• Stroke Learning Pathway