The Simpson grade of meningioma resection was described in 1957 and correlated the degree of surgical resection completeness with with symptomatic recurrence 1.
Although the type of resection still plays a part in the likelihood of symptomatic recurrence, other factors (such as the MIB-1 index...
The Singh index is a classification system for bone density of the femoral neck based on the visibility of the trabecular types that can be seen in the femoral neck.
Trabecular types in proximal femur
Five trabecular types can be present in the proximal part of the femur:
Situs classification can be a daunting topic, but it falls into three main groups :
situs solitus: the normal configuration of thoracic and abdominal organs
situs inversus: mirror image of normal
situs ambiguus: an intermediate configuration with duplication (isomerism)
Situs is best thought...
Situs solitus refers to the normal position of the thoracic and abdominal organs.
On plain radiograph, careful attention should be directed at the location of the aortic arch, gastric fundus, cardiac apex, pulmonary fissures and the branching pattern of ...
A small for dates fetus can result from a number of factors
structural anomalies (syndromes)
fetal Warfarin syndrome
hydantoin embryopathy (Dilantin TM)
The WHO 2002 classification of soft tissue tumours is as follows:
This, however, has been revised under the 2013 WHO tissue tumour classification system 4.
lipomatosis of nerve 8850/0
The Spetzler-Martin AVM grading system allocates points for various features of intracranial arteriovenous malformations to give a grade between 1 and 5. Grade 6 is used to describe inoperable lesions. The score correlates with operative outcome.
size of nidus
small (<3cm) = 1
Spinal arteriovenous malformations can be classified in a number of ways:
extramedullary: 80% 1
Or into four types 2:
type I: single coiled vessel (dural AV fistula)
type II: intramedullary glomus AVM
type III: juvenile
type IV: intradural perimedullary (AV fistula)
Spinal cord injury (SCI) can be traumatic or non-traumatic (i.e. neoplastic/stenosis) but the syndromes associated with spinal cord injury can be seen in all aetiologies.
Injury to the spinal cord can be incomplete or complete and depends upon the mechanism of injury. This is important as diffe...
The spinal instability neoplastic score (SINS) helps to assess tumour related instability of the vertebral column. It has been shown to useful in guiding the mobilisation or operative management of patients with neoplastic spinal disease.
Studies have reported good inter-observer agreement amon...
Spinal metastases is a vague term which can be variably taken to refer to metastatic disease to any of the following:
vertebral metastases (94%)
may have epidural extension
intradural extramedullary metastases (5%)
intramedually metastases (1%)
Each of these are discussed separately. Below...
Spondylolisthesis is a term denoting anterolisthesis of a vertebra relative to the segment below, typically due to spondylolysis (pars interarticularis defects). This term is often used to denote anterolisthesis from any cause (e.g. degenerative spondylosis).
A commonly adopted method of grading spondylolisthesis is the Meyerding classification, based on the ratio of [overhanging part of the superior vertebral body] to [anteroposterior length of the adjacent inferior vertebral body]:
grade I: 0-25%
grade II: 26-50%
grade III: 51-75%
grade IV: ...
The Stahl classification of Kienbock disease, modified by Lichtman, is the most commonly used staging system and is useful in the treatment of Kienbock disease (avascular necrosis of the lunate). This system divides the disease into four stages:
stage I: normal radiograph
stage II: increased ...
Along with the DeBakey classification, the Stanford classification is used to separate aortic dissections into those that need surgical repair, and those that usually require only medical management. The Stanford classification divides dissections by the most proximal involvement:
type A: A aff...
The St. Anne-Mayo grading system, also known as the Daumas-Duport grading system, introduced in 1988 was for a time a popular system for grading diffuse astrocytomas but has now largely been replaced by the WHO grading system which is, however, derived from the St Anne-Mayo system and thus share...
Steinberg staging of avascular necrosis of hip is a commonly used system (at the time of writing, mid-2016) similar to the Ficat and Arlet staging.
History and etymology
It is based on the radiographic appearance and location of lesion. It primarily differs from the other systems by quantifyi...
The Stewart classification for proximal fifth metatarsal fractures is based upon fracture location and morphology. It is divided into five types.
extra-articular transverse or oblique fracture between base of 5th metatarsal and diaphysis (jones fracture)
Grading of SUFE (slipped upper femoral epiphysis) can be made on both AP and true lateral projections.
On a AP radiograph a line along the superior margin of the femoral neck (line of Klein) should intersect the lateral corner of the epiphysis.
As the epiphysis slips, the metaphysis can be di...
SVC obstruction can cause SVC syndrome which is the most common condition affecting this vessel. It can be secondary to an extrinsic compression or intraluminal thrombosis/stenosis. Collateral pathways, with the azygos vein being the most important collateral vessel, form in response to severe n...
Supracondylar humeral fractures, often simply referred to as supracondylar fractures, are a classic paediatric injury which require vigilance as imaging findings can be subtle.
Simple supracondylar fractures are typically seen in younger children, and are uncommon in adults; 90% a...
The staging system for moyamoya disease first described by Suzuki and Takaku in their seminal 1969 article1 is still in use today. Formally, the staging refers to findings on conventional angiography, although there are efforts to apply similar systems to MR angiography.2
Suzuki stage appears t...
There are specific terms used when describing a syrinx or other cystic lesions within the spinal cord 1:
hydromyelia: fluid accumulation/dilatation within the central canal, therefore, lined by ependyma
syringomyelia: cavitary lesion within cord parenchyma, of any cause (there are many); locat...
The Tabar 5-tier grading system is used to classify mammographic lesions. This should not be confused with the Tabar classification of parenchymal patterns in breast imaging. It is a separate but translatable system to the BI-RADS classification system (please note that Tabar grade 3 ≠ BI-RADS 3...
Talar neck fractures extend through the thinnest cross-sectional portion of the talus, just proximal to the talar head. They represent one of the most common types of talus fracture (~30-50%), along with chip and avulsion fractures of the talus (~40-49%). These fractures are commonly associated ...
The Tanaka criteria (or Fukuoka consensus guidelines) is a classification system for intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms (MCNs).
The original international consensus guidelines (2006) were referred to as the Sendai criteria. This later evolved into th...
Temporal bone fractures are usually a sequela of significant blunt head injury. In addition to potentially damaging hearing and the facial nerve, associated intracranial injuries, such as extra-axial haemorrhage, diffuse axonal injury and cerebral contusions are common. Early identification of t...
There are numerous terms used in radiology that are worth knowing and this is list of some of them.
The thoracolumbar injury classification and severity score (TLICS) has been developed by the Spine Trauma Group to overcome some of the perceived difficulties regarding the use of other thoracolumbar spinal fracture classification systems for determining treatment 1.
There are several thoracolumbar spinal fracture classification systems:
three column concept of thoracolumbar spinal fractures (Denis classification)
thoracolumbar injury classification and severity score (TLICS)
The three column concept of thoracolumbar spinal fractures was initially devised by Francis Denis and presently CT is mandatory for an accurate classification.
While initially developed for classification of thoracolumbar spinal fractures, it can also be applied to the lower cervical spine 3 as...
The thrombolysis in cerebral infarction (TICI) grading system was described in 2003 by Higashida et al 1 as a tool for determining the response of thrombolytic therapy for ischaemic stroke. In neurointerventional radiology it is commonly used for patients post endovascular revascularisation. Lik...
The thrombolysis in myocardial infarction (TIMI) risk score is a prognostic risk stratification system that categorises the risk of death and ischemic events in patients with unstable angina / NSTEMI and provides a basis for therapeutic decision making. It is thought to have potential to improve...
TIRADS is a risk stratification system for classifying thyroid lesions and was recently recognized in an American College of Radiology (ACR) white paper 1. Its use is being advocated similar to BIRADS category for breast lesions.
In 2017, a white paper 2 was released by the ACR committee on th...
Tillaux fractures are Salter-Harris III fractures through the anterolateral aspect of the distal tibial epiphysis, with variable amounts of displacement.
It occurs in older children and adolescents when the medial aspect of the distal tibial growth plate has started to fuse.
The TOAST (trial of ORG 10172 in acute stroke treatment) classification denotes five sub types of ischaemic stroke.
large-artery atherosclerosis (embolus / thrombosis)*
cardioembolism (high-risk / medium-risk)*
small-vessel occlusion (lacune)*
stroke of other determined aetiology *
The Todani classification of bile duct cysts divides choledochal cysts into five groups.
See: type I choledochal cyst
account for 80-90% of all bile duct cysts
characterised by fusiform dilation of the extrahepatic bile duct
a subclassification has been proposed
Torg's classification of proximal fifth metatarsal fractures is based on the degree of sclerosis adjacent to the fracture on imaging at the time of presentation to determine the fracture age.
narrow fracture line with sharp margins and no widening
minimal cortical hyper...
Transitional cell carcinomas of the urothelium are graded histologically as follows:
transitional cell papilloma
benign tumour, not a carcinoma but sometimes included in classification systems
carcinoma in situ
do not penetrate the basement membrane
cells resemble those of grade II or III ...
Triplane or triplanar fractures are of the distal tibia only occurring in adolescents. As the physiological closure of the physeal plate begins medially, the lateral (open) physis is prone to this type of fracture. The name is due to the fact of the fracture expanding both in frontal and lateral...
Trochanteric fracture is a fracture involving the greater and/or lesser trochanters of the femur.
Fractures in these region can be classified as:
greater trochanteric avulsion fracture
lesser trochanteric avulsion fracture
There are a number of tumours of muscular origin, which overall are relatively uncommon, representing only 1.7% of benign soft tissue tumours, and 10.3% of malignant soft tissue tumours1.
The tumours can be divided according to the type of muscle fibre:
Skeletal muscle origin
Tumours of the male urethra are uncommon. They can be categorised both on the grounds of histology and location.
squamous cell carcinoma of the urethra: 80%
urothelial/transitional cell carcinoma of the urethra: 15% (predominantly posterior urethra)
adenocarcinoma of the urethra: 5...
Tumours of the meninges are a heterogeneous group of lesions which usually occur as extra-axial masses. Although a large number of lesions that can involve meninges are scattered throughout the WHO classification of CNS tumours, the main entities to be considered include:
meningioma and nume...
Ultrasound assessment of carotid arterial atherosclerotic disease has become the first choice for carotid artery stenosis screening, permitting the evaluation of both the macroscopic appearance of plaques as well as flow characteristics in the carotid artery.
This article focus on internal caro...
The ultrasound "U" classification of thyroid nodules has been developed by the British Thyroid Association (BTA) as part of their 2014 guidelines on the management of thyroid cancer 1.
It allows for stratifying thyroid nodules as benign, suspicious or malignant based on ultrasound appearances t...
Uterine biophysical profile refers to assessment of uterus to produce a successful conception and implantation environment.
Uterine scoring system for reproduction (USS)
The uterine scoring system for reproduction comprises the following parameters, taken in mid-cycle:
1. endometrial thickne...
The Vancouver classification of periprosthetic hip fractures proposed by Duncan and Masri is the most widely used classification system. It takes into account the fracture site, the status of the femoral implant, and the quality of surrounding femoral bone stock.
type A: fractures involve the t...
The VASARI (Visually AcceSAble Rembrandt Images) MRI feature set is a system designed to enable consistent description of gliomas using a set of defined visual features and controlled vocabulary. It is the result of work by The Cancer Imaging Archive (TCIA) who publish relevant guides to use, an...
Vesicoureteric reflux (VUR) grading divides vesicoureteric reflux according to the height of reflux up the ureters and degree of dilatation of the ureters:
grade 1: reflux limited to the ureter
grade 2: reflux up to the renal pelvis
grade 3: mild dilatation of ureter and pelvicalyceal system
The Weber ankle fracture classification (or Danis-Weber classification) is a simple system for classification of lateral malleolar fractures, relating to the level of the fracture in relation to the ankle joint. It has a role in determining treatment.
below the level of...
The Weiss classification is one of the classification systems used for lateral humeral condyle fractures and is based on the degree of displacement measured on an internal oblique view of the elbow:
type 1: <2 mm displacement
type 2: 2-4 mm displacement
type 3: >4 mm displacement
The degree ...
The WFNS (World Federation of Neurosurgical Societies) grading system uses the Glasgow Coma Scale and presence of focal neurological deficits to grade the severity of subarachnoid haemorrhage. This grading system was proposed in 1988, and this is one of the accepted systems (although not conside...
The World Health Organisation classifies anal canal neoplasms into intraepithelial neoplasms and invasive neoplasms which are further divided to epithelial and non-epithelial tumours and secondary lesions:
squamous cell carcinoma of anal canal
adenocarcinoma of anal canal
The WHO classification of anal margin tumours or perianal skin tumours is:
Bowen disease (precursor of squamous cell carcinoma)
Paget's disease (precursor of adenocarcinoma)
squamous cell carcinoma
basal cell carcinoma
The WHO classification of CNS tumours is the most widely accepted system for classifying CNS tumours and was based on the histological characteristics of the tumour. Although the most recent version of the 'blue book' is the 4th edition from 2007, an update has been released in 2016 3, which sho...
The WHO classification scheme for thymic epithelial tumours is one of many classifications systems for thymoma and related tumours, and classifies them according to histology:
spindle cell thymoma
type ab: mixed thymoma
type b1: lymphocyte rich
WHO (World Health Organisation) grading of CNS tumours is based on histological characteristics such as cellularity, mitotic activity, pleomorphism, necrosis, and endothelial proliferation (neoangiogenesis). It is used in the WHO classification of CNS tumours.
It should be noted that at the ti...
The WHO grading system is the most widely used system for grading diffuse astrocytomas (at the time of writing i.e. mid 2016), and is an adaptation of the now superseded St Anne-Mayo grading system (also known as the Daumas-Duport grading system).
Grade I is reserved for localised astrocytom...
Wiberg classification is a system used to describe the shape of the patella based mainly on the asymmetry between the patellar medial and lateral facets on axial views of the patella. Increasing number type indicates a larger degree of asymmetry.
Wiberg type 1 or a
The Winquist classification of femoral shaft fractures is based on fracture comminution and was proposed by Winquist in 1980. This classification is used with regards to management decision making, in determining whether a fracture requires an intramedullary nail or open reduction.
Type 0: no ...
The Yasargil classification is one of the two common systems for classifying vein of Galen malformations that is currently in use at the time of writing (mid 2016).
type I: small pure cisternal fistula between the vein of Galen (voG) and either the pericallosal arteries (anteri...
The Young and Burgess classification is a modification of the Tile classification 1. It is the recommended 5 and most widely used classification system for pelvic ring fractures.
It takes into account force type, severity, and direction, as well as injury instability.
The Zabramski classification of cerebral cavernomas has been proposed as a way of classifying cerebral cavernous malformations, and although not used in clinical practice it is useful in scientific publications that seek to study cavernous malformations.
The classification was proposed in 1994 ...