2005 Radiology Exam - Artifacts Case 1

Objective of the Case
1. Recognize artifact
2. identify cause
3. discuss prevention

Information provided to Candidate
Written instructions to:
1. describe the artifact
2. give its cause and
3. describe prevention where applicable

See image below. Click to enlarge.

Findings Expected from Candidate

  • Identify artifact: Identify study as TcO4 scan. Linear high intensity uptake in the cervical region only seen on the left lateral view and disappears on the opposite lateral. The uptake is anatomically within the plane of the esophagus.
  • Cause: Gastroesophageal reflux. TcO4 is treated as chloride and excreted into the gastric lumen following injection.
  • Prevention: No prevention. Rescan if necessary.

Summary of Overall Candidate Performance
The question was worth a total of 6 points. The average score was 2.89/6.0 or 48%. Most candidates were able to identify the type of nuclear scan. Many candidates believed the uptake represented a mass. Many candidates that were able to determine it was TcO4 within the esophagus, could not explain how it might arrive there.