RADILOGY MCQ--The 'wire spring' appearanc and Accordion sign

The 'wire spring' appearanc AND Accordion sign 

Q1.Pseudodiverticula,the ‘wire spring/hidebound ‘appearance on barium study of small intestine is noted in
a.progressive systemic sclerosis
b.nodular lymphoid hyperplasia
c.Whipple’s disease
d.intestinal lymphangiectasia

Q2.Accordion sign on CT scan of intestine is noted in
a.progressive systemic sclerosis
b.nodular lymphoid hyperplasia
c.Whipple’s disease
d.pseudomembranous colitis


ANS-1--a===.progressive systemic sclerosis
          2--d===pseudomembranous colitis

Progressive systemic sclerosis 

• In progressive systemic sclerosis barium examination shows dilatation of the duodenum and jejunum, diminished peristalsis, decreased motility and delayed transit. Sacculations, also known as pseudodiverticula, are seen frequently as large, broad-based outpouchings with a somewhat squared contour.
•  A characteristic sign of progressive systemic sclerosis is an increased number of mucosal folds – the ‘wire spring or ‘hidebound’ appearance 

Pseudomembranous colitis










eurorad.org

• Pseudomembranous colitis results from the effects of cytoplasmic endotoxins produced by overgrowth of Clostridium difficile, usually as a result of broad-spectrum antibiotic therapy.
• Plain radiographs may show a generalized ileus and nodular haustral thickening. 
• CT may show gross wall thickening, with marked mucosal enhancement and extensive low attenuation from submucosal oedema. This produces a very prominent target sign, often described as the accordion sign .
• The accordion sign  is typical of pseudomembranous colitis, but may be seen in acquired immune-deficiency syndrome (AIDS)-related or ischaemic colitis and in severe oedema from cirrhosis.