Chest x rays

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Information about Chest x rays

Published on March 16, 2014

Author: premmjha

Source: slideshare.net

X RAY CHEST

1. Patient particulars 2. View- PA / AP / LATERAL / OBLIQUE 3. Exposure/penetration 4. Centralisation 5. Skeleton 6. Lung fields 7. Cardiovascular silhouette 8. Mediastinum 9. Costo phrenic & cardio phrenic angles 10. Diaphragm 11. Soft tissue abn. 12. Conclusion

Radiologically, lung fields are divided into 3 ZONES…… UPPER ZONE - From above upto 2nd costal cartilage MIDDLE ZONE - 2ND TO 4TH Costal cartilage LOWER ZONE - Below 4th costal cartilage

 Patient particulars  View- Pa / AP / Lateral / Oblique

Should see ribs through the heart Barely see the spine through the heart Should see pulmonary vessels nearly to the edges of the lungs

OVERPENETRAT ED FILM • Lung fields darker than normal—may obscure subtle pathologies • See spine well beyond the diaphragms • Inadequate lung detail

Underpenetrated Film •Hemidiaphragms are obscured •Pulmonary markings more prominent than they actually are

 Should be able to count 9-10 posterior ribs  Heart shadow should not be hidden by the diaphragm 1 2 3 4 5 6 7 8 9 10

Medial ends of bilateral clavicles are equidistant from the midline or vertebral bodies

If spinous process appears closer to the right clavicle (red arrow), the patient is rotated toward their own left side If spinous process appears closer to the left clavicle (red arrow), the patient is rotated toward their own right side

Check for  Symmetry  Deformities  Fractures  Masses  Calcifications  Lytic lesions

Check for Cardiomegaly Mediastinal and Hilar contours Trachea- upper med. Apex of heart- lower med.

 Check sharpness of borders  Right is normally higher than left  Check for free air, gastric bubble, pleural effusions  >1.5 cm - normal  < 1.0 cm- flat diaphragm

 To help you determine abnormalities and their location…  Use silhouettes of other thoracic structures

This is chest radiograph, PA view with normal exposure, no rotation and without any apparent bony abnormality. Trachea is placed centrally & lung fields are clear with normal broncho-vescicular markings. Cardiovascular silhouette is within normal limits with normal cardiothoracic ratio. Mediastinum, costo-phrenic, cardio-phrenic angles, dome of diaphragm & soft tissue shadow within normal limits.

Remember… be systematic!

Consolidation

a) PNEUMONIA b) COLLAPSE c) FIBROSIS d) PULMONARY INFARCTION e) CA LUNG f) TUBERCULOSIS

Multiple bilateral cavitary lesions with air- fluid levels

1. LUNG ABSCESS 2. HYDROPNEUMOTHORAX 3. INFECTED LUNG CYST

 PERICARDIAL EFFUSION  DCMP  RHD  IHD  ASD  VSD  SYST HTN

Non homogenious infiltrates

Non homogenious infiltrates

1. PULMONARY TB 2. RESOLVING BACTERIAL PNEUMONIA 3. ALVEOLAR CELL CA 4. PULMONARY EDEMA 5. FUNGAL INFECTION OF LUNG

Dextrocardia

Emphysema

emphysema

1) EMPHYSEMA 2) B/L PNEUMOTHORAX 3) LARGE MULTIPLE BULLAE 4) B. ASTHMA 5) OVER EXPOSED FILM

Normal broncho-vescicular markings 2/31/3

UPTO 2/3 – Normal BEYOND 2/3 – Chronic bronchitis

 Fibosis  Collapse  infiltration

Foreign body ? Trachea ? esophagus

Ans. Is…Lateral X-Ray Chest. & Symptoms

pneumothorax

1) Pneumothorax 2) Bullae 3) Lung cyst 4) Obtructive emphysema 5) Mastectomy 6) Poor technique

Miliary tuberculosis

1. Miliary tb 2. Tropical eosinophilia 3. Pneumoconiosis 4. Lymphangitis carcinomatosa 5. Extrisic allergic alveolitis 6. Haemosiderosis 7. Sarcoidosis 8. Fungal ds

Homogeneous opacity

Homogenious opacity

Homogenious opacity

Homogenious opacity Homogenious opacity

1) Pleural effusion 2) Empyema thorasis 3) Collapse 4) Consolidation 5) Thickened pleura 6) Pleural mesothelioma 7) Agenesis of lung 8) Surgical removal 9) Fibrosis

Right lung opacity

Left lung opacity

 Ca lung  Loculated pleural effusion

Thank you all The besT

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fixed matches | 31/01/15
Hey there owner of www.slidesearchengine.com. Great site. I think you should be little more strict with the comments.

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