Chest X-ray Interpretation.pptx

Interpretation of chest X-ray

1. Chest X-rays S A Saleemi

2. X-ray DENSITIES Blackest Air< fat< liver< blood< muscle< bone Whitest

3. Common Abnormal finding on Chest X-ray Lucency (lower density than surrounding tissue) Opacity (higher density than surrounding tissue)

4. Linear Reticular Reticulonodular Alveolar

5. CYSTS and Cavities

6. Consolidation Collapse Nodule Mass

7. M C Alraies 7 Technical Aspects Identification – name, file number, date & time Projection – PA or AP Position – Upright or Supine Inspiratory effort – ?poor inspiration Exposure - ?overexposed ?underexposed thoracic intervertebral disc space just visible Positioning/rotation medial clavicle heads equidistant to spinous process

8. Four major positions are utilized for producing a chest radiograph: Posterior-anterior (PA) Anterior-posterior (AP) Lateral Lateral Decubitus

9. 9 AP (Antero-posterior) (Portable) FILM FILM X-ray Beam PA ( Postero-anterior) PA or AP view

10. PA Scapulae are visible over lung fields Heart appear larger Mediastinum widens Diaphragm are higher Pulmonary vascularity increase AP

11. LATERAL view

12. Decubitus View "decubitus" means "lying down“ To confirm free flowing effusion.

13. Three Main Factors Determine the Technical Quality of the Radiograph Inspiration Exposure (Penetration) Rotation

14. Good inspiration film Poor inspiration film 9-10 post ribs 5-6 ant ribs

15. Good exposure Under-exposed Over-exposed Over-exposed Under-exposed

16. Is this film rotated? Is this film rotated? Rotation

17. Extreme rotation

18. Cardiothoracic Ratio

19. Anatomical Structures in the Chest Mediastinum Hilum Lung Fields Diaphragmatic Domes Pleural Surfaces Bones Soft Tissue

20. Anatomy of Chest X-ray scapula Oblique fissure Oblique fissure horizontal fissure

21. Upper lobe Lower lobe Left LUNG Right Lung Upper lobe Lower lobe Middle lobe Right Lung 2 fissures (oblique and horizontal). 3 lobes (upper, middle, lower) 10 segments Left Lung 1 fissure (oblique) 2 lobes (upper and lower) 8 segments Lingula

22. R I G H T L U N G L E F T L U N G Lingula

23. SILHOUETTE SIGN

24. Normal X-ray

25. Pleural effusion Meniscus sign

26. Pulmonary edema

27. Bronchiectasis

28. Bronchiectasis Varicose Cystic cylindrical

29. Cavities with air fluid level

30. Hampton Hump Sign Pulmonary infarction secondary to pulmonary embolism

31. Westermark sign

32. ILD

33. Ground glass

34. COPD

35. RUL consolidation

36. Cardiomegaly

37. Right lung collapse Massive right pleural effusion

38. LLL pneumonia

39. Lingular Pneumonia

40. Lung mass

41. Right Pneumothorax

42. Tension Pneumothorax

43. Dextro -cardia/situs inverses

44. Bilateral hilar lymphadenopathy

45. 60 years old with gastric lymphoma and acute abdominal pain

46. PH

47. Hiatus hernia

48. Right diaphragm paralysis

49. Tenting of right diaphragm due to right upper lobe collapse

50. Bulging Fissure Sign Klebsiella pneumoniae (Friedlander pneumonia)

51. Deep Sulcus Sign

52. Gloved finger Sign allergic bronchopulmonary aspergillosis.

53. Halo Sign Invasive aspergillus infection Adenocarcinoma Metastatic disease

54. NG tube right lung

55. Left lower lobe posterior segment consolidation

56. Hidden areas of Chest X-ray

57. Thanks