chest x-rays - basics to few uncommons 18 07-2013

XraysBy Mohit Goyal

Guide: Sr. Prof. Dr. V. K. GoyalDept. of Medicine, R.N.T. Medical College, Udaipur

18-07-2013

The 1901 Nobel for Physics was awarded to Wilhelm Conrad Röntgen "in recognition of the extraordinary services he has rendered by the discovery

of the remarkable rays (in 1895) subsequently named after him".

Electrons are liberated from the heated filament and

accelerated by a high voltage towards the metal

target. The X-rays are produced when the electrons

collide with the atoms and nuclei of the metal.

On the table for the day

Normal Röntgenogram Chest PA & Lateral

Some common Chest X-rays

Unusual Chest X-rays

Miscellaneous spot films

A young female came to his hospital for pre-

employment checkup. After seeing the picture on

the X-ray, the GP sent a reference to the resident

Internist. What one question should the Internist

ask to this lady?

What’s your differential diagnosis for this

skiagram?

The differential diagnosis of very dense miliary opacities

includes :

Healed varicella pneumonia

Pulmonary haemosiderosis, e.g. mitral stenosis

Repeated haemorrhage, e.g Goodpasture syndrome

Silicosis (exposure to pure silica)

Pulmonary alveolar microlithiasis

Calcified metastases, e.g. osteosarcoma

Idiopathic

It is common to believe that coins seen end-on (sagittal plane)

in the middle of the chest on A-P radiographs are in the

trachea, whereas coins in the oesophagus will have a disk

appearance on antero-posterior chest radiographs. This

radiograph demonstrates that this is not always the case.

Larry Mellick, Professor of Emergency Medicine, Medical College of Georgia

Conners GP, Hadley JA. Esophageal coin with an unusual radiographic

appearance. Pediatric Emerg Car. 2005;21:667-669

Raney LH, Losek JD. Child with esophageal coin and atypical radiograph. J Emerg

Med 2008;34:63-66

Thank youH a p p y I n t e r p r e t I n g!