cxr imaging

Rania Ma’adat

What to check first

Name, Age, Date , sex

Clinical info. History “not always”

Technical factors:

1-Marker

Marker to determine

right or left side =

direction of the

picture

2- Centralization

The distance between

the medial end of the

clavicle and the

spinous processes

“Should” be equal

bilaterally.

3- Full inspiration

We count , 9 posterior ribs, 7 anterior ribs

6th rib is perpendicular to the diaphragm

ExposureThe retro cardiac vertebrae are just visible

Lung zones

Upper

Middle

Lower

any lesion is said

to be located in

one of these zones

abnormalities

Remember that:Bone is white on X-rayAir is blackTissue is grey

Abnormal findings are:

Consolidation

Collapse, hyper inflation

Pleural sac abnormality

Bone abnormality

Consolidation

Any abnormal white batches except those of normal anatomy slide 2 is said to be consolidation.

1- fibrosis

2- mass

3-tracheal shift “ not mediated” slide 5, Aoticaneurysm, esophageal problem

4- lymph node enlargement

5- pneumonia “ at the base of the lung”

etc

Right lung

pneumonia

Right lung mass

Aortic aneurysm

Multiple nodules=

Lung metastases

2- collapse

Absent part of

the lung usually

with obstruction

normal lung

tissue but

missed part

Hyper inflation

Main sign is flat

diaphragm

Pleural abnormality

We have visceral and parietal pleura

accumulation of air, fluid, blood or pus

can lead to CXR abnormality.

1- Pneumothorax: Air “black”

2- Pleural effusion: Fluid “white”

3- Hemothorax: blood “white”

4- Empyema: pus “white”

Plueraleffusion

No air bronchogram

No costophrenicangle

Upper border of fluid is concave

Hemopneumothorax

Similar to

pnuemothorax but

the upper border is

flat cuz of air

pneumothorax

Bone abnormalities Ribs fracture

Notes:

Air under diaphragm is always

abnormal! The main cause is bowel

perforation

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Best of luck!