CXR

NOT111

Lobes and Fissures

pleural effusion extending into the fissure

Mediastinum and Lungs

Pulmonary Vasculature

How to Read a Chest X-Ray

• Patient Data (name history #, age, sex, old films)

• Routine Technique: AP/PA, exposure, rotation, supine or erect

• Trachea: midline or deviated, caliber, mass

• Lungs: abnormal shadowing or lucency

• Pulmonary vessels: artery or vein enlargement

• Hila: masses, lymphadenopathy

• Heart: thorax: heart width > 2:1 ? Cardiac configuration?

• Mediastinal contour: width? mass?

• Pleura: effusion, thickening, calcification

• Bones: lesions or fractures

• Soft tissues: don’t miss a mastectomy

• ICU Films: identify tubes first and look for pneumothorax http://www.med-ed.virginia.edu/courses/rad/cxr/interpretation1chest.html

Silhouette sign

air bronchogram

• 6 causes : lung consolidation, pulmonary edema, nonobstructive atelectasis, • severe interstitial disease, neoplasm, and normal expiration.

Solitary Pulmonary Nodule

Atelectasis

LUL atelectasis

Luftsichel Sign

=‘air crescent’ at aortic knob

LLL atelectasis

RUL atelectasis

RML atelectasis

RLL atelectasis

Pul. Edema :cardiogenic , noncardiogenic

• cephalization of pulmonary vessels, Kerley B lines or septal lines, peribronchial cuffing, "bat wing" pattern, patchy shadowing with air bronchograms,fluid in fissure , pleural effusion and increased cardiac size.

Kerley B lines

Pneumonia

Pneumonia

???

??

left pleural effusion

Pleural Effusion : 200ml vs 75ml

Pneumothorax

hydropneumothorax

Emphysema

Flail chest

Anterior Mediastinal Mass : 3T1L

Middle Mediastinal Mass : Arch,Eso.

Posterior Mediastinal Mass

• ddx : neoplasm, lymphadenopathy,aneurysm, lung mass, neurenteric cyst,meningocele, and extramedullary hematopoiesis

Pneumomediastinum

Diaphragmatic hernia :hiatal,Boch.,Morg.

Hilar Adenopathy

Normal Abnormal

CA

• cavitation, which is found more characteristically in squamous cell CA