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

???

TB

??

RUL hemorrhage

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