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Radiology for Undergraduate Part 1

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Chest X-Rays How to interpret, description of commonly found X-Ray abnormalities in Medical Wards

Chest X-Rays How to interpret, description of commonly found X-Ray abnormalities in Medical Wards

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  • 1. Chest Roentgenogram
    DR. S. ASWINI KUMAR. MD
    Professor of Medicine
    Medical College Hospital
    Thiruvananthapuram
  • 2. Chest Roentgenogram
    4/15/2010
    2
    X-Ray machine
    X-Rays produced by it
    Pass through the human body
    Black and white film
    Placed on the opposite side
  • 3. Chest X-Ray-Views
    4/15/2010
    3
    PA view
    Postero-anterior view
    X-Rays-Posterior to anterior
    Delineates the heart and lungs
    Spine is not in focus
  • 4. Chest X-Ray Views
    4/15/2010
    4
    Lateral view
    Lesions of lung and mediastinum
    Right or left lateral view
    Spine posteriorly - heart anteriorly
    Useful in detecting the lobe of lung
  • 5. Densities
    4/15/2010
    5
    The background - black
    The soft tissues - light white
    The bone - dense white
    Fluid, blood - white as well
    The air - black
  • 6. How do you read a Chest X-Ray PA
    4/15/2010
    6
    Soft tissue shadows
    Position of trachea and mediastinum
    Costo and cardiophrenic angles
    Study the lung parenchyma
    Study the heart shadow
  • 7. The fissures and lobes of Lung
    4/15/2010
    7
  • 8. Right Upper Lobe
    4/15/2010
    8
  • 9. Right Upper Lobe in the lateral view
    4/15/2010
    9
  • 10. Right Middle Lobe in the PA view
    4/15/2010
    10
  • 11. Right lower lobe consolidation
    4/15/2010
    11
  • 12. Right Middle Lobe Silhouette in Lateral View
    4/15/2010
    12
  • 13. Extend of left upper lobe of lung
    4/15/2010
    13
  • 14. Extend of left lower lobe of lung
    4/15/2010
    14
  • 15. Consolidation of lung
    4/15/2010
    15
  • 16. Pleural Effusion Left Side
    4/15/2010
    16
    Dense homogenous opacity
    Left lower zone outer aspect
    A higher level in axilla
    Obliteration of angles
    No air bronchograms
  • 17. Massive Pleural Effusion Right Side
    4/15/2010
    17
    Tracheal shift to left side
    Dense homogenous opacity
    No air bronchograms
    Obliteration of cardiophrenic
    Obliteration of costophrenic
  • 18. Bilateral pleural Effusion
    4/15/2010
    18
    Trachea & mediastinum central
    2 shadows both lower zones
    Higher levels in axillae
    Cardiophrenic angles obliteralted
    Costophrenic angles obliteralted
  • 19. Encysted Pleural effusion
    4/15/2010
    19
    Rounded and oval shadows
    Correspond to the fissures
    One to horizontal fissure
    The other oblique fissure
    CP and CP angles are free
  • 20. Cavity - Left Lung
    4/15/2010
    20
    Right lung is normal
    Thin walled cavity - left middle
    Homogenous opacity - lower part
    An air fluid level above opacity
    CP and CP obliteralted
  • 21. Lung abscess - Right side
    4/15/2010
    21
    Left lung is normal
    A thick walled cavity Rt middle
    Hhomogenous opacity lower part
    An air fluid level above opacity
    CP & CP angles not obliteralted
  • 22. Lung abscess - Left upper lobe
    4/15/2010
    22
    Right lung is normal
    Thick walled cavity left upper
    A thick opacity - lower part
    Air fluid level above the opacity
    CP & CP angles not obliteralted
  • 23. Infilterative lesions of lung
    4/15/2010
    23
    A close up of apex left lung
    Non-homogenous opacities
    Thin walled cavities
    Minimal air fluid levels
    early lesions of PTB
  • 24. Breaking down Consolidation
    4/15/2010
    24
    left lung - few infiltrates
    Involvement of Rt UZ
    Non-homogenous opacity
    Breaking down of opacity
    Formation of a cavity
  • 25. Cavity - Right upper lobe
    4/15/2010
    25
    The left lung is normal
    Disease of Rt upper zone/lobe
    Thin walled cavity
    No air fluid levels inside
    Cavity characteristic of PTB
  • 26. Fibrosis – Left Upper Lobe
    4/15/2010
    26
    The right lung - few infiltrates
    The trachea is shifted to left
    Mediastinum is shifted to left
    Intercostal spaces are narrowed
    There are cavities inside
  • 27. Bilateral Upper lobe Fibrosis
    4/15/2010
    27
    Trachea shifted to right
    The mediastinum is central
    Both upper zones thin cavities
    Fibrotic bands
    Compensatory emphysema
  • 28. Miliary Mottling
    4/15/2010
    28
    All areas both the lung fields
    Multiple small 1-2 mm rounded
    Best seen in middle and lower
    Miliary mottling
    Hematogenous spread of TBB
  • 29. Reticulo-nodular Opacities
    4/15/2010
    29
    All areas both the lung fields
    Multiple small 2-4 mm rounded
    Middle and lower zones
    Reticulonodular shadows
    Granulomatous spread of TB
  • 30. Bronchopneumonia
    4/15/2010
    30
    Patient with acute dyspnoea
    Both the lung fields are involved
    Middle and lower zones
    Fluffy non-homogenous opacities
    No air bronchograms
  • 31. Adult Respiratory Distress Syndrome
    4/15/2010
    31
    Patient with acute dyspnoea
    Both the lung fields are involved
    Middle and lower zones
    Fluffy non-homogenous opacities
    No air bronchograms
  • 32. Emphysema of lungs
    4/15/2010
    32
    Chest is elongated
    Diaphragm pushed down
    Ribs are horizontally placed
    Lung markings are reduced
    Heart elongated and tubular
  • 33. Pneumothorax Right side
    4/15/2010
    33
    The chest is emphysematous
    Minimal tracheal shift
    Right side no lung markings
    Complete collapse compression
    Air in the pleural cavity
  • 34. Hydro-Pneumothorax Right side
    4/15/2010
    34
    Left lung normal lung markings
    Right lung has no lung markings
    Right lung-completely collapsed
    Compression by the air
    Air-fluid level in pleural space
  • 35. Massive Hydropneumothorax Left side
    4/15/2010
    35
    Homogenous opacity left thorax
    Small air fluid level at the apex
    No higher level in the axilla
    Left heart border not visible
    CP & CP angles obliteralted
  • 36. Bronchiectasis in Plain X-Ray Chest
    4/15/2010
    36
    Both the lung fields are affected
    Nonhomogenous opacities
    No air bronchgrams
    Bilateral and basal
    Few cystic lesions also
  • 37. Mass lesion in the lungs
    4/15/2010
    37
    Right lung parenchyma
    A homogenous opacity
    Central hyperdense lesion
    Peripheral streaks
    No air bronchograms
  • 38. Lung mass with Collapse
    4/15/2010
    38
    The right lung is involved
    Dense homogenous opacity
    No air bronchgrams
    Tracheal shift to the right side
    Collapsed right upper lobe
  • 39. Solitary Nodule of Lung
    4/15/2010
    39
    The right lung is involved
    Dense homogenous opacity RMZ
    No air bronchgrams
    Round shadow & clear margins
    Could be a mass lesion or an inter lobar effusion
  • 40. Cannon Ball shadows
    4/15/2010
    40
    Both the lung fields are affected throughout
    Dense homogenous opacities middle and lower zones
    Again there are no air bronchgrams
    Rounded shadow with not so clear margins
    Could be a secondaries from any other primary site
  • 41. Pleural Calcification
    4/15/2010
    41
    Both the lung fields are relatively clear
    Dense homogenous opacity lateral part of middle zone
    It is dense and white with irregular margins
    These are due to pleural thickening
    May be there is additional calcification of pleura
  • 42. Emphysematous Bulla
    4/15/2010
    42
    The chest is emphysematous and elongated
    There is an additional area of hypertransleucencies
    There is a large air space in the left middle zone laterally
    The wall of the lesion is very thin
    There is no mediastinal shift to suggest pneumothorax
  • 43. Right Upper Lobe Collapse
    4/15/2010
    43
    A dense opacity in upper zone
    There is a lower margin
    Absorption collapse of the lobe
    Due to bronchial obstruction
    Right Upper Lobe Atelectasis
  • 44. Right Middle lobe Collapse
    4/15/2010
    44
    A more diffuse type of shadow
    Seen in the right middle zone
    a linear triangular shadow
    in the lateral view suggestive
    Right Middle Lobe Atelectasis
  • 45. Right Lower lobe Collapse
    4/15/2010
    45
    A linear opacity
    near the right diaphragm
    shift of the right border of heart
    Posterior triangular shadow in
    Seen in a lateral view-
  • 46. Thank You For The Patient Hearing
    4/15/2010
    46

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