7. PA & AP View
Posterior – Anterior View
X ray beam comes from behind
Normal sized cardiac shadow
Medial border of scapula
widely spaced
Vertebral bodies shadow
appears blurred
Done in stable patient
Antero – Posterior View
X ray beam is from front
Apparent cardiomegaly
Medial border is closer
Vertebral shadows can be clearly
seen
Usually done in moriband or
seriously ill patients
9. Xray beam is from the lateral side of the patient
Right or Left lateral view is decided by the level of
diaphragm
Indications
- Visualisation of anterior and posterior
Costophrenic angle
- For localisation of lesion
- Segmental Collapse
- Mediastinal lesion
Lateral view
11. Oblique View :
- Both lungs from the apices are included
- Maximum area of the lung is demonstrated
- Diaphragm and heart border appear sharp
- Heart and blood vessels appear magnified
Apicogram :
For detailed evaluation of lung apex
13. Both CP angles should be clearly visible
Both the lung apices should be clearly visible
Bilateral chest wall soft tissue shadows clearly seen
Complete/ Incomplete
14. A well exposed film, the spinous process of T4
vertebra should be clearly seen
In an under exposed film the X ray film appears to be
more radio opaque (white) and in an over exposed
film the X ray film appears to be more radioluscent
(black)
Exposure
15. Distance between medial border of clavicle and the
lateral border of the adjacent vertebra is noted
In a centrally placed film this distance on both sides
should be equal
Right rotation - Right distance increased
Left rotation - Left distance increased
Rotation
17. Size
Position : Tracheal shadow
Heart shadow
Central : Consolidation
Same side : Collapse, Fibrosis
Opposite side: Effusion, Hydropneumothorax,
Pneumothorax, Huge mass
Mediastinum
18. Position
- Normally placed heart is 1/3 rd on the right and 2/3rd on the left
Shape:
Water bottle shaped-Pericardial effusion
Tubular heart-Emphysema
Boot shaped heart-TOF
Box shaped heart-Tricuspid atresia
Upturned apex- ASD
Size : Cardiothoracic ratio > 50% then Cardiomegaly
Heart
19. Position
- at the level of 5th to 7th ribs space
- left diaphragm is 1 rib space below than the right
Elevated: collapse lower lobe,
Phrenic nerve palsy
Subpulmonic effusion
Subdiaphragmatic abscess
Hepatomegaly, Ascitis
Depressed: Emphysema, Chronic bronchitis
Diaphragm
21. Curvature
-If the length of perpendicular <1 cm- flattening of Diaphragm
- Flattening of diaphragm is seen in Emphysema
Margins
Normal – clear margins
Abnormal(blurred) - Lower lobe basal lesion
( consolidation, pulm. Oedema, tumour)
22. Normal Hila is formed by vessels, lymph nodes and bronchus
Position
- Normally hila at the level of 3rd to 5th
rib
- right hila is normally at a higher level than left
Elevation : Upper lobe Collapse
Upper lobe Fibrosis
Depression: Lower lobe Collapse
Hila
24. Normally lung fields are Radiologically described in 3
Zones
Upper zone- Apex – lower margin of 2nd rib
Mid zone- lower margin of 2nd rib to lower margin of
4th rib
Lower zone- Lower margin of 4th rib to below
Lung feilds
26. Luscency
normally luscency is equal in both lung
fields
Unilateral hyperluscency is seen in
- Rotated film
- Unilateral emphysema
- Unilateral Bullae
- Compensatory emphysema
- Poland’s syndrome(post viral unilateral bronchiolitis)
Bilateral hyperluscent lung
- Emphysema
- Bronchiolitis
Lung Fields
27. Bronchovascular markings
Prominence
- Bronchitis
- Pulmonary hypertension
- LVF (upper zone more prominent than
lower)
- Pulmonary arteriovenous malformations
Decreased
- Severe emphysema
- Pulmonary embolism
Lung fields contd…
28. Costophrenic angle
- normally both CP angles are clear and acute
- Blunting seen in
- Pleural effusion
- Severe emphysema
- Basal consolidation
Lung fields contd…
