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Approach to reporting radiographs
- 1. Approach to reporting radiographs Dr G Abraham
- 2. X-Ray • Form of electromagnetic radiation. • First discovered in 1895 by Wilhelm Röntgen who recognized its medical properties. • A radiograph is obtained by passing X ray beams through the patient who is in front of a detector. Bones and other structures cast a shadow allowing their visualisation
- 3. Quick guide • Patient identity • Inspiration – 5- 7 anterior ribs for chest x ray • Rotation –thoracic spinous processes/clavicles • Projection • Penetrance • Field of view • Overall quality • The obvious abnormality? • Systematic check of anatomical structures • Consider the clinical question
- 4. Anatomical structures on the chest X- ray • Trachea and bronchi • Hilar structures • Heart and mediastinum • Lung fields • Pleura • Lung lobes and fissures • Costophrenic angles • Diaphragm • Soft tissues • Bones
- 5. Normal anatomy • Dark – gas • White – bone/calcification • Grey – soft tissues • Dark grey - fat
- 6. 68 year old gentleman with shortness of breath.
- 7. 85 year old lady with a fever and recurrent falls
- 8. 68 year old smoker with hemoptysis
- 9. 75 year old with reduced GCS in ED resus.
- 10. 20 year old intoxicated in ED with multiple injuries.
- 11. 30 year old with severe abdominal pain.
- 12. 49 year old man with chest pain and low blood pressure
- 13. 80 year old gentleman admitted with a fall.
- 14. 67 year old with extensive smoking history
- 15. 40 year old woman pleuritic chest pain.
- 16. Summary • A systematic approach is vital • Start with technical aspects and then anatomy • Remember bone, soft tissue and artefacts • Consider clinical context • Investigations are an adjunct to clinical assessment.