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Chest x - ray


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An introduction to Chest X-ray

Published in: Health & Medicine

Chest x - ray

  1. 1. Chest X- Ray demonstration Presented BY DR Laith Fadhil Al hialy P.G. C.R –
  2. 2. Chest X-Ray procedure Standing position / View PA cassette at chest stand Film size 14 x 14, 14 x17 inch Tube distance 1.5 m Focus at T5 vertebra KV 50 -- 75 KV Mass 15 – 20 mil A Other views Lateral ( RT – LT ) Frontal projection ( AP ) Supine ( pediatric , disable patient ) Lordotic ( vitalized the lung apex ) Oblique ( RT – LT ) chest wall , medistainum
  3. 3. Other views Lateral CXR Lateral decubitus CXR
  4. 4. Lordotic view
  5. 5. Normal CXR What can be found in CXR ? A chest x-ray can detect: 1. Changes in the size and shape of the heart & in the major blood vessels 2. Abnormalities in the lungs such as ( mass , consolidation , collapse , any shadows, calcification, edema , and cavities ) 3. Any mediastinal abnormalities , diaphragmatic abnormality 4. Any bone ( ribs , vertebra , clavicle ) abnormality 5. Both hialy shadows ( LN , bronco-vascular abnormality 6. X-Ray technique – look for ( clavicles , trachea, No of Ribs , aeration of pulmonary fields ) 7. Pneumothorax
  6. 6. X-Ray markers
  7. 7. Different cases Dextrocardia Stomach bubble on left Right diaphragm lower Position of heart determines which diaphragm is lower, not liver.
  8. 8. Single cavitary lesion Hydatid Cyst
  9. 9. Chest HC Multiple Multiple
  10. 10. Segmental Pneumonia Superior segment of RLL Patchy consolidation
  11. 11. Air Bronchogram The term air Bronchogram is used for signifies alveolar disease. Note the branching radiolucent columns of air corresponding to the bronchi, in Right Upper Lobe consolidation in the adjacent CXR.
  12. 12. Bilateral Upper Lobe Disease Tuberculosis Sarcoidosis Histoplasmosis Silicosis Ankylosing spondylitis Eosinophilic granuloma Tuberculosis LUL cavities RUL infiltrate
  13. 13. Sarcoidosis Bilateral hilar LN enlargement ( lobulated shape )
  14. 14. Silicosis Bilateral upper lobe disease
  15. 15. Butterfly Pattern Indicative of bilateral diffuse alveolar disease Also called medullar distribution Also called Bat wing appearance This case is alveolar proteinosis. Also in (Pulmonary - edema) CT
  16. 16. Solitary Pulmonary Nodule On steroids develops solitary pulmonary nodule in one month FNAB: Aspergillus Resolved with discontinuation of steroids
  17. 17. Solitary Pulmonary Nodule Left infra hilar region Adenocarcinoma lung
  18. 18. Polycyclic Margin The wavy shape of the mediastinal mass margin indicates that it is made up of multiple masses, usually lymph nodes. This is a case of lymphoma.
  19. 19. Cannon Balls – Lung Metastasis Recto sigmoid Cancer Multiple Bilateral Round mass densities Sharp margins
  20. 20. Popcorn Calcification Solitary pulmonary nodule Popcorn calcification Hamartoma
  21. 21. Cavitating Metastasis Multiple Thin Walled Cavities Metastases from Cervix Ca
  22. 22. Honeycombing Seen in end stage lung disease Indicative of diffuse interstitial fibrosis Due to bronchiolectasia Most of the time in bases Upper lobe distribution seen in Eosinophilic granuloma Close up and gross lung specimens below.
  23. 23. Lung Cancer Large cell type Mass Round or oval Sharp margin Homogenous