How read chest xr 14

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How read chest xr 14

  1. 1. HOW READ CHEST XR -14 ANAS SAHLE ,MD
  2. 2. Brief review
  3. 3. POSITION PA AP QUALITY ROTATION PENETRATION INSPIRATION LESIONOPACIT OPACITY Homo Heterogenous Wellill defined Zone Centralperipher Silhouet sign al Y Necrotic PATCHY HILUMMEDIASTINAL NODULE Central deviasionwided MASS COSTO-PHRENIC ANGEL Freeoblitern CAVITARY OTHERINFILTIRATION Bone soft tissuediaphragm
  4. 4. ConsolidationInfection causes Non-infection causes Broncho- WEGNER CardiacPneumonia Lymphoma alveolar COP Sarcoid disease failure carcinoma
  5. 5. Solitary Pulmonary Nodule(SPN) Appearance Margin Calcification cavitation Comparison with a Size previous x-ray to >8mm <8mm Assess growth over time. Location Upperhillar zone Lowerbasesup-pleural Associated abnormalitiesLymph node enlargement Rib destruction/erosion
  6. 6. Cavitary lesion Air + Air-fluid level Air onlytissue Wall thickness Straight Wavy Thick Thin 1. Fungal ball. 2. Rupture hydatid cyct site 3. Necrotic tumor ruptured 4. Blood glot Hydatid Abscess Irregular Regular Peripheral Central inner wall inner wall cyst Emphesemato Cavitating Chronic us pneumatoc neoplasm abscess ele bulla
  7. 7. LINEAR PATTERN LINEAR PATTERNLEFT VENTRICULAR FAILURE Perihilar and peripheral basal septal lines, changes acutely and resolves with diureticsNormal ageing Coarsening of lung markings in lower zones, no change on review of recent filmsLymphangitis Coarse nodular and linear thickening of markings, known malignancy, often associated with pleural effusion, rapid clinical deterioration of patient
  8. 8. LINEAR PATTERN LINEAR PATTERNAtelectasis Short thin lines, often basal, new on review of previous filmsSubsegmental Longer thicker bands, often perihilar or basal,collapse suggest recent infection or infarctionScarring Any length, persist over time unchangedFibrosis Volume loss is key, persists over time
  9. 9. Causes of fibrosis Mid zone lung Lower zone lung Upper zone lungtuberculosis Drug indused fibrosis sarcoidosis (most common)Chronic extrinsic allergic UIPalveolitisRadio-therapy Asbestose-related fibrosisAnkylosing spondylitisProgressive massivefibrosishistoplasmosis
  10. 10. Mediastinum
  11. 11. MEDIASTINAL ANATOMYSuperior: Upper of T4Inferior: Lower of T4( T4-T8)

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