2. INTRODUCTION
CHEST XRAY
•Chest X-rays are a commonly performed
diagnostic imaging test.
•They provide a detailed image of the structures
within the chest, including the heart, lungs, and
surrounding tissues.
•Chest X-rays are invaluable tools for detecting a
wide range of abnormalities, including trauma-
3. ANATOMY OVERVIEW
• The chest X-ray captures structures within the thoracic cavity.
• Major components include the lungs, heart, ribs, diaphragm, and
mediastinum.
• The lungs appear as translucent areas with vascular markings.
• The heart is located in the mediastinum, with the left ventricle
typically larger than the right.
• The diaphragm separates the thoracic cavity from the abdominal
cavity and appears as a curved line on the X-ray.
• Ribs and bony structures provide support and protection to internal
organs.
4.
5. CHARACTERISTICS OF NORMAL CHEST X-
RAY
•Clear visualization of lung fields with well-defined
borders.
•Bilateral symmetry of lung structures.
•Normal cardiac silhouette with appropriate size
and shape.
•Diaphragmatic domes at the expected level.
•Absence of abnormal opacities or consolidations.
6. ABNORMAL CHEST X-RAY
What Constitutes an Abnormal X-ray?
•Any deviation from the characteristics of a
normal chest X-ray may indicate abnormalities.
•Abnormal findings may include opacities,
consolidations, masses, or deviations from
normal anatomical structures.
•Other abnormalities such as pneumothorax,
pleural effusion, or rib fractures may also be
7. X-ray chest PA view showing left
apical opacity (Arrow mark)
Chest X-ray with an arrow
showing left lower lobe
consolidation
Chest X-ray - Lung cancer - Hilar
mass and effusion
Pleural effusion A chest radiograph showed
fractures of the left sixth and
seventh ribs (arrow)
8. COMMON ABNORMALITIES
Trauma-related Abnormalities:
•Rib fractures: Visible as discontinuities or abnormal
angulations in the ribs.
•Soft tissue injuries: Swelling, hematoma, or air under
the skin.
•Pneumomediastinum: Air in the mediastinum due to
trauma.
•Flail chest: Multiple rib fractures causing paradoxical
9. PNEUMOTHORAX
•Partial or complete collapse of the lung due to
air in the pleural space.
•Visible as a lucent area with absent lung
markings peripheral to the collapsed lung.
•Signs may include a visible visceral pleural line,
deep costophrenic angles, and mediastinal
shift.
10. TRAUMA AND CHEST X-RAY
Causes of Trauma
•Trauma refers to physical injuries resulting
from external forces.
•Common causes include motor vehicle
accidents, falls, assaults, sports injuries, and
occupational accidents.
•Severity of trauma can vary from minor injuries
to life-threatening conditions.
11. Impact on Chest X-ray Appearance
• Trauma can lead to various abnormalities
visible on chest X-rays.
• These may include fractures, soft tissue
injuries, pneumothorax, or mediastinal
injuries.
• The extent and location of abnormalities
depend on the nature and severity of the
trauma.
13. PNEUMOTHORAX
Pneumothorax is the presence of air in the pleural space, leading
to lung collapse.
Types:
• Primary spontaneous pneumothorax: Occurs without
underlying lung disease, often in young, tall individuals.
• Secondary spontaneous pneumothorax: Associated with
underlying lung conditions such as COPD, asthma, or cystic
fibrosis.
• Traumatic pneumothorax: Results from chest trauma, including
blunt or penetrating injuries.
• Tension pneumothorax: Emergent condition where air enters
but cannot escape the pleural space, causing mediastinal shift
16. MECHANISM OF INJURY
•Traumatic pneumothorax typically results
from a sudden increase in intrathoracic
pressure.
•This can occur due to rib fractures,
penetrating wounds, or barotrauma (e.g.,
blast injuries).
•Air enters the pleural space through a
17. SIGNS AND SYMPTOMS
i. Sudden onset of chest pain: Sharp or stabbing pain, worsened by
breathing or coughing.
ii. Shortness of breath: Dyspnea may range from mild to severe
depending on the size of the pneumothorax.
iii. Decreased breath sounds: As the affected lung collapses, breath
sounds may be diminished or absent on the affected side.
iv. Tachycardia and tachypnea: Compensatory responses to
decreased oxygenation and lung collapse.
v. Cyanosis: Bluish discoloration of the skin due to hypoxemia in
severe cases.
vi. Subcutaneous emphysema: Palpable crepitus caused by air
escaping into the subcutaneous tissues.
18. IMPORTANCE OF DETECTING
ABNORMALITIES
•Early detection of abnormalities on chest X-rays
can lead to prompt diagnosis and treatment.
•Timely identification of abnormalities can
significantly improve patient outcomes and
prevent potential complications.
•Chest X-rays play a crucial role in the diagnosis
and management of various respiratory,
cardiac, and traumatic conditions.
