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Chest x - ray
This document provides an overview of chest X-ray procedures and demonstrations of various chest X-ray images. It describes the standard positioning and views for chest X-rays, including posteroanterior, lateral, lordotic, and others. It then shows examples of normal chest X-ray findings and various pathologies that can be detected, such as heart and lung abnormalities, pneumothorax, cavitary lesions, pneumonia, and tumors. Specific disease examples include tuberculosis, sarcoidosis, silicosis, and lung cancer.
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Chest x - ray
- 1. Chest X- Raydemonstration Presented BY DR Laith Fadhil Al hialy P.G. C.R – MB.ch.B
- 2. Chest X-Ray procedure Standingposition / 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. Other views Lateral CXR Lateraldecubitus CXR
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- 5. Normal CXR What canbe 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
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- 8. Different cases Dextrocardia Stomach bubbleon left Right diaphragm lower Position of heart determines which diaphragm is lower, not liver.
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- 11. Segmental Pneumonia Superior segmentof RLL Patchy consolidation
- 12. Air Bronchogram The termair 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.
- 13. Bilateral Upper LobeDisease Tuberculosis Sarcoidosis Histoplasmosis Silicosis Ankylosing spondylitis Eosinophilic granuloma Tuberculosis LUL cavities RUL infiltrate
- 14. Sarcoidosis Bilateral hilar LN enlargement (lobulated shape )
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- 16. Butterfly Pattern Indicative ofbilateral diffuse alveolar disease Also called medullar distribution Also called Bat wing appearance This case is alveolar proteinosis. Also in (Pulmonary - edema) CT
- 17. Solitary Pulmonary Nodule On steroidsdevelops solitary pulmonary nodule in one month FNAB: Aspergillus Resolved with discontinuation of steroids
- 18. Solitary Pulmonary Nodule Left infrahilar region Adenocarcinoma lung
- 19. Polycyclic Margin The wavyshape of the mediastinal mass margin indicates that it is made up of multiple masses, usually lymph nodes. This is a case of lymphoma.
- 20. Cannon Balls –Lung Metastasis Recto sigmoid Cancer Multiple Bilateral Round mass densities Sharp margins
- 21. Popcorn Calcification Solitary pulmonarynodule Popcorn calcification Hamartoma
- 22. Cavitating Metastasis Multiple ThinWalled Cavities Metastases from Cervix Ca
- 23. Honeycombing Seen in endstage 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.
- 24. Lung Cancer Large celltype Mass Round or oval Sharp margin Homogenous