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A Surgeon’s Reading of Chest X Ray
- 1. ‘ I can talk on plain CXR PA view for, at least, one day’ Dr. R.Ravi Ex HOD, Radiology, KEM Hospital
- 2. A Surgeon’s Reading of Chest X Ray Anil Tendolkar
- 3. Preparation for Practical Examination
- 4. Everything cannot be diagnosed in ONE investigation
- 10. Normal LA Enlarged LA
- 12. Basic knowledge of PATHOLOGY w.r.t. Chamber enlargement is ESSENTIAL
- 13. HALLMARK
- 17. Observation + Other evidences = Inference
- 18. Observation + Other evidences = Inference Clinical Case (H/O, Insp, Palp, Percussion, Auscultation ) ± ECG is always in reference
- 20. 1. Frontal view Centralisation Hard Plate vs Soft Plate
- 22. 2. CT Ratio
- 24. Cardiomegaly = • More volume/ Failed ventricle /fluid in pericardium • Degree of cardiomegaly diagnostic of diseases • Pressure overload of chamber = concentric hypertrophy
- 25. >75% Cardiomegaly Multi and mixed valvular disease, Pericardial effusion , Ebstein’s anomaly, Dilated cardiomyopathy
- 26. ≈65% Cardiomegaly ASD, VSD, MS
- 27. Mini quiz Clinically ASD but CTR > 65%
- 28. Clinically ASD but CTR > 65% If in a clinical case CTR is > than expected, Think of additional pathologies which increase L to R shunt ASD with an additional L SVC ?
- 29. Cyanotic with large heart
- 30. < 55% Cardiomegaly TOF, AS, Mild forms of diseases, Normal Heart
- 31. Severe Disease, Small Heart • AS • PS • HT • CAD • TGA
- 32. 3.Mediastinal Widening Normal SC- TAPVC Thymoma
- 33. Mediastinal Widening Mediastinal LN enlargement
- 34. Mediastinal Widening : Dilated aorta
- 35. Mediastinal widening & Pediatric case Normal thymic enlargement Supra Cardiac TAPVC
- 36. Mediastinal widening & Pediatric case TGA : Narrow pedicle
- 37. Narrow Pedicle in adults
- 38. Narrow Pedicle in adults What would be the CXR in Supine position ?
- 39. 4.Left Border of Heart : Aortic Knuckle Normal Prominent Rt Knuckle
- 40. Left Border of Heart : Aortic Knuckle Normal Prominent Rt Knuckle MVD, ASD, VSD AR, PDA, Arch Aneurysm Truncus , TOF TOF
- 41. Left Border of Heart : Aortic Knuckle Calcified knuckle
- 42. 5.Left Border of Heart : Pulmonary Segment Normal Baying Full/ Prominent Aneurysmal
- 43. Left Border of Heart : Pulmonary Segment Post stenotic dilatation of MPA
- 44. 6.Left Border of Heart : LA appendage
- 45. 7.Left Heart Border : Ventricular Contour: RV Type MS ASD TOF
- 46. Left Heart Border : Ventricular Contour: LV Type AR MR Coarctation of aorta
- 47. Mini – quiz : Clinically ASD Diagnosis ?
- 48. 8. Right Heart Border : Lower half Upper half
- 49. 9.Lung Fields : Congested Moderate Severe Severe
- 50. Lung Fields : Congested
- 51. Lung Fields : Plethora
- 52. Lung Fields : Oligemia
- 53. Mini – quiz : Spot Diagnosis ?
- 54. 10.Opacities within Cardiac Silhouette
- 58. Spot Diagnosis
- 59. 12.CXR & Situs
- 60. 35yr Female Operated for MVR. This is the chest Xray today Diagnosis?
- 61. Fallacy of CTR in a PO CXR • Preop CTR > 70% rarely decrease • Upto 6 months to regress • AF : an additional cause of high CTR • Preop CXR : a MUST for comparison • CTR is a Prognostic Indicator
- 62. Thanks Presentation available for free distribution & freely distributing
- 63. This is CXR of Mr. Sureshbhai Parmar, with severe AS. Conclusion?
- 64. Is there any fallacy of CT Ratio ?
- 68. 48yr Dhanjibhai Naran , Anjar, Kutch MVR in 1985 Comes with this CXR DIAGNOSIS?
- 71. Can you name the prosthesis from CXR?
- 79. So, NO shadow= NO valve?
- 82. In a bileaflet valve, one functioning leaflet may prevent development of pulmonary edema
- 83. Which of the following cases will have the most severe form of Dyspnea ?
- 84. 1 2 3 4
- 86. Mr. M.Ashokan has this chest xray
- 87. Mr. M. Ashokan is sent to Dr. Hiremath at the Sathya Sai Institute for treatment. 2days later Mr. Ashokan’s CXR is …….. POSSIBLE?