Practice cases to go with the second CXR lecture, with cases relating to the pleura and mediastinum

1. Med Home Unit
Chest 2: Pleural and
MediastinalCases
RAH Radiology

2. Review: Chest Xray interpretation
“In-to-out” approach -
cardiomediastinum -> hilar -> lung fields -> pleura -> bones + soft tissues
Location of the abnormality -
Pleura – dependant or anti-dependant, posterior recesses, veiling
Mediastinum – anterosuperior, middle, posterior
Pneumo -
absent lung markings > pleural edge
tension
mediastinal layer in pneumomediastinum

3. Diagnosis: Right sided pneumothorax with rib fractures and subcut emphysema

4. Diagnosis: Left sided hydropneumothorax.

5. Diagnosis: Subtle left apical pneumothorax. No lung markings.

6. Diagnosis: Supine pneumothorax. Lucent right side with “deep sulcus”.

7. Diagnosis: Left sided tension pneumothorax.

8. Diagnosis: Left sided tension pleural effusion, semi-erect.

9. Diagnosis: Right sided pleural effusion.

10. Diagnosis: Right sided pleural effusion (supine).

11. Diagnosis: Anterosuperior mediastinal mass. Terrible lymphoma

12. Diagnosis: Anterosuperior mediastinal mass. Terrible lymphoma.

13. Diagnosis: Anterosuperior mediastinal mass. Teratoma.

14. Diagnosis: Anterosuperior mediastinal mass. Thymoma.

15. Diagnosis: Posterior mediastinal mass. Extramedullary haematopoeisis (anemia).

16. Diagnosis: Posterior mediastinal mass. Neuroblastoma.

17. Diagnosis: CT example of posterior mediastinal mass. Nerve sheath tumour.

18. Diagnosis: Middle mediastinal mass, hiatus hernia.

19. Diagnosis: Aortic root aneurysm.

20. Diagnosis: Aortic aneurysm (with variant anatomy).