This document provides instructions on how to interpret a chest X-ray. It begins by explaining that basic interpretation is easy and involves classifying any abnormalities as being too white, too black, too large, or in the wrong place. It recommends checking technical details like the patient name, date, and comparing to prior films. The document then discusses how to evaluate the technical quality by examining the projection, orientation, rotation, penetration, and inspiration. It provides examples of how these factors can impact the appearance of the X-ray. The next section guides the reader through scanning the PA film by examining specific anatomical structures and features.
This document discusses techniques for measuring corneal thickness, known as pachymetry. It begins by introducing pachymetry and its importance in assessing corneal health and thickness. It then describes 12 techniques for measuring corneal thickness, including the gold standard of ultrasonic pachymetry. The document provides details on the principles, advantages, and disadvantages of each technique. It concludes by discussing the clinical utility of pachymetry in procedures like LASIK and for conditions like glaucoma and keratoconus.
This document discusses pachymetry, which is the measurement of corneal thickness. It begins by defining pachymetry and noting its importance in assessing corneal health. Normal corneal thickness ranges are provided. Techniques for measuring corneal thickness are then outlined, including ultrasonic pachymetry, specular microscopy, slit-scanning pachymetry, OCT, and confocal microscopy. Clinical applications of pachymetry in glaucoma, refractive surgery, and contact lens use are discussed. Factors that influence corneal thickness and techniques for correcting intraocular pressure based on thickness are also summarized.
This document provides an overview of the basic approach to interpreting chest X-rays. It discusses evaluating technical adequacy, the cardiothoracic ratio, mediastinal contours, lung zones, and bony structures. Common normal variants like the azygos lobe fissure are also addressed. The lateral view is described as helpful for localization of abnormalities and differentiating hilar masses. Key areas like pleural effusions, diaphragm abnormalities, and the anterior mediastinum are highlighted. An inside-to-outside approach is suggested starting with technical adequacy and moving outward.
1) The document provides guidance on interpreting chest x-rays by focusing on patterns of lung abnormalities including consolidation, pulmonary nodules and masses, and cavitary lesions.
2) Consolidation is described according to its contents, pattern of distribution, and chronicity which helps limit differential diagnoses. Common causes of lobar and diffuse consolidation are also outlined.
3) Pulmonary nodules and masses are differentiated and important characteristics for assessing each such as edges, number, density, and vascular pedicles are highlighted.
4) Cavitary lesions are described based on internal contents and location to suggest potential etiologies such as abscess, ruptured cyst, or pneumatocele.
This document provides guidance on positioning and interpreting basic chest x-rays. It discusses typical views like PA and lateral chest x-rays. Additional views like decubitus and lordotic are also covered. The document reviews how to assess film quality and check for inspiration. It describes systematically checking the diaphragm, heart, hilum, lung fields and other structures. Specific findings like infiltrates, masses, air bronchograms and silhouette signs are addressed. The goal is to provide a structured approach to reading and interpreting chest x-rays.
Based on the provided chest x-ray, the ET tube tip is located above the carina and in the proper position within the trachea. It does not appear to need adjustment. Feeding through the R/T tube would be appropriate.
This document discusses chest x-ray interpretation and provides guidance on evaluating x-rays. It explains that tissue density determines how an x-ray beam penetrates, with denser tissues appearing whiter and less dense tissues appearing blacker. It also outlines different chest x-ray views and factors to consider like patient orientation, age, gender, and rotation. Abnormalities are described as appearing too white, too black, too large, or in the wrong place. The document stresses a systematic approach of identifying, localizing, describing lesions, and providing differential diagnoses.
This document provides diagrams and descriptions of common chest x-ray findings including pneumothorax, COPD/emphysema, subcutaneous emphysema, pulmonary edema, pleural effusion, cardiomegaly, and atelectasis. Pneumothorax is depicted as an air-filled black space in the pleural cavity causing lung collapse and mediastinal shift. COPD/emphysema shows over-inflated lungs, a long thin heart, and flattened diaphragms. Atelectasis is described as collapsed lung lobes appearing as triangular or linear densities.
This document discusses techniques for measuring corneal thickness, known as pachymetry. It begins by introducing pachymetry and its importance in assessing corneal health and thickness. It then describes 12 techniques for measuring corneal thickness, including the gold standard of ultrasonic pachymetry. The document provides details on the principles, advantages, and disadvantages of each technique. It concludes by discussing the clinical utility of pachymetry in procedures like LASIK and for conditions like glaucoma and keratoconus.
This document discusses pachymetry, which is the measurement of corneal thickness. It begins by defining pachymetry and noting its importance in assessing corneal health. Normal corneal thickness ranges are provided. Techniques for measuring corneal thickness are then outlined, including ultrasonic pachymetry, specular microscopy, slit-scanning pachymetry, OCT, and confocal microscopy. Clinical applications of pachymetry in glaucoma, refractive surgery, and contact lens use are discussed. Factors that influence corneal thickness and techniques for correcting intraocular pressure based on thickness are also summarized.
This document provides an overview of the basic approach to interpreting chest X-rays. It discusses evaluating technical adequacy, the cardiothoracic ratio, mediastinal contours, lung zones, and bony structures. Common normal variants like the azygos lobe fissure are also addressed. The lateral view is described as helpful for localization of abnormalities and differentiating hilar masses. Key areas like pleural effusions, diaphragm abnormalities, and the anterior mediastinum are highlighted. An inside-to-outside approach is suggested starting with technical adequacy and moving outward.
1) The document provides guidance on interpreting chest x-rays by focusing on patterns of lung abnormalities including consolidation, pulmonary nodules and masses, and cavitary lesions.
2) Consolidation is described according to its contents, pattern of distribution, and chronicity which helps limit differential diagnoses. Common causes of lobar and diffuse consolidation are also outlined.
3) Pulmonary nodules and masses are differentiated and important characteristics for assessing each such as edges, number, density, and vascular pedicles are highlighted.
4) Cavitary lesions are described based on internal contents and location to suggest potential etiologies such as abscess, ruptured cyst, or pneumatocele.
This document provides guidance on positioning and interpreting basic chest x-rays. It discusses typical views like PA and lateral chest x-rays. Additional views like decubitus and lordotic are also covered. The document reviews how to assess film quality and check for inspiration. It describes systematically checking the diaphragm, heart, hilum, lung fields and other structures. Specific findings like infiltrates, masses, air bronchograms and silhouette signs are addressed. The goal is to provide a structured approach to reading and interpreting chest x-rays.
Based on the provided chest x-ray, the ET tube tip is located above the carina and in the proper position within the trachea. It does not appear to need adjustment. Feeding through the R/T tube would be appropriate.
This document discusses chest x-ray interpretation and provides guidance on evaluating x-rays. It explains that tissue density determines how an x-ray beam penetrates, with denser tissues appearing whiter and less dense tissues appearing blacker. It also outlines different chest x-ray views and factors to consider like patient orientation, age, gender, and rotation. Abnormalities are described as appearing too white, too black, too large, or in the wrong place. The document stresses a systematic approach of identifying, localizing, describing lesions, and providing differential diagnoses.
This document provides diagrams and descriptions of common chest x-ray findings including pneumothorax, COPD/emphysema, subcutaneous emphysema, pulmonary edema, pleural effusion, cardiomegaly, and atelectasis. Pneumothorax is depicted as an air-filled black space in the pleural cavity causing lung collapse and mediastinal shift. COPD/emphysema shows over-inflated lungs, a long thin heart, and flattened diaphragms. Atelectasis is described as collapsed lung lobes appearing as triangular or linear densities.
This document summarizes a case conference discussion of chest radiology findings. It lists various pathologies that can be seen on chest x-rays and their effects on tracheal positioning and lung opacification. These include pneumonectomy, lung collapse, masses, effusions, hernias and edema. Specific cases are then discussed, including a patient who developed a massive pneumothorax due to their chest tube Heimlich valve being placed backwards, preventing air escape.
This document provides an overview of how to interpret a chest x-ray. It discusses the normal anatomy seen on a CXR and various patterns of abnormality. It describes how to systematically analyze a CXR by examining the airways, bones, cardiovascular system, diaphragm, lungs, and soft tissues. Common abnormalities are outlined, including consolidation, interstitial lung disease, atelectasis, nodules/masses, cavities/cysts, and calcification. Specific examples of different pathological processes are also reviewed.
This document provides an overview of chest radiograph interpretation for interns, covering normal anatomy, common pathologies, and technical factors. It summarizes how to evaluate for adequate penetration, inspiration, rotation, magnification, and angulation. Common pathologies like pleural effusion, pneumothorax, pneumonia, and pulmonary tuberculosis are described with examples. Normal pediatric and adult chest x-ray features are outlined along with how to read and interpret the major anatomical structures visible.
This document provides an overview of chest x-ray basics including essential information to document, different views, positioning, and indications. The standard frontal view is the posteroanterior (PA) view with the patient standing and x-ray beam from back to front. The anteroposterior (AP) view is used for sick patients and images the chest from front to back with the patient supine. Key differences between the PA and AP views are noted. Additional views like lateral, decubitus, expiration, and lordotic may be used to better evaluate specific conditions. Critical anatomy like the heart, hilum, ribs are also reviewed.
This document provides an overview of how to interpret chest x-rays. It discusses the basic principles of x-rays, including how x-rays interact with different tissues. It outlines the standard views and techniques for chest x-rays. It also describes what qualifies as a technically adequate chest x-ray and discusses some common pathologies seen on chest x-rays like cardiomegaly, pleural effusions, pneumothorax, and pulmonary diseases. Quizzes are provided to test the interpretation of technical errors and common diagnoses.
This document discusses the stages of pulmonary edema seen on chest x-rays and associated wedge pressures. Stage I shows early signs like deer antler sign and Kerley B lines with pressures of 12-18 mmHg. Stage II shows interstitial edema on x-ray with pressures of 19-25 mmHg. Stage III is alveolar edema appearing as bat wing shadowing on x-ray associated with pressures over 25 mmHg.
This document provides an overview of chest x-ray interpretation from JSS Medical College in Mysuru, India. It begins with an introduction to radiographic densities and viewing chest x-rays. It then details an "ABCDEFGHI" approach to interpretation, covering the airway, bones, cardiomediastinal silhouette, diaphragm, effusions, lung fields, gastric bubble, hila, and impressions. Common abnormalities such as pneumonia, effusions, pneumothorax, and masses are described. The presentation emphasizes reviewing patient details, comparing to prior films, and examining all structures visible on a chest x-ray.
Presentation1.pptx. interpretation of x ray chest.Abdellah Nazeer
This document provides guidance on interpreting chest x-rays from Dr. Nazeer. It outlines common indications for chest x-rays such as evaluating chest symptoms or physical exam findings. It then describes how to analyze x-rays for abnormalities like consolidation, nodules, masses, cavities, and effusions. Specific pathological conditions are also discussed such as pneumonia, tuberculosis, lung cancer, and mediastinal lesions.
The document provides an overview of interpreting chest x-rays, including:
1. It describes the radiologic signs of lobar and segmental lung collapse including displacement of fissures, volume loss, hilar elevation, and crowding of vessels and bronchi.
2. Specific features of collapse in different lung lobes are outlined, such as the triangular density seen in right middle lobe collapse on lateral view.
3. Degree of collapse can affect radiologic findings from subtle increased opacity to complete loss of fissure lines. Additional signs like the superior triangle sign may help with diagnosis.
4. Causes of an opacified hemithorax are discussed, highlighting how mediastinal shift
Chest x ray - basic principles and interpretitionMohamed Shaaban
An x-ray machine uses an x-ray tube to emit radiation through a patient onto film. The x-ray tube produces x-rays that pass through the patient, and any structures inside the patient will absorb some of the x-rays in different amounts. The film captures the x-ray image, showing light and dark areas corresponding to dense and less dense areas inside the patient.
The document provides an overview of the pathology of lung diseases as seen on chest x-rays, including signs, appearances and common causes of conditions such as consolidation, pleural effusion, atelectasis, pneumothorax, lung masses, fibrosis and infections like tuberculosis. Differential diagnoses are also provided for various lung abnormalities seen on x-rays.
This document provides an overview of a chest x-ray procedure, including:
- What a chest x-ray is and its common uses such as evaluating the lungs, heart, and chest for conditions like pneumonia or lung cancer.
- How the procedure is performed, including positioning the patient and obtaining frontal and lateral x-ray images.
- How chest x-rays work by exposing the chest to low-dose radiation and producing images based on tissue density.
- The benefits of chest x-rays in providing fast, low-risk imaging to diagnose chest conditions, weighed against the small radiation exposure risk.
- Key anatomy seen on chest x-rays like the lungs, heart borders, f
This document provides guidelines for interpreting a chest x-ray, including structures to identify, technical aspects to evaluate, and what to examine in different areas of the image. It describes how to analyze the trachea, heart, diaphragms, lungs, hilum, and other areas. Key points covered are proper centering, penetration, inspiration, and angulation of the x-ray. Anatomical landmarks are identified for assessing abnormalities in each lung field.
The document discusses how chest X-rays work and what they can show. Different tissues absorb X-rays at different rates, with bone appearing white, soft tissue grey, and air black. A PA view has X-rays enter through the back while an AP view is from the front. Proper exposure level is needed to see details in the lungs and heart without being over or under penetrated. Positioning is important to evaluate symmetry and check for abnormalities in soft tissues and bones like the ribs, spine, diaphragm and heart. Lung fields and costophrenic angles should have sharp margins and be checked for issues like infiltrates or masses.
This document provides guidance on interpreting a normal chest x-ray. It outlines the key factors to consider, including orientation, inspiration, penetration, and rotation. It describes the normal radiographic anatomy, including the lungs, heart, diaphragm, mediastinum, and other structures. A proper technique is important to avoid artifacts that could be mistaken for pathology. The document emphasizes performing the examination with good inspiration in the PA orientation for optimal visualization of structures.
1) The document provides guidance on how to properly examine abdominal x-rays, including establishing patient details, film projection, and systematically scanning structures.
2) Key structures to examine are the bones, kidneys, liver, spleen, stomach, and intestines. Abnormalities may include size, position, calcification, or presence of gas/fluid.
3) Always check for left/right markers and compatibility with anatomy. Rare conditions like situs inversus must be considered if markers do not match visible structures.
This document provides an overview of the basics of radiograph interpretation. It discusses the four densities seen on radiographs: gas, fat, water, and mineral. Gas appears black, fat is a dark gray, water is a lighter gray, and mineral is white. An example abdominal radiograph is shown and labeled to identify the different densities. The document emphasizes the importance of recognizing normal patterns and outlines several reference materials and techniques to aid in radiograph interpretation, such as using rulers, comparing views over time, and ensuring all necessary information is obtained.
Optical coherence tomography (OCT) is a non-invasive imaging technique that uses light to capture high-resolution, cross-sectional images of the retina and anterior segment of the eye. OCT provides depth resolution on the scale of 10 microns, allowing it to visualize and measure individual layers of the retina. OCT can detect various retinal pathologies through qualitative and quantitative analysis of the pre-retinal, overall retinal, foveal, and macular profiles. It is useful for diagnosing conditions like macular edema, retinal detachments, and glaucoma.
This document summarizes a case conference discussion of chest radiology findings. It lists various pathologies that can be seen on chest x-rays and their effects on tracheal positioning and lung opacification. These include pneumonectomy, lung collapse, masses, effusions, hernias and edema. Specific cases are then discussed, including a patient who developed a massive pneumothorax due to their chest tube Heimlich valve being placed backwards, preventing air escape.
This document provides an overview of how to interpret a chest x-ray. It discusses the normal anatomy seen on a CXR and various patterns of abnormality. It describes how to systematically analyze a CXR by examining the airways, bones, cardiovascular system, diaphragm, lungs, and soft tissues. Common abnormalities are outlined, including consolidation, interstitial lung disease, atelectasis, nodules/masses, cavities/cysts, and calcification. Specific examples of different pathological processes are also reviewed.
This document provides an overview of chest radiograph interpretation for interns, covering normal anatomy, common pathologies, and technical factors. It summarizes how to evaluate for adequate penetration, inspiration, rotation, magnification, and angulation. Common pathologies like pleural effusion, pneumothorax, pneumonia, and pulmonary tuberculosis are described with examples. Normal pediatric and adult chest x-ray features are outlined along with how to read and interpret the major anatomical structures visible.
This document provides an overview of chest x-ray basics including essential information to document, different views, positioning, and indications. The standard frontal view is the posteroanterior (PA) view with the patient standing and x-ray beam from back to front. The anteroposterior (AP) view is used for sick patients and images the chest from front to back with the patient supine. Key differences between the PA and AP views are noted. Additional views like lateral, decubitus, expiration, and lordotic may be used to better evaluate specific conditions. Critical anatomy like the heart, hilum, ribs are also reviewed.
This document provides an overview of how to interpret chest x-rays. It discusses the basic principles of x-rays, including how x-rays interact with different tissues. It outlines the standard views and techniques for chest x-rays. It also describes what qualifies as a technically adequate chest x-ray and discusses some common pathologies seen on chest x-rays like cardiomegaly, pleural effusions, pneumothorax, and pulmonary diseases. Quizzes are provided to test the interpretation of technical errors and common diagnoses.
This document discusses the stages of pulmonary edema seen on chest x-rays and associated wedge pressures. Stage I shows early signs like deer antler sign and Kerley B lines with pressures of 12-18 mmHg. Stage II shows interstitial edema on x-ray with pressures of 19-25 mmHg. Stage III is alveolar edema appearing as bat wing shadowing on x-ray associated with pressures over 25 mmHg.
This document provides an overview of chest x-ray interpretation from JSS Medical College in Mysuru, India. It begins with an introduction to radiographic densities and viewing chest x-rays. It then details an "ABCDEFGHI" approach to interpretation, covering the airway, bones, cardiomediastinal silhouette, diaphragm, effusions, lung fields, gastric bubble, hila, and impressions. Common abnormalities such as pneumonia, effusions, pneumothorax, and masses are described. The presentation emphasizes reviewing patient details, comparing to prior films, and examining all structures visible on a chest x-ray.
Presentation1.pptx. interpretation of x ray chest.Abdellah Nazeer
This document provides guidance on interpreting chest x-rays from Dr. Nazeer. It outlines common indications for chest x-rays such as evaluating chest symptoms or physical exam findings. It then describes how to analyze x-rays for abnormalities like consolidation, nodules, masses, cavities, and effusions. Specific pathological conditions are also discussed such as pneumonia, tuberculosis, lung cancer, and mediastinal lesions.
The document provides an overview of interpreting chest x-rays, including:
1. It describes the radiologic signs of lobar and segmental lung collapse including displacement of fissures, volume loss, hilar elevation, and crowding of vessels and bronchi.
2. Specific features of collapse in different lung lobes are outlined, such as the triangular density seen in right middle lobe collapse on lateral view.
3. Degree of collapse can affect radiologic findings from subtle increased opacity to complete loss of fissure lines. Additional signs like the superior triangle sign may help with diagnosis.
4. Causes of an opacified hemithorax are discussed, highlighting how mediastinal shift
Chest x ray - basic principles and interpretitionMohamed Shaaban
An x-ray machine uses an x-ray tube to emit radiation through a patient onto film. The x-ray tube produces x-rays that pass through the patient, and any structures inside the patient will absorb some of the x-rays in different amounts. The film captures the x-ray image, showing light and dark areas corresponding to dense and less dense areas inside the patient.
The document provides an overview of the pathology of lung diseases as seen on chest x-rays, including signs, appearances and common causes of conditions such as consolidation, pleural effusion, atelectasis, pneumothorax, lung masses, fibrosis and infections like tuberculosis. Differential diagnoses are also provided for various lung abnormalities seen on x-rays.
This document provides an overview of a chest x-ray procedure, including:
- What a chest x-ray is and its common uses such as evaluating the lungs, heart, and chest for conditions like pneumonia or lung cancer.
- How the procedure is performed, including positioning the patient and obtaining frontal and lateral x-ray images.
- How chest x-rays work by exposing the chest to low-dose radiation and producing images based on tissue density.
- The benefits of chest x-rays in providing fast, low-risk imaging to diagnose chest conditions, weighed against the small radiation exposure risk.
- Key anatomy seen on chest x-rays like the lungs, heart borders, f
This document provides guidelines for interpreting a chest x-ray, including structures to identify, technical aspects to evaluate, and what to examine in different areas of the image. It describes how to analyze the trachea, heart, diaphragms, lungs, hilum, and other areas. Key points covered are proper centering, penetration, inspiration, and angulation of the x-ray. Anatomical landmarks are identified for assessing abnormalities in each lung field.
The document discusses how chest X-rays work and what they can show. Different tissues absorb X-rays at different rates, with bone appearing white, soft tissue grey, and air black. A PA view has X-rays enter through the back while an AP view is from the front. Proper exposure level is needed to see details in the lungs and heart without being over or under penetrated. Positioning is important to evaluate symmetry and check for abnormalities in soft tissues and bones like the ribs, spine, diaphragm and heart. Lung fields and costophrenic angles should have sharp margins and be checked for issues like infiltrates or masses.
This document provides guidance on interpreting a normal chest x-ray. It outlines the key factors to consider, including orientation, inspiration, penetration, and rotation. It describes the normal radiographic anatomy, including the lungs, heart, diaphragm, mediastinum, and other structures. A proper technique is important to avoid artifacts that could be mistaken for pathology. The document emphasizes performing the examination with good inspiration in the PA orientation for optimal visualization of structures.
1) The document provides guidance on how to properly examine abdominal x-rays, including establishing patient details, film projection, and systematically scanning structures.
2) Key structures to examine are the bones, kidneys, liver, spleen, stomach, and intestines. Abnormalities may include size, position, calcification, or presence of gas/fluid.
3) Always check for left/right markers and compatibility with anatomy. Rare conditions like situs inversus must be considered if markers do not match visible structures.
This document provides an overview of the basics of radiograph interpretation. It discusses the four densities seen on radiographs: gas, fat, water, and mineral. Gas appears black, fat is a dark gray, water is a lighter gray, and mineral is white. An example abdominal radiograph is shown and labeled to identify the different densities. The document emphasizes the importance of recognizing normal patterns and outlines several reference materials and techniques to aid in radiograph interpretation, such as using rulers, comparing views over time, and ensuring all necessary information is obtained.
Optical coherence tomography (OCT) is a non-invasive imaging technique that uses light to capture high-resolution, cross-sectional images of the retina and anterior segment of the eye. OCT provides depth resolution on the scale of 10 microns, allowing it to visualize and measure individual layers of the retina. OCT can detect various retinal pathologies through qualitative and quantitative analysis of the pre-retinal, overall retinal, foveal, and macular profiles. It is useful for diagnosing conditions like macular edema, retinal detachments, and glaucoma.
Optical Coherence Tomography - principle and uses in ophthalmologytapan_jakkal
Optical coherence tomography (OCT) is a non-invasive imaging technique that uses light to capture high-resolution, cross-sectional images of the retina and anterior segment of the eye. OCT provides depth resolution on the scale of 10 microns, allowing it to visualize detailed layers and structures within the retina. OCT can be used to qualitatively and quantitatively analyze the retina, detecting various pathological features and measuring retinal thickness. Anterior segment OCT also allows high-resolution imaging of the cornea, iris, angle, and anterior chamber.
Optical coherence tomography (OCT) is a non-invasive imaging technique that uses light to capture high-resolution, cross-sectional images of the retina and anterior segment of the eye. OCT provides depth resolution on the scale of 10 microns, allowing it to visualize and measure individual layers of the retina. OCT can detect various retinal pathologies and abnormalities through qualitative and quantitative analysis of the pre-retinal, overall retinal, foveal, and macular profiles.
Evaluating the optic nerve head in glaucomaRiyad Banayot
The best method readily available to the clinician for performing this examination is high plus lens fundus biomicroscopy. Optimal magnification can be achieved by using a +60D lens which provides 1.5 times the magnification of a 90D lens. During this examination the patient's pupils must be maximally dilated with a combination of mydriatic agents such as 1% Tropicamide and 2.5% Phenylephrine.
This document provides an overview of interpreting normal radiographs. It discusses common radiographic terminology and densities seen on x-rays. It then examines how to interpret different types of radiographs, including the skull, chest, abdomen, pelvis, spine and extremities. For each area, it outlines the standard views, anatomy visible, and things to look for. Overall, the document serves as a guide for medical professionals on analyzing normal findings across various radiographic images.
This document provides instruction on point-of-care ultrasound techniques for rural emergency situations. It covers the goals of learning basic ultrasound machine settings and techniques for detecting fluid in the chest, abdomen, and around the heart. Key scans taught are the extended focused assessment for shock and trauma exam and scanning the aorta for abdominal aortic aneurysms. Terminology used in ultrasound is defined, including echogenicity, artifacts, and probe features. Proper techniques are described for cardiac, aortic, and pleural scans.
in this tutorial i am speaking about chest x-ray quality that include :
1- Inclusion
2- inspiration/lung
3- volume
4- projection
5- penetration
6- Rotation
7- artifact
i try to make it easy and simple for medical students and junior doctors to help them in clinical life.
The document provides a checklist and guidelines for systematically analyzing a chest x-ray, including checking patient identity, image quality, inspecting the lungs, heart, bones and soft tissues, and reviewing specific areas. Key steps involve assessing the image for rotation, inspiration, and penetration/exposure; comparing lung fields and cardiac size; and scrutinizing areas like the apices, edges, and behind the heart. Following the checklist helps provide an organized analysis of the essential anatomical structures and findings on a chest x-ray.
This document discusses fractures that require special attention due to their location or potential to be overlooked. It identifies two main groups - fractures of the ribs, scapula, Lisfranc joint, cervicothoracic junction, and posterior spinal elements, and fractures of the scaphoid, radial head, and femoral neck. It emphasizes the importance of optimal imaging like CT scans to detect these fractures, and provides guidance on imaging techniques and views needed to properly evaluate common fracture sites.
Dr. Emad Efat provides a tutorial on chest x-ray fundamentals that includes:
1. A systematic approach for analyzing chest x-rays that involves checking anatomical structures, patient and image data, describing abnormalities, and interpreting findings based on clinical context.
2. Guidelines for assessing chest x-ray quality including factors like inclusion, projection, rotation, inspiration, penetration, and artifacts that can impact the ability to identify abnormalities.
3. An overview of chest x-ray anatomy covering structures like the airways, hilar regions, lung zones, pleura, lung lobes/fissures, diaphragm, heart contours and size, and mediastinum.
Chest X-rays provide important information about cardiac anatomy and physiology by showing the contrast between air-filled lungs and the opaque heart and blood vessels filled with blood. A careful evaluation of a chest X-ray can yield significant anatomical and physiological data, but interpreting chest X-rays requires considering technical factors, patient factors, and the interpreter's training and experience. The document then discusses considerations for obtaining and interpreting normal and abnormal findings on chest X-rays.
1. Chest X-ray is a commonly used and inexpensive imaging test that provides important information to evaluate clinical questions.
2. It is important to thoroughly examine all aspects of the X-ray such as quality, projections, inspiration and anatomy to identify any abnormalities.
3. Descriptions of abnormalities should include their location, size and other relevant characteristics compared to the surrounding normal structures.
Articulate Rise educational module of the Anatomy of the Hand and Wrist. This module explores the details of a hand and wrist x-ray and helps one learn the anatomy and building knowledge of the hand and wrist.
Optical Coherence Tomography (OCT) is a non-invasive imaging technique that examines living tissue using low coherence radiation. It provides high resolution cross-sectional images of the retina in real time. OCT allows for both qualitative and quantitative analysis of retinal thickness, volume, and nerve fiber layer thickness. Scans can be customized using different protocols like line, circle, or radial line scans to examine specific areas of interest like the macula or optic nerve.
This video explains Lumbar Microsurgical Minimally Invasive Decompression in Detail. When degenerative disc disease begins to affect the spine this is called degenerative disc disease. This video highlights the history, epidemiology, and treatment options both conservative and surgical. If you or someone you know needs to be seen in regards to Lumbar Disc Replacement feel free to look us up online www.beverlyspine.com or www.santamonicaspine.com OR call toll free 1-8SPINECAL-1
The Unbelievable Tale of Dwayne Johnson Kidnapping: A Riveting Sagagreendigital
Introduction
The notion of Dwayne Johnson kidnapping seems straight out of a Hollywood thriller. Dwayne "The Rock" Johnson, known for his larger-than-life persona, immense popularity. and action-packed filmography, is the last person anyone would envision being a victim of kidnapping. Yet, the bizarre and riveting tale of such an incident, filled with twists and turns. has captured the imagination of many. In this article, we delve into the intricate details of this astonishing event. exploring every aspect, from the dramatic rescue operation to the aftermath and the lessons learned.
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The Origins of the Dwayne Johnson Kidnapping Saga
Dwayne Johnson: A Brief Background
Before discussing the specifics of the kidnapping. it is crucial to understand who Dwayne Johnson is and why his kidnapping would be so significant. Born May 2, 1972, Dwayne Douglas Johnson is an American actor, producer, businessman. and former professional wrestler. Known by his ring name, "The Rock," he gained fame in the World Wrestling Federation (WWF, now WWE) before transitioning to a successful career in Hollywood.
Johnson's filmography includes blockbuster hits such as "The Fast and the Furious" series, "Jumanji," "Moana," and "San Andreas." His charismatic personality, impressive physique. and action-star status have made him a beloved figure worldwide. Thus, the news of his kidnapping would send shockwaves across the globe.
Setting the Scene: The Day of the Kidnapping
The incident of Dwayne Johnson's kidnapping began on an ordinary day. Johnson was filming his latest high-octane action film set to break box office records. The location was a remote yet scenic area. chosen for its rugged terrain and breathtaking vistas. perfect for the film's climactic scenes.
But, beneath the veneer of normalcy, a sinister plot was unfolding. Unbeknownst to Johnson and his team, a group of criminals had planned his abduction. hoping to leverage his celebrity status for a hefty ransom. The stage was set for an event that would soon dominate worldwide headlines and social media feeds.
The Abduction: Unfolding the Dwayne Johnson Kidnapping
The Moment of Capture
On the day of the kidnapping, everything seemed to be proceeding as usual on set. Johnson and his co-stars and crew were engrossed in shooting a particularly demanding scene. As the day wore on, the production team took a short break. providing the kidnappers with the perfect opportunity to strike.
The abduction was executed with military precision. A group of masked men, armed and organized, infiltrated the set. They created chaos, taking advantage of the confusion to isolate Johnson. Johnson was outnumbered and caught off guard despite his formidable strength and fighting skills. The kidnappers overpowered him, bundled him into a waiting vehicle. and sped away, leaving everyone on set in a state of shock and disbelief.
The Immediate Aftermath
The immediate aftermath of the Dwayne Johnson kidnappin
The Future of Independent Filmmaking Trends and Job OpportunitiesLetsFAME
The landscape of independent filmmaking is evolving at an unprecedented pace. Technological advancements, changing consumer preferences, and new distribution models are reshaping the industry, creating new opportunities and challenges for filmmakers and film industry jobs. This article explores the future of independent filmmaking, highlighting key trends and emerging job opportunities.
At Digidev, we are working to be the leader in interactive streaming platforms of choice by smart device users worldwide.
Our goal is to become the ultimate distribution service of entertainment content. The Digidev application will offer the next generation television highway for users to discover and engage in a variety of content. While also providing a fresh and
innovative approach towards advertainment with vast revenue opportunities. Designed and developed by Joe Q. Bretz
Christian Louboutin: Innovating with Red Solesget joys
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The Enigmatic Portrait, In the heart of a sleepy town
Reading chestxray
1. CHAPTER 1
How to look at a
chest X-ray
1.1 Basic interpretation is
easy 2
1.2 Technical quality 4
1.3 Scanning the PA film 10
1.4 How to look at the
lateral film 13
2. 1.1 Basic interpretation is easy
1.1 Basic interpretation is easy
Basic interpretation of the chest X-ray is easy. It is simply a black and
white film and any abnormalities can be classified into:
1. Too white.
2. Too black.
3. Too large.
4. In the wrong place.
To gain the most information from an X-ray, and avoid inevitable panic
when you see an abnormality, adopt the following procedure:
1. Check the name and the date.
2. If you are using a picture-archiving system, see whether previous
X-rays are on the system for comparison. The patient may have had
previous X-rays which are stored on film. If you cannot access previ-
ous films, look for old radiology reports, which may be helpful.
3. Check the technical quality of the film. (Explained in Chapter 1.2.)
4. Scan the film thoroughly and mentally list any abnormalities you
find. Always complete this stage. The temptation is to stop when
you find the first abnormality but, if you do this you may get so
engrossed in determining what it is that you will forget to look at
the rest of the film. Chapter 1.3 explains how to scan a film.
5. When you have found the abnormalities, work out where they are.
Decide whether the lesion is in the chest wall, pleura, within the
lung or mediastinum. Chapter 2 explains how to localize lesions
within the lung and the heart, Chapter 8 the mediastinum and
Chapter 9 the ribs.
6. Mentally describe the abnormality. Which category does it fall into:
I. Too white.
II. Too black.
III. Too large.
IV. In the wrong place.
Chapters 4 to 11 will take you through how to interpret your
findings.
2
3. Basic interpretation is easy continued 1.1
7. Always ensure that the film is reported on by a radiologist. Basic
interpretation of the chest X-ray is easy, but more subtle signs
require the trained eye of a radiologist. Seeking a radiologist’s
opinion can often expedite a diagnosis or the radiologist may
suggest further imaging.
8. Finally, do not forget the patient. It is possible and, indeed, quite
common for a very sick patient to have a normal chest X-ray.
3
4. 1.2 Technical quality
1.2 Technical quality
The next four X-rays are examples of how the technical quality of a film can
affect its appearance and potentially lead to misinterpretation Above is an AP
film which shows how the scapulae are projected over the thorax and the heart
appears large Compare this to the film opposite which is a standard PA projec-
tion showing how the scapulae no longer overlie the thorax and the heart size
now appears normal
4
6. 1.2 Technical quality continued
Films on pages 6 and 7 show the effects of respiration The above film is taken
with a poor inspiration, and page 7 with a good inspiration Note how the lung
bases look whiter, and the heart size appears larger
6
8. 1.2 Technical quality continued
Always check the technical quality of any film before interpreting it
further. To do this you need to examine in turn the projection, orienta-
tion, rotation, penetration and degree of inspiration. Problems with any
of these can make interpretation difficult and unless you check the
technical quality carefully you may misinterpret the film.
Projection
Look to see if the film is anteroposterior (AP) or posteroanterior (PA).
The projection is defined by the direction of the X-ray beam in relation
to the patient. In an AP X-ray the X-ray machine is in front of the
patient and the X-ray film at the back. In a PA film the beam is fired
from behind the patient and the film placed in front. The standard chest
X-ray is PA but many emergency X-rays are AP because these can be
taken more easily with the patient in bed. AP films are marked AP by
the radiographer and PA films are often not marked since this is the
standard projection. If you are not sure then look at the scapulae. If the
scapulae overlie the lung fields then the film is AP. If they do not it is
most likely PA. If the X-ray is AP you need to be cautious about inter-
pretation of the heart size which will appear magnified on an AP film
because the heart is anterior. The shape of the mediastinum can also
be distorted. An AP film can be taken with the patient sitting or lying.
The film should be marked erect or supine by the radiographer. It is
important to note this since the appearance of a supine X-ray can be
very different to that of an erect one.
Orientation
Check the left/right markings. Do not assume that the heart is always
on the left. Dextrocardia is a possibility but more commonly the medi-
astinum can be pushed or pulled to the right by lung pathology. Radi-
ographers always safeguard against this by marking the film left and
right. Always check these markings when you first look at the film but
remember the radiographer can sometimes make mistakes – if there is
any doubt re-examine the patient.
Rotation
Identify the medial ends of the clavicles and select one of the vertebral
spinous processes that falls between them. The medial ends of the
clavicles should be equidistant from the spinous process. If one clavicle
is nearer than the other then the patient is rotated and the lung on that
side will appear whiter.
8
9. Technical quality continued 1.2
A patient with a thoracic scoliosis may appear to have a rotated film.
Check whether the spinous processes on the vertebral column are
aligned. If they are it is more likely that the patient is rotated.
Penetration
To check the penetration, look at the lower part of the cardiac shadow.
The vertebral bodies should only just be visible through the cardiac
shadow at this point. If they are too clearly visible then the film is over
penetrated and you may miss low-density lesions. If you cannot see
them at all then the film is under penetrated and the lung fields will
appear falsely white. When comparing X-rays it is important to check
that the level of penetration is similar.
Degree of inspiration
To judge the degree of inspiration, count the number of ribs above the
diaphragm. The midpoint of the right hemidiaphragm should be
between the 5th and 7th ribs anteriorly. The anterior end of the 6th rib
should be above the diaphragm as should the posterior end of the 10th
rib. If more ribs are visible the patient is hyperinflated. If fewer are
visible the patient has not managed a full intake of breath, perhaps due
to pain, exhaustion or disease. It is important to note this, as a poor
inspiration will make the heart look larger, give the appearance of basal
shadowing and cause the trachea to appear deviated to the right.
Remember also that patients are all different shapes! Some are broad
with relatively short chests and some are tall with long chests. To assess
whether the patient has failed to take a deep breath in or simply has a
short chest it can be useful to compare the current X-ray with previous
ones. If the number of ribs above the diaphragm has changed then it
is likely to be due to changes in the degree of inspiration.
9
10. 1.3 Scanning the PA film
1.3 Scanning the PA film
8
4 9
2
3
1
5
6
7 7
The PA film
10
11. Scanning the PA film continued 1.3
If you are looking at a printed film find a decent viewing box with a
functioning light that does not flicker. If possible lower the ambient
lighting.
If you are using a workstation or computer screen the amount you
will see will depend on the resolution of the screen. Make sure you are
using a suitable screen and turn down the ambient lighting. You may
wish to use an alternative screen if the image is not clear enough. At a
workstation the contrast and brightness of the image can be altered to
bring out subtle abnormalities; for example, inverting black and white
can help make detection of rib abnormalities easier.
If looking at a printed film, in order to recognize areas that are too
white or too black you need to survey the X-ray from a distance (about
4 ft/1.2 m) and then repeat this close up.
1. Lung fields. These should be of equal transradiancy and one should
not be any whiter or darker than the other. Try to identify the
horizontal fissure (1) (this may be difficult to see) and check its
position. It should run from the hilum to the 6th rib in the axillary
line. If it is displaced then this may be a sign of lung collapse.
An important sign of many lung diseases is loss of volume of
that lung and so you need to determine whether either of the
lung fields is smaller than it should be. This is difficult since the
presence of the heart makes the left lung field smaller. As you
see more and more chest X-rays, however, you will gain an
appreciation of how the two lung fields should compare in size
and therefore be able to detect when one is smaller than it
should be.
Look for any discrete or generalized shadows. These are described
in Chapter 4 – The white lung field. Remember that the shadows
that appear to be in the lung can represent abnormalities any-
where from the patient’s clothing and jewellery inwards.
2. Look at the hilum. The left hilum (2) should be higher than right (3)
although the difference should be less than 2.5 cm. Compare the
shape and density of the hila. They should be concave in shape
and look similar to each other. Chapter 6 describes how to inter-
pret hilar abnormalities.
3. Look at the heart. Check that the heart is of a normal shape and that
the maximum diameter is less than half of the transthoracic diam-
eter at the broadest part of the chest. Check that there are no
abnormally dense areas of the heart shadow. Chapter 7 takes you
through interpretation of the abnormal heart shadow.
11
12. 1.3 Scanning the PA film continued
4. Check the rest of the mediastinum. The edge of the mediastinum
should be clear although some fuzziness is acceptable at the angle
between the heart and the diaphragm. A fuzzy edge to any other
part of the mediastinum suggests a problem with the neighbour-
ing lung (either collapse or consolidation) dealt with in Chapter
4. Interpretation of the widened mediastinum is dealt with in
Chapter 8.
Look also at the right side of the trachea. The white edge of the
trachea (4) should be less than 2–3 mm wide on an erect film. (See
Chapter 8 for interpretation.)
5. Look at the diaphragms. The right diaphragm (5) should be higher
than the left (6) and this can be remembered by thinking of the
heart pushing the left diaphragm down. The difference should be
less than 3 cm. The outline of the diaphragm should be smooth.
The highest point of the right diaphragm should be in the middle
of the right lung field and the highest point of the left diaphragm
slightly more lateral.
6. Look specifically at the costophrenic angles (7). They should be well-
defined acute angles.
7. Look at the trachea (8). This should be central but deviates slightly
to the right around the aortic knuckle (9). If the trachea has been
shifted it suggests a problem within the mediastinum or pathol-
ogy within one of the lungs.
8. Look at the bones. Step closer to the X-ray and look at the ribs,
scapulae and vertebrae. Follow the edges of each individual bone
to look for fractures. Look for areas of blackness within each bone
and compare the density of the bones which should be the same
on both sides. Sometimes turning the image on its side can make
rib fractures easier to see.
9. Soft tissues. Look for any enlargement of soft tissue areas.
10. Look at the area under the diaphragm. Look for air under the dia-
phragm or obviously dilated loops of bowel. Remember that
abdominal pathology can occasionally present with chest
symptoms.
12
13. How to look at the lateral film 1.4
1.4 How to look at the lateral film
4
5
7
6
1
2
3
Lateral film
13
14. 1.4 How to look at the lateral film continued
A lateral chest X-ray can be taken with either the right or left side of
the patient against the film. Do not worry about which way it has been
taken since for all but the most subtle signs it makes little difference.
It is useful to get into the habit of always looking at the film the same
way and we suggest looking at the film with the vertebral column on
the right and the front of the chest on the left. Once you have done this:
1. Check the name and the date.
2. Identify the diaphragms. The right hemidiaphragm (1) can be seen
to stretch across the whole thorax and can be clearly seen passing
through the heart border. The left (2) seems to disappear when it
reaches the posterior border of the heart.
Another method of identifying the diaphragms is to look at the
gastric air bubble (3). Look again at the PA film and work out the
distance between the gastric air bubble (which falls under the left
diaphragm) and the top of the left diaphragm. Make a note of this.
Now go back to the lateral. The diaphragm that is the same distance
above the gastric air bubble is the left diaphragm.
You can now set about interpreting the film. As with the PA step
back from the film and adopt the following process:
1. Compare the appearance of the lung fields in front of and above the
heart to those behind. They should be of equal density. Check that
there are no discrete lesions in either field.
2. Look carefully at the retrosternal space (4), which should be the
blackest part of the film. An anterior mediastinum mass will obliter-
ate this space turning it white.
3. Check the position of the horizontal fissure (5). This is a faint white
line which should pass horizontally from the midpoint of the hilum
to the anterior chest wall. If the line is not horizontal the fissure is
displaced. Check the position of the oblique fissure (6) which should
pass obliquely downwards from the T4/T5 vertebrae, through the
hilum, ending at the anterior third of the diaphragm.
4. Check the density of the hila (7). A hilar mass may make the hila
whiter than usual.
5. Check the appearance of the diaphragms. Occasionally a pleural
effusion is more obvious on a lateral film. Its presence would
cause a blunting of the costophrenic angle either anteriorly or
posteriorly.
14
15. How to look at the lateral film continued 1.4
6. Look at the vertebral bodies. These should get more translucent
(darker) as one moves caudally. Check that they are all the same
shape, size and density. Look for collapse of a vertebra or for ver-
tebrae that are significantly lighter or darker than the others, which
may indicate bone disease. Consolidation in the posterior costo-
phrenic sulcus can also make the vertebral bodies appear abnor-
mally white.
15