structures seen on plain chest xray pa view

1. Structures seen on
plain CHEST X-RAY
PA view.
DR SARGAM DHILLON
RESIDENT RADIOLOGY

2. BEFORE WE START …..

3. BEFORE INTERPRETATING THE
RADIOGRAPH
1) Patient identification details.
2) X-ray view PA or AP….
3) Breath : inspiration or expiration.
4) X-ray penetration : under or over penetrated
5) Rotation
6) Extras

4. FOUR MAJOR CHEST XRAY VIEWS

5. POSTERIOR ANTERIOR POSITION

6. PA VIEW POSITION

7. .

8. THREE MAIN FACTORS DETERMINE THE
TECHNICAL QUALITY OF THE RADIOGRAPH

9. INSPIRATION

10. GOOD INSPIRATION

11. PENETRATION

12. UNDEREXPOSURE

13. OVEREXPOSURE

15. ROTATION

16. ROTATION

17. REVIEW OF BASICS

18. NORMAL RADIOGRAPH

19. ABCDEFGHI APPROACH

20. A- AIRWAY

21. B-BONES AND SOFT TISSUE

22. SOFT TISSUE

23. SOFT TISSUE

24. C-CARDIA

25. C- CARDIA

27. C-CARDIA

28. MACH EFFECT

29. D-DIAPHRAGM

30. DIAPHRAGMATIC HUMPS

31. E-EFFUSION

32. F-LUNG FIELDS

33. F- LUNG FIELDS

34. LUNGS

35. LOBAR ANATOMY RIGHT LUNG

36. LOBAR ANATOMY LEST LUNG

37. HIDDEN AREAS

38. GASTRIC BUBBLE

39. H-HILUM AND MEDIASTINUM

40. H-HILUM

41. MEDIASTINUM

43. MEDIASTINAL CONTENTS

44. ICU TUBE

45. SILHOUETTE SIGN

46. Normal chest x-ray

47. .

48. Normal Chest X-Ray

49. How to read chest xray
PA view.
.

50. PLEURAL EFFUSION
patient ID: XYZ.
Projection: PA
Penetration: Adequate – vertebral bodies just visible behind heart
Inspiration: Limited - 5 anterior ribs visible Rotation:
The patient is rotated to the right
AIRWAY
The trachea is displaced slightly to the right –
this may be due to patient rotation or a mass effect.
BREATHING
There is complete, homogeneous opacification of the left hemithorax,
in keeping with a large pleural effusion.
The right lung is clear. The lungs are not hyperinflated.

51. PLEURAL EFFUSION
The right pleural space is clear.
Normal pulmonary vascularity.
CIRCULATION
The left heart border is obscured by the effusion.
The cardiac size cannot therefore be accurately assessed.
The right heart border is clear.
The thoracic aorta is obscured.
The mediastinum is central, not widened, with a clear right border.
The left border is obscured.
The left hilum is obscured by the effusion. Normal size, shape, and position of the right hilum.

52. PLEURAL EFFUSION
Diaphragm
The left hemidiaphragm is obscured by the effusion.
Normal position and appearance of the right hemidiaphragm.
The imaged skeleton is intact with no fractures or destructive bony lesions visible.
The visible soft tissues are unremarkable.
EXTRAS + REVIEW AREAS
No vascular lines, tubes, or surgical clips.
Lung Apices: The left apex is opacified. The right apex is clear.
Hila: Left hilum is obscured. Normal right hilum.
Behind Heart: Left side obscured by the effusion
Costophrenic Angles: Obliteration of the left costophrenic angle.
Right side clear. Below the Diaphragm: Normal

53. PLEURAL EFFUSION
Patient rotated to the right
Large left pleural effusion
Obscured left heart border
Mild tracheal deviation may be due to
rotation or mass effect from the pleural effusion
Clear right lung
Clear right heart border
Obscured left hemidiaphragm
Normal right hemidiaphragm
Normal gastric bubble

54. SUMMARY