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Chest X-Ray Basics for Nottingham SCRUBS

The document provides an overview of chest x-ray interpretation including densities seen on x-rays, projection techniques, chest anatomy, common pathologies, and example cases. It aims to teach the basics of reading chest x-rays and instill an interest in radiology. Key points covered include the five main densities seen, anatomical structures like the lobes and heart, and common abnormalities such as pneumonia, effusions, and fractures.

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188 views74 pages

Chest X-Ray Basics for Nottingham SCRUBS

The document provides an overview of chest x-ray interpretation including densities seen on x-rays, projection techniques, chest anatomy, common pathologies, and example cases. It aims to teach the basics of reading chest x-rays and instill an interest in radiology. Key points covered include the five main densities seen, anatomical structures like the lobes and heart, and common abnormalities such as pneumonia, effusions, and fractures.

Uploaded by

surendrakhosya
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd

The Chest X-Ray

For: Nottingham SCRUBS 26th August 2006


Presented by: Matthew
Aims:
•Basics
•Best exam results
•Appreciate the role radiology plays
•? Instil an interest in radiology
Contents:
•Densities
•Techniques
•Anatomy
•CXR Interpretation
•Common Pathologies
•Questions
Densities
The big two densities are:

(1) WHITE - Bone


(2) BLACK - Air

The others are:

(3) DARK GREY- Fat


(4) GREY- Soft tissue/water

And if anything Man-made is on the film, it is:

(5) BRIGHT WHITE - Man-made


Techniques - Projection
•P-A (relation of x-ray beam to patient)
Techniques - Projection (continued)
•A-P Supine/Erect
Techniques - Projection (continued)
•Lateral
Techniques - Projection (continued)
•Lateral Decubitus
Techniques - Projection (continued)
•Oblique
Orientation
•Orientation
Rotation
Rotation (continued)
Penetration
Inspiration/Expiration
Anatomy
Anatomy
Anatomy
Lobes
• Right upper lobe:
Lobes (continued)
• Right middle lobe:
Lobes (continued)
• Right lower lobe:
Lobes (continued)
• Left lower lobe:
Lobes (continued)
• Left upper lobe with Lingula:
Lobes (continued)
• Lingula:
Lobes (continued)
• Left upper lobe - upper division:
Pleura
• Layers:
Heart

Right border: Edge of (r) Atrium

3. Left border: (l) Ventricle + Atrium

4. Posterior border: Reft Ventricle

5. Anterior border: Right Ventricle


Heart (continued)
Heart (continued)
Heart (continued)
• Valves
Mediastinum
Hilum

Made of:

1. Pulmonary Art.+Veins
2. The Bronchi

Left Hilus higher (max 1-2,5 cm)

Identical: size, shape, density


Hilum
Ribs
Soft tissue & bones
Lateral CXR
Lateral CXR (continued)
Lateral CXR (continued)
Lateral CXR (continued)
Lateral CXR (continued)
CXR Interpretation
Technical Details

•Type
•Orientation
•Rotation
•Inspiration/expiration
•Penetration
Lungs:
• Lungs
• Density
• Symmetry
• Lesions
Heart
•Size:
Heart •Size of heart

•Size of individual
chambers of heart

•Size of pulmonary
vessels

•Evidence of stents, clips,


wires and valves

•Outline of aorta and IVC


and SVC
Mediastinum:
• Width
• Contour
• AP window

Hila:
• Size
• Location
Review areas:
• Apices
• Behind the heart
• CP angles
• Below the diaphragm
• Soft tissues ( breast, surgical emphysema)
• Ribs & clavicle
•Vertebrae
Identify the lesion → localise the lesion
→ describe the lesion → give DD

Never stop looking, carry on with your


systematic approach!!
Pathology
RUL pneumonia
RML pneumonia
RLL pneumonia
LUL pneumonia
LLL pneumonia
Consolidation on CT
Hilar m l
The Enlarged Hila
Causes:

1. Adenopathies (neoplasia, infection)

2. Primary Tumor

3. Vascular

4. Sarcoidosis
Multiple Masses
Hilar Lymphadenopathy - BL
Pleural Effusion
Pulmonary Fibrosis
?
Heart failure
Pneumothorax
RUL collapse
LLL collapse
Air under the diaphragm
Emphysema
Cervical Rib
Cavitating lesion
Hiatus hernia
Miliary shadowing
Chest Tube, NG Tube, Pulm. artery cath
Dextrocardia

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