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The Chest X-Ray. Dr Mohamed El Safwany, MD. Intended learning outcome. The student should learn at the end of this lecture Clinical aspects of Chest X ray. Aims:. Basics Best exam results Appreciate the role radiology plays. Contents:. Densities Techniques Anatomy CXR Interpretation

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The Chest X-Ray


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    1. The Chest X-Ray Dr Mohamed El Safwany, MD.

    2. Intended learning outcome The student should learn at the end of this lecture Clinical aspects of Chest X ray .

    3. Aims: Basics Best exam results Appreciate the role radiology plays

    4. Contents: Densities Techniques Anatomy CXR Interpretation Common Pathologies Questions

    5. 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

    6. Techniques - Projection P-A (relation of x-ray beam to patient)

    7. Techniques - Projection (continued) A-P Supine/Erect

    8. Techniques - Projection (continued) Lateral

    9. Techniques - Projection (continued) Decubitus

    10. Techniques - Projection (continued) Oblique

    11. Rotation

    12. Rotation (continued)

    13. Penetration

    14. Inspiration/Expiration

    15. Anatomy

    16. Anatomy

    17. Lobes Right upper lobe:

    18. Lobes (continued) Right middle lobe:

    19. Lobes (continued) Right lower lobe:

    20. Lobes (continued) Left lower lobe:

    21. Lobes (continued) Left upper lobe with Lingula:

    22. Lobes (continued) Lingula:

    23. Lobes (continued) Left upper lobe - upper division:

    24. Pleura Parietal , visceral Layers:

    25. Heart Right border: Edge of (r) Atrium 3. Left border: (l) Ventricle + Atrium 4. Posterior border: Reft Ventricle 5. Anterior border: Right Ventricle

    26. Heart (continued)

    27. Heart (continued)

    28. Heart (continued) Valves

    29. Mediastinum

    30. Hilum Made of: 1. Pulmonary Art.+Veins 2. The Bronchi Left Hilus higher (max 1-2,5 cm) Identical: size, shape, density

    31. Hilum

    32. Ribs

    33. Lateral CXR (continued)

    34. Lateral CXR (continued)

    35. Lateral CXR (continued)

    36. Lateral CXR (continued)

    37. CXR Interpretation

    38. Technical Details Rotation Inspiration/expiration Penetration

    39. Lungs: Lungs Density Symmetry Lesions

    40. Heart Size:

    41. 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

    42. Mediastinum: Width Contour AP window Hila: • Size • Location

    43. Review areas: Apices Behind the heart CP angles Below the diaphragm Soft tissues ( breast, surgical emphysema) Ribs & clavicle Vertebrae

    44. Identify the lesion → localise the lesion → describe the lesion → give DDNever stop looking, carry on with your systematic approach!!

    45. Pathology

    46. RUL pneumonia

    47. RML pneumonia

    48. RLL pneumonia

    49. LUL pneumonia

    50. LLL pneumonia