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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 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 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) Decubitus
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 Parietal , visceral 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) Valves
Hilum Made of: 1. Pulmonary Art.+Veins 2. The Bronchi Left Hilus higher (max 1-2,5 cm) Identical: size, shape, density
Technical Details 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 DDNever stop looking, carry on with your systematic approach!!