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 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!!