Chest Xray Path correlation Normal structures Densities Genesis

Chest X-ray Path correlation • • • Normal structures Densities Genesis of abnormal densities Localization Pathological correlation Steps in evaluation of CXR

Left RV RA LV LA

Densities

Hemorrhage H e m

Localization • • Lobar distribution Air bronchogram Silouhette sign Extra pleural sign

Lobar density

Silouhette sign

Silouhette sign

RUL RML RLL LUL Lingula LLL Silouhette sign

Extrapleural sign

Peripheral Sharp inner Indistinct outer Concave angles Extrapleural sign

Air bronchogram

Pathological correlation • • Consolidation Cavitation Mass Atelectasis Pleural effusion Pneumothorax Pulmonary edema

Consolidation

Pneumonia

Air bronchogram Lobar No loss of volume Consolidation

Hole Wall Lumen Content Cavity

Mass

Homogenous Sharp margin No respect Mass

Atelectasis

Loss of lung volume Atelectasis

Homogenous Costophrenic angle Meniscus Pleural effusion

Pneumothorax

Air in pleura Atelectatic lung Hemithorax Mediastinual shift Pneumothorax

Pulmonary edema

Pulmonary edema

Bilateral Diffuse Alveolar

Emphysema

Bleb Emphysema

Bullous emphysema

Emphysema

Emphysema Flat diaphragm

Dark lungs AP diameter Low flat diaphragms Vertical heart Retrosternal air Infracardiac air Avascularity Blebs Emphysema

Mediastinal nodes

Metastases

Honeycombing

Interstitial fibrosis

Diffuse interstitial

Lines Honeycombing Nodules Diffuse interstitial

Steps in evaluation of CXR • • • Identify abnormalities Localize Identify pathological process Probable etiology Tests to confirm

Case 1

Case 7

Case 8