CHEST XRAYS Dr Faezeh Sakhinia FY 2 Aims

CHEST XRAYS Dr Faezeh Sakhinia FY 2

Aims Basics of CXR interpretation OSCE approach Images with explanation Quiz!!

Initial Approach Details: Correct patient Correct date Correct examination (CXR) Correct view ○ AP/PA ○ Supine/portable/lateral

Projections PA AP LATERAL

Picture Quality Rotation Inspiration Picture Exposure (Penetration)

Order of View Airway– is it deviated? Breathing – Lungs Circulation – Heart (normal<½ cardiothoracic ratio in PA view) Diaphragm – R>L by ~ 1 intercostal space, cardiophrenic and costophrenic angles Extras – pneumoperitoneum? air under the skin (surgical emphysema), fractures, lines (NG, ECG, chest drains, pacemaker)

OSCE Approach OSCE Example: “This is a plain chest xray of John Smith in a PA view. The film is adequately exposed and orientated. ” ○ The main findings are: ○ Starting off with the airways. .

Normal Xray

Pleural Effusion

Consolidation with Air Bronchograms

COPD

Pneumothorax

Left Lower Lobe Collapse

Left Upper Lobe Collapse

Right Lower Lobe Collapse

Right Upper Lobe Collapse

Lung Cancer

Heart failure

QUIZ!!! Easy. . . Odd!

Consolidation & Collapse (pneumonia)

Pneumothorax (COPD)

Mastectomy

Dextocardia with Situs Inversus

Valve Replacements

Nipple Ring!

If you can answer these. . . a career in radiology is for you!!!

Pneumonectomy

Surgical Emphysema Secondary to Chest Drain

Asbestos Related Pleural Plaques

Quiz Done. . . and Relax!!!

Summary

Thank You!!