Chest X-rays & Abdominal Plain Films… PDF
Preview Chest X-rays & Abdominal Plain Films…
Chest X-rays & Abdominal Plain Films… Shervin Rafie, MD Check List Identify Film: patient name, date and study Inspiration: 9-10 posterior ribs above right hemidiaphragm Position: upright (gastric air-fluid level) Exposure:bronchovascular structures visible through heart and diaphragm Rotation: line through spinous processes bisects line between clavicular heads PA vs AP PA: clavicles appear lower, scapulae project more laterally, posterior elements of vertebral bodies clearer AP: magnifies heart AP PA Chest X-Rays: The Yellow Brick Road ABC’s…D & E Air: lungs, including central airways & pulmonary vessels Bones: ribs, clavicles, spine, shoulders, scapulae Cardiac: heart & mediastinum Diaphragm & pleural surfaces Everything else: lines & tubes, upper abdomen, soft tissues of chest wall and neck Air Air Space vs Interstitial disease pattern Air Space/alveolar disease pattern: aka consolidation Fluid density in alveoli Signs: inhomogenous, patchy opacities, air bronchograms (bronchi surrounded by opaque alveoli) Causes: usually acute/subacute- bacterial pna, cardiogenic & noncardiogenic pulmonary edema, aspiration, pulmonary hemorrhage Alveolar Disease Air Interstitial Disease pattern: aka reticular/reticulonodular Fluid density in interstitium Signs: diffuse white lines throughout lungs, with or without tiny white nodules Causes: usually subacute/chronic- pulmonary fibrosis, sarcoidosis, Metastatic carcinoma (lymphangitic), occupational lung dz (abestosis, silicosis) Exceptions: cardiogenic pulmonary edema & atypical pneumonia (viral, mycoplasma, miliary TB, histoplasmosis) Interstitial Disease Mycoplasma pna
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