Manual of Chest Radiology Manual of Chest Radiology Hariqbal Singh MD DMRD Professor and Head Smt Kashibai Navale Medical College Pune, Maharashtra, India Sushil Kachewar MD DNB Assistant Professor Smt Kashibai Navale Medical College Pune, Maharashtra, India ® JAYPEE BROTHERS MEDICAL PUBLISHERS (P) LTD Mumbai • St. Louis (USA) • Panama City (Panama) • London (UK) New Delhi • Ahmedabad • Bengaluru • Chennai • Hyderabad • Kochi Kolkata • Lucknow • Nagpur Published by Jitendar P Vij Jaypee Brothers Medical Publishers (P) Ltd Corporate Office 4838/24 Ansari Road, Daryaganj, New Delhi - 110002, India, Phone: +91-11-43574357 Fax: +91-11-43574314 Registered Office B-3 EMCA House, 23/23B Ansari Road, Daryaganj, New Delhi - 110 002, India Phones: +91-11-23272143, +91-11-23272703, +91-11-23282021 +91-11-23245672, Rel: +91-11-32558559, Fax: +91-11-23276490, +91-11-23245683 e-mail: [email protected], Website: www.jaypeebrothers.com Offices in India • Ahmedabad, Phone: Rel: +91-79-32988717, e-mail: [email protected] • Bengaluru, Phone: Rel: +91-80-32714073, e-mail: [email protected] • Chennai, Phone: Rel: +91-44-32972089, e-mail: [email protected] • Hyderabad, Phone: Rel:+91-40-32940929, e-mail: [email protected] • Kochi, Phone: +91-484-2395740, e-mail: [email protected] • Kolkata, Phone: +91-33-22276415, e-mail: [email protected] • Lucknow, Phone: +91-522-3040554, e-mail: [email protected] • Mumbai, Phone: Rel: +91-22-32926896, e-mail: [email protected] • Nagpur, Phone: Rel: +91-712-3245220, e-mail: [email protected] Overseas Offices • North America Office, USA, Ph: 001-636-6279734 e-mail: [email protected], [email protected] • Central America Office, Panama City, Panama, Ph: 001-507-317-0160 e-mail: [email protected], Website: www.jphmedical.com • Europe Office, UK, Ph: +44 (0) 2031708910 e-mail: [email protected] Manual of Chest Radiology © 2010 Hariqbal Singh, Sushil Kachewar All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the authors and the publisher. This book has been published in good faith that the material provided by authors is original. Every effort is made to ensure accuracy of material, but the publisher, printer and authors will not be held responsible for any inadvertent error (s). In case of any dispute, all legal matters are to be settled under Delhi jurisdiction only. First Edition: 2010 ISBN 978-81-8448-906-4 Typeset at JPBMP typesetting unit Printed at Ajanta Offsetand Packagings Ltd., New Delhi. Dedicated to Our dear wives Arvind Babbal Hariqbal Smita Sankaye Kachewar Preface Manual of Chest Radiology is a concise, comprehensive, brief and a small-sized book meant for students preparing for Postgraduate Medical Admission Tests, who are always short of time and have wide curriculum. It is a handy manual for the resident and the practitioner providing useful information. Chapter on “Must Remember Before Proceeding to MCQs” must be remembered in totality by the student appearing for the competitive examination. Multiple choice questions being the culture of the day have been put together for the best advantage. These MCQ’s have been picked up from various competitive examination papers. We thank Prof MN Navale, Founder President, Sinhgad Technical Educational Society and Dr Arvind V Bhore, Dean, Smt Kashibai Navale Medical College for their kind permission in this endeavor. Dr Anand Kamat, Prashant Naik, Abhijit Pawar, Anubhav Khandelwal, Sheetal Dhote and Mrunalini Shah have helped in compiling the images. Dr Sachin Patil, Smita Kachewar and Nimeesh have been generous to allow the use of images from their collection for this educational entity. We are greateful to GOD and mankind who have allowed us to have this wonderful experience. Hariqbal Singh Sushil Kachewar Contents 1. Introduction...............................................................01 2. Normal Radiograph of Chest..................................09 3. Consolidation ............................................................13 4. Pulmonary Tuberculosis (TB) .................................17 5. Miliary Tuberculosis.................................................21 6. Collapse......................................................................25 7. Pulmonary Sequestration........................................29 8. Coin Lesion (Pulmonary/Lung Nodule)..............31 9. Lung Metastases........................................................35 10. Pulmonary Hamartoma...........................................39 11. Interstitial Lung Disease..........................................41 12. Cavitary Lung Lesion...............................................45 13. Fibrosis .......................................................................49 14. Bronchiectasis............................................................51 15. Chronic Obstructive Pulmonary Disease (COPD).........................................................55 16. Drug-induced Lung Diseases..................................59 17. Pleural Disorders ......................................................61 18. Pulmonary Embolism...............................................69 19. Trauma.......................................................................73 20. Hilar Enlargement....................................................81 21. Heterotaxy Syndrome..............................................85 22. Heart...........................................................................87 23. Mitral Stenosis...........................................................93 24. Pericardial Effusion..................................................97 25. Mediastinal Widening..............................................99 26. Aortic Imaging ........................................................105 27. Diaphragm...............................................................107 28. Rib Abnormality .....................................................113 29. Lung Amyloidosis ..................................................115 30. Sternal Abnormality...............................................117 x Manual of Chest Radiology 31. Thymus.....................................................................119 32. Kerley Lines.............................................................121 33. Trachea.....................................................................123 34. Chest Wall................................................................125 35. Must Remember Before Proceeding to MCQs....129 36. MCQs for Practice...................................................135 Index..........................................................................153