chest x ray

Summary

Get a comprehensive education on comprehending Chest X-ray with this practical and systematic approach by following the ABCs of Adequacy, Bones, Cardiac, Diaphragm, and Effusion/Extra-thoracic soft tissue all the way down to Hila and Mediastinum. This is intertwined with intriguing case studies that span across all topics to ensure you get an in-depth understanding. This session is tailored for medical professionals who are eager to enhance their radiology skills and interpretation abilities. From subcutaneous emphysema to gastric lymphoma, you'll gain knowledge on a wide range of conditions, eventually improving your diagnostic precision. Don't miss out on this valuable chance to enhance your medical proficiency systematically.

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Description

X-Ray: Approach and Beyond the Basics
A part of the National Collaborative Radiology Teaching series
Presented by Anna Nather (Cambridge University Radiology Society)
Friday 16th February!
Online

Learning objectives

By the end of this teaching session, participants will be able to systematically approach analyzing a chest X-ray (CXR) using the mnemonic: ABCDEFGH, representing Adequacy, Bones, Cardiac, Diaphragm, Effusion and extrathoracic soft tissue, Fields, fissures and foreign bodies, Great vessels, Gastric bubble, Hila and mediastinum.
Participants will be able to assess the adequacy of a chest X-ray, they will understand the various effects of inadequate rotation and will be able to differentiate between normal and pathological cases.
Participants will learn how to identify abnormalities in the bones visible on a chest X-ray and will be able to diagnose common conditions associated with such abnormalities, such as thoracic outlet syndrome.
Participants will learn how to evaluate the heart and diaphragm on a chest X-ray, including recognising cardiac diseases, interventions and deviations of the diaphragm, they will be able to provide differentials based on CXR findings.
Finally, participants will be able to describe common erron or pathologic findings related to the effusion/extrathoracic soft tissue, fields, fissures and foreign bodies, great vessels and

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CHEST XRAY EXEMPLATORY CASESTHE SYSTEMATIC APPROACH • A – ADEQUACY • B – BONES • C – CARDIAC • D – DIAPHRAGM • E – EFFUSION/EXTRATHORACIC SOFTTISSUE • F – FIELDS, FISSURES, FOREIGN BODIES • G – GREATVESSELS, GASTRIC BUBBLE • H – HILA AND MEDIASTINUM • (I – IMPRESSION)A – ADEQUACY: ROTATION WHAT POPULATION IS IT DIFFICULT TO ACHIEVE ADEQUATE ROTATION? • 1) unilateral hyperlucency of the side that the THE 6 patient is rotated towards; • 2) the side ‘up’ appears larger; MAIN • 3) apparent deviation of the cardiomediastinal shadow in the direction that the chest is rotated towards; EFFECTS • 4) apparent cardiomegaly; • 5) distorted cardio-mediastinal configuration • artery and vein catheters with rotation to the left. Radiologists tip: in any case check the spaces between medial clavicle and spinous processes!WHICH ONE IS PATHOLOGICAL AND HOW? Child with respiratory distress, increased work of breathing and wheezing.B – BONES 25 years female presented with progressive tingling sensation and weakness of right upper arm with muscle power ⅗ for 6 months. She also had shortness of breath for two weeks.THORACIC OUTLET SYNDROME a group of conditions in which there's pressure on blood vessels or nerves in the area between the neck and shoulder .C – CARDIAC What was/were the intervention/s?WHICH VALVE IS WHICH?WHICH VALVE IS WHICH?D – DIAPHRAGM What are your differentials?.D – DIAPHRAGM What are your differentials?.D – DIAPHRAGM What are your differentials?. • pleura THE LIST OF • subpulmonic pleural effusion DIFFERENTIALS • pleural mass • Diaphragm • lung • eventration • mass • Consolidation e.g. round • rupture pneumonia) • Morgagni hernia • subdiaphragmatic region • lung mass • liver/stomach mass • collapse • subdiaphragmatic collection • pulmonary infarction • phrenic nerve palsy • hemiplegiaD – DIAPHRAGM What are your differentials?painD – DIAPHRAGM What are your differentials?.E – EFFUSION AND EXTRATHORACIC SOFT TISSUE 75 year old male presented 3 days post pneumonectomy with swollen tissue and discomfort. Clinically, cutaneous crepitus was felt.SUBCUTANOUS EMPHYSEMA INTERNALLY SUBCUTANOUS EMPHYSEMA – •Pneumothorax •Oesophageal WHERE IS IT COMING perforation FROM? •Fistula DE NOVO PRODUCED EXTERNALLY •Gas producing infection •Trauma (necrotising fasciitis) •iatrogenic F: FIELDS, FISSURES AND FOREIGN BODIES Practicing the vocabulary. OPACIFICATION - AIRSPACEOpacification - airspace Unila eral uppere Unilateral middle Unilateral blackening Bilateral lower “linear” airspace consolidation. airspace ring opacity. hemithof the lung.horax c nsol dationss and lung collapse OPACIFICATION - NODULAR Opacification - nodular Milary (<2mm) micronodular (2-7mm) Nodule (7-30mm) Mass > 30mm, with fluid level OPACIFICATION - LINEAOpacification - linear Reticular interstitial markings, Reticulo- Tram-track opacities, Linear interstitial no nodularity nodular bronchovascular markings patternG – GREAT VESSELS AND GASTRIC BUBBLEG – GREAT GASTRIC BUBBLE 45 year old female pain and early satiety.ic GASTRIC LYMPHOMAH-HILA TOP TO BOTTOM APPROACH Trachea: Width, deviation, Bronchi visible Mediastinum: diameter, contour Lymph nodes: presence, size, calcificationH - HILAR 20 year old male presented with nonproductive cough. There is high community prevalence of TB.WHY? SARCOIDOSIS MALIGNANCY • Lymphoma INFECTION • Carcinoma • Tuberculosis • Mycoplasma INORGANIC DUST DISEASE • histoplasmosis • Silicosis • beryllosisTHANK YOU FOR PARTICIPATING