Chest Radiographs

Question 1

What abnormality does this CXR show?

Answer 1

consolidation following pneumonia in right lower lung field

Question 2

What does the whiteness & the border of any abnormality on a CXR indicate? i.e. uniform whiteness & well-demarcated border and vice versa

Answer 2

Question 3

What abnormality does this CXR show?

Answer 3

Coin lesion

= discrete area of whitness in lung field

can represent

• benign tumour
• malignant tumour
• infection e.g. TB, pneumomia,
• hyatid cyst (common manifestation of hyatid disease - 2nd most common site of echinococcosis granulosus after liver)
• abscess
• rheumatoid nodule (rare manifestation of rheumatoid arthritis)

Question 4

What is a complication (rare) of a pulmonary rheumatoid nodule?

Answer 4

rupture into the pleural space (rare):

with resultant

• pneumothorax,
• pleural effusion, or
• pleural empyema (abnormal collection of pus in normal body cavity)

Question 5

Does the course of pulmonary rheumatoid cysts follow the course of rheumatoid arthritis?

Answer 5

NO - although they are manifestations of rheumatoid arthritis

Question 6

What abnormality does this CXR show?

Answer 6

left sided pneumothorax

with partial collapse of left lung (lung border is pointed to w arrow)

Question 7

What abnormality does this CXR show?

Answer 7

bilateral hilar enlargement (lymphadenopathy)

Question 8

What is required to confirm a ?hilar lymphadenopathy?

Answer 8

lateral CXR

Question 9

What is the next step when hilar lymphadenopathy is identified via CXR?

Answer 9

bronchoscopy

Question 10

What are some causes of hilar lymphadenopathy?

Answer 10

Question 11

What abnormality does this CXR show?

Answer 11

lung hyperinflation (indicative of COPD)

• because 7+ anterior ribs can be counted
• OR diaphragm: usually flat/scalloped rather than concave

Question 12

What abnormality does this CXR show?

Answer 12

cardiomegaly (usually indicative of left ventricular failure)

Question 13

Which view allows us to comment on the size of the heart?

Answer 13

PA

• AP film = always enlarges heart

Question 14

T or F?

The right border of the heart on a CXR is due to the right atria alone

Answer 14

TRUE

• right ventricle sits anteriorly (hence border cannot be seen on PA CXR)

Question 15

What does air under the diaphragm indicate?

Answer 15

MEDICAL EMERGENCY

• perforation of a hollow viscus (i.e. hollow organ in abdo)