Chest X-ray

Question 1

What do Kerley-B lines indicate?

Answer 1

Interstitial oedema eg: from heart failure

Question 2

What are the signs of left atrial enlargement on CXR (4)? When would this occur?

Answer 2

Mitral stenosis secondary to rheumatic heart disease

Signs of left atrial enlargement include a double right heart border, bulging of the left heart border, splaying of the carina to greater than 120 degrees, and prominent left atrial appendage.

Question 3

What is the structure that can cause a “bulge” of the left side of the mediastinum above the left heart border? What does this indicate?

Answer 3

Pulmonary artery– if prominent= pulmonary hypertension

Question 4

Ddx for enlarged cardiac silhouette? (5)

Answer 4

cardiomegaly (most common cause by far)

pericardial effusion

anterior mediastinal mass

prominent epicardial fat pad

expiratory radiograph

Question 5

Ddx for enlarged cardiac silhouette? (5)

Answer 5

cardiomegaly (most common cause by far)

pericardial effusion

anterior mediastinal mass

prominent epicardial fat pad

expiratory radiograph