Chest X-Ray interpretation

Question 1

Technical quality

Answer 1

-AP/PA
-exposure
-rotation
-volumes
-orientation

Question 2

Use ABCDFHT

Answer 2

A-airways, angles, attachments
B- bony structures
C- cardiac position
D- diaphragm
F- lung fields
H- hilum
T- soft tissue

Question 3

Chest X-Ray Abnormalities

Answer 3

-consolidation
-collapse
-pneumothorax
-haemothorax
-pleural effusion
-COPD
-bronchiectasis
-cardiac failure and pulmonary oedema

Question 4

Consolidation

Answer 4

-air-filled spaces are filled with water, pus or blood due to disease
-there is an air bronchogram
-airways appear as black branching against white background
-lower lungs appear darker and demarcated
-localized= infection
-widespread- ARDS, pulmonary oedema or pneumonia

Question 5

Collapse

Answer 5

-increased density
-shift of fissures towards side of collapse
-hilar shift and distortion to side of collapse
-crowding of vessels and airways
-mediastinal shift to side of collapse
-crowding of ribs on side of collapse
-elevation of hemidiaphragm on side of collapse

Question 6

Pneumothorax

Answer 6

-air entering the pleural space
-caused by penetrating injuries and breeching
-black lung field
-mediastinal shift away from pneumothorax
-hyperinflated lung
-edge of lung pulled away from rib cage

Question 7

Haemothorax

Answer 7

-blood enters the pleural space
-caused by trauma
-grey lung field in supine
-white density over lung with meniscus sign in sitting
-mediastinal shift away from haemothorax

Question 8

Pleural effusion

Answer 8

-fluid found in the pleural space
-caused by fluid overload, infection, malignancy, trauma or surgery
-loss of lung volume
-meniscus sign
-white shadowing below meniscus sign
-upper border of effusion peaks laterally
-mediastinal shift

Question 9

COPD

Answer 9

-hyperinflated lung @ ribs 9-10
-black lung fields
-flattened diaphragms
-elongated narrow heart shadow
-bullae visible

Question 10

Bronchiectasis

Answer 10

-dilation of bronchi associated with inflammation
-bronchial wall as single or parallel thin lines
-ring and curvilinear opacities
-infective consolidation
-overinflation=widespread

Question 11

Cardiac failure and pulmonary oedema

Answer 11

-shadowing of bilateral lung
-diversion of upper lobe BV
-enlarged heart shadow
-angel-wing shadowing around hilae