Chest Xrays

Question 1

What does the chest xray of an acute asthma attack look like?

Answer 1

75% of asthma CXR are normal but some show:

• hyperinflation
• bronchial wall thickening
• pulmonary oedema (rare)

Question 2

What does pulmonary oedema look like on a CXR?

Answer 2

alveolar - “fluffy opacities”

Alveolar oedema has a “bat wing “ distribution where fluffy dense airspace shadowing caused by fluid filling the alveoli and small airways.

It starts at hilum and radiated out. Then becomes more generalized with time.

Question 3

What does the CXR of COPD look like?

Answer 3

• hyperinflation (>6 ribs)
• Bullae (dilated airspace occurs in emphysema)
• flattened diaphragm
• floating heart (due to hyperinflation)
• consolidation if there is an infective exacerbation.

Question 4

What does consolidation look like and how to describe it systematically?

Answer 4

Opacity = consolidation
Tissue involved = lung
Size
Side (unilateral / bilateral Or right/left)
Distribution (focal / widespread)
Position (lung zone)

Question 5

What does a bronchial carcinoma look like on a CXR?

Answer 5

• focal well defined lesion

- effusion (sometimes)