CXR Flashcards
Most common view for CXR
Posterior-anterior (PA)
Other views
AP
Lateral
View/orientation that makes anterior structures appear larger
Anterior posterior (AP)
Lateral views are best for
Pathologies behind the heart shadow or deep in the diaphragmatic sulci
First thing on interpretation
Name, date, orientation
Lung fields
Translucency - equal? Horizontal fissure - from the right hilum to 6th rib at the anterior axillaire line Masses Consolidation Cavitation
Lung apices
Check behind the clavicles and above for: masses, consolidation and cavitation
Trachea
Central: midway between the clavicules heads
Deviated by collapse (towards the lesion) or expansion (away from the lesion)
Paratracheal mass
Goitre - retrosternal
Heart
Shape
Cardiothoracic ratio <50%
Retrocardiac mass
Hila
Left should be higher than right
Shape - should be concave laterally
Convex laterally - lymphadenopathy it’s mass
Density
Diaphragm
Right higher than left
Hyperinflation - at most 10 posterior ribs should be visible above the diaphragm
Costophrenic angles
Acute and well defined
If not - pleural fluid or thickening
Soft tissues
Breast shadows in females
Chest wall for masses or subcutaneous emphysema
Bones
Ribs, vertebrae, scapulae and clavicles
Any fracture visible at bone margins or lucencies
Increased shadowing
Accumulation of fluid, lobar collapse and consolidation
Air bronchogram
Patent proximal bronchi
Uncomplicated consolidation
Position of mediastinum unaffected
Collapse
Obstructed lobar bronchus
Accompanied by loss of volume and displacement of the mediastinum towards the affected side
Bronchiectasis
Ring shadows - thickened bronchi seen end-on
Tram line shadows - thickened bronchi seen side-on
Tubular shadows - bronchi filled with secretions
Most sensitive test for bronchiectasis
CT
Large pulmonary embolism
Lung fields abnormally dark due to oligaemia
Increased translucency
Bullae
Pneumothorax
Oligaemia
Unilateral hilar enlargement
TB
Bronchial carcinoma
Lymphoma
Bilateral hilar enlargement
Sarcoid
Lymphoma
TB
Silicosis
Consolidation seen in:
Infection
Infarction
Inflammation
Bronchoalveolar cell carcinoma
Lobar collapse seen in:
Mucus plugging
Tumour
Compression by lymph nodes
Multiple modules seen in:
Miliary TB Dust inhalation Metastatic malignancy Healed varicella pneumonia Rheumatoid disease
Cavitating lesions seen in:
Tumour Abscess Infarct Pneumonia: Staphylococcus/Klebsiella Granulomatosis with polyangitis
Reticular, nodular and reticulonodular shadows seen in:
Diffuse parenchymal lung disease
Infection
Pleural abnormalities seen in:
Fluid
Plaques
Tumor
Order of intepretation
Name, date, orientation Lung fields Lung apices Trachea Heart Hila Diaphragm Costophrenic angles Soft tissues Bones
Silhouette sign
Loss of border between heart and lung signifying pneumonia or collapse causing loss of clarity of the right heart border
Hyperinflation
5 to 7 ribs visible anteriorly or 10 posteriorly
Seen in COPD
