CXR Flashcards

Normal PA view: upright

Normal lateral view
left of large line: upper lobe
right of large line: lower lobe
below short line: middle lobe

PA view: ideal view
can see spinous processes

air bronchogram: classic in pneumonia

ASD with air bronchogram

bilateral air space disease with a little air bronchogram: left side pleural effusion
infiltrate
with bilateral infiltrate on CXR

sputum: rusty
pneumonia

cardiomegaly with perihilar infiltrate
bilateral alveolar infilatrate: see dots that are most abundant at hilum

CHF before and after Lasix

batwing infiltrate: pulmonary edema (CHF)

cephalization: earliest radiologic sign of CHF

cardiomegaly

left: normal
right: cephalization: flow is no longer caudal

fluid in the fissures: can see in CHF
presented with hemoptysis and blood in urine

pulmonary hemmorhage: Good pasture’s

reticulonodular pattern: sarcoidosis
reticlular: crisscrossing of lines

reticularnodular pattern

reticular nodular pattern

paratracheal or bilateral hilar adenopathy with or without reticular infiltrates
sarcoidosis
Possible causes of hilar and mediastinal lymphadenopathy
lymphoma
histoplasmosis
phenytoin
TB
Castleman’s Disease
HIV
Sarcoidosis (Dx of exclusion)

non-caseating granuloma: sarcoidosis

honeycomb pattern: endstage IPF (idiopathic pulmonary fibrosis)

COPD: flat diaphragm

COPD: flat diaphragm

Bullous Emphysema

bronchiectasis

cystic bronchiectasis

pulmonary embolism: elevated left hemi diaphragm

Westermark sign: can’t see any vasculature markings in right lung
pneumothroax or pulmonary embolism

hampton hump: pulmonary embolism

pneumothroax

pleural effusion

Nodule
signs of benign solitary pulmonary nodule (SPN)
well defined nodules
no associated lymph or mediastinal masses
no satellite lesions
calcified nodules
Types of benign calcifications: dense, popcorn, lamellar
features of malignancy of SPN
spiculated nodules
non-calcified nodules
associated mediastinal or lymph node masses
presence of cavitation
large nodules

SPN

SPN

SPN: solitary pulmonary nodule

Normal alveoli

low V/Q

low V/Q + shunt

pulmonary edema
low V/Q and shunt

interstitial lung disease
low V/Q

pulmonary fibrosis
low V/Q and diffusion limitation

AP view: supine
heart looks larger than it is
AP or PA view?

right: PA upright
left: AP supine

RUL

RML

RLL

LUL

LLL
How does acinar/alveolar/airspace disease appear on xray?
dots
How does interstitial disaese appear on xray?
lines in irregular weblike pattern
radiologic signs of CHF
cephalization
cardiomegaly
perihilar infiltrates
peribronchial cuffing
R. pleural effusion
enlarged azygos vein
kerley B lines

- Ascending aorta
- left pulmonary artery
- left mainstem bronchus
- Descending aorta
- esophagus
- right mainstem bronchus
- superior vena cava
How do we diagnose SPN (solitary pulmonary nodule)?
- surgical excision
- transbronchial sampling in bronchoscopy
- trans throracic needle aspiration
- sputum cytology (low yield)

edema: laying down and all flows to dorsal region: ARDS
cardiogenic edema would be nearly symmetrical and not all in the dorsal portion

cardiogenic pulmonary edema: edema is uniform
ARDS would just be dorsal laying down

COPD
arrows
- increased vascular markings
- hyperinfalated lung
- TEAR DROP shaped heart
- flat diaphragm

bullous emphysema

ground glass: early stage ILD

reticular, nodular
reticulo-nodular
mid stage ILD

end stage ILD
honeycomb