CXRs Flashcards
What are the first things you must check when presenting a CXR?
Name and date of birth of the patient
AP or PA
Rotation - if the film is rotated then you cannot comment on the trachea
Inspiration - can you count 7 ribs anteriorly
Penetration - Can you see the vertebrae behind the heart?
Exposure - can you see enough of the chest?
What size should the heart be?
Less than 50% of the chest cavity on a PA film.
You can comment on the heart size if it is an AP film.
What should you check after confirming the identity of the patient, orientation and RIPE?
Lung fields - should be black and clear. If you can see the sharp edge of a lung, then it is a pneumothorax.
If cardiophrenic angles are blunted, there may be effusion.
What do you look for when you look at the soft tissues and bones?
Are both breasts present (in females)
Are there any fractures?
What does this CXR show?
Left sided pneumothorax
What does this CXR show?
Consolidation, possibly lobar pneumonia
If the whiteness is has well demarkated borders and is uniform, it is likely to be a collapse or effusion.
If the whiteness does not have well demarkated borders and is not uniform, it is more likely to be consolidation, fibrosis or other infiltrative disease
What does this CXR show?
Coin lesion
This can be a sign of a malignant or benign tumour or infection e.g. TB, pneumonia
What does this CXR show?
Bilateral hilar lymphadenopathy
Causes may include:
Neoplastic causes
Infective e.g. TB
Sarcoidosis (usually bilateral)
What does this CXR show?
Hyperinflated lungs
This is typical of COPD and you can count more than 7 ribs anteriorly. There is also evidence of “barrel-chest”
What does this CXR show?
Cardiomegaly
What does this CXR show?
This is a normal CXR
What does this CXR show?
There is a pancoast tumour in the top left lung field.
What does this CXR show?
Pleural effusion
You can see the meniscus effect
What does this CXR show?
Cannonball lung metastases
