Imaging

Question 1

presenting a CXR

Answer 1

1) type of radiograph and projection (normally PA - scapula are retracted)
2) patients name
3) the date the X-Ray was taken
4) comment on film quality
5) ABC of chest radiology
6) short summary (ie what is wrong/is it normal)

Question 2

CXR interpretation

Answer 2

RIP ABCDE

Rotation (compare clavicle heads)
Inspiration (5-7 anterior ribs, 10 posterior ribs)
Penetration (vertebral bodies only just visible behind heart)

Airway (trachea and bronchi)
Breathing (lung fields - divide into three zones and look around the outside to check the lung markings are visible)
Circulation (heart, great vessels and hilum) D
Diaphragm (costo/cardiophrenic angles, under diaphragm)
Everything else (bone, sopt tissue, artefacts - ECG leads, ET tubes, drains , surgical clips, pacemakers)

Question 3

cavities on a CXR

Answer 3

CAVITIES 
Cancer
Autoimmune - Wegeners, RA
Vascular - septic emboli, PE
Infection - TB, aspergillosis, Klebsiella pneumonia, abscess
Trauma
Young - bronchogenic cyst

Question 4

lobar collapse on CXR

Answer 4

sail sign behind heart

trachea and mediastinum deviated

Question 5

systematic approach to a AXR

Answer 5

labelling - pt, location and projection 
quality - field capture (hemidiaphragms and hip joints visible), penetration (vertebral outlines should be visible) 
ABCDE
Air (start from rectum) 
Bone (look for #s)
Calcifications 
Disability (soft tissues) 
Everything else

Question 6

coffee bean sign on an AXR

Answer 6

volvulus

Question 7

bowel gas pattern

Answer 7

small bowel <3cm
large bowel <6cm
caecum <9cm

small bowel - central location, valvulae conniventes (across whole lumen)

large bowel - peripheral location, taenia coli/haustra (across part of the lumen)

Question 8

approach to # radiographs

Answer 8

IPADS
Information
Pattern of # - transverse, oblique, longitudinal
Anatomical location - which bone, location of bone, intra-articular involvement, dislocation
Distal fragment - displacement, angulation, rotation, impaction
Soft tissues and bone quality

Question 9

NOF#

Answer 9

look if intracapsular or extracapsular
displaced or undisplaced
trace Shenton’s line
look for osteopenia