Imaging Flashcards
Key point to remember for an Xray
Look if old films are available for comparison
CXR film specific details
Patient name, age and DoB
Location of patient
Date take
CXR film quality factors
Rotation
Inspiration
Penetration
On which Xray can you comment on heart size
PA
Heart is magnified by AP XR so can not comment on size.
Structure to CXR
Assess structures: HLMB
- Heart & major vessels
- Lungs and pleura
- Mediastinum (Inc. Hila)
- Bones and soft tissues
Review areas: 5
- Costophrenic angles
- Apices
- Behind the heart
- Below diaphragms
- Breast shadows (if female)
CXR Heart and major vessels:
Size of heart (PA)
Size of pulmonary vessels, outline aorta and SVC
Evidence of stents, clips, wires, valves, pacemakers
CXR Lungs
Size Intrapulmonary pathology (collapse, effusion, consolidation, mass)
CXR Pleura
Thickness or calcification
Fluid or air in pleural space
CXR mediastinum & Hila
Width of mediastinum
Contour of mediastinum
Size and density of hila
Symmetry of hila
CXR Bones and soft tissues
Diffuse or focal bony abnormalities
Surgical emphysema (pneumothorax or surgery)
Breasts
Gas on AXR
Black
intraluminal normal (abnormal if there is too much causing dilation of bowel)
extraluminal abnormal
Causes of extraluminal gas on AXR
abdo surgery
perforation
abscess/collection
causes of abdo calcification
stone: renal, gallstones
Ca e.g. pancreas, mets
When to do CT following trauma
GCS less than 13
suspected skull base fracture
post-traumatic seizure
focal neurological deficit
vomiting more than once
coagulopathy + any amnesia or loss of consciousness since injury
more than 30 min of amnesia preceding the event
when to use contrast in head CT
For Aneurysms, tumours and abscesses
Do not use if suspected bleed as blood and contrast are both white
