Radiology Flashcards
Chest radiograph summary
-
Introduction
- patient identification
- date of radiograph
- old radiographs
-
Comment on quality of film
- Rotation
- Inspiration
- Projection
- Exposure
- ABCDE
- Review areas and silhouette signs
rotation on X-ray
central trachea and equal distance between medial end of clavicle and midline
projection on CXR
- Usually PA not AP (heart may look magnified)
Exposure
can you see vertebrae behind heart
ABCDE approach to CXRAY
Airway
Breathing
Circulation
Diaphragm
Everything else
ABCDE approach to CXRAY
Airway
breathing
circulation
diaphragm
Airway
tracheal central?
breathing
- Lung fields (opacification)
- Upper
- Middle
- Lower
- Costophrenic angles
- Compare left lung to right lung
circulation
- Aortic knuckles
- L and right hilar region
- Heart size
- Cardiothoracic ratio
- Cardio phrenic angle
Diaphragm
compare both sides
- Tented?
- Flattened?
- Pneumoperitoneum?
- Gas in stomach normal
- Pneumoperitoneum?
Everything else for CXRAY
bones
soft tissue
review areas for CXRAY
- Apices
- Mass
- Pneumothorax
- Hilar
- Unilateral- cancer
- Bilateral- sarcoidosis
- Heart
- Look through the heart to the lungs
- Lung hidden by diaphragm
- Look through the heart
silhouette signs
if you lose a key silhouette sign the atelectasis or consolidation is in a specific place
lost left hemidiaphragm
atelectasis or consolidation in the left lower lung (LLL)
lost right hemidiaphragm
atelectasis or consolidation in the RLL
lost right heart border
atelectasis or consolidation in the rright middle lobe
lost left heart border
atelectasis or consolidation in the lingula
lost upper border of the horizontal fissure
right upper longer
diagnose
C - lung metastases
- ‘Canon ball mets’
- Older patients
- Primary sites: bowel, renal cell, pancreatic and breast cancer
diagnose
C- right pneumothorax
diagnosed
B- bilateral hilar lymphadenopathy
e.g. sarcoidosis
diagnosed
C- right upper lobe collapse
- Atelectasis- mediastinum pulled towards collapse
diagnose
D- left lung
diagnose
B- pneumoperitoneum
diagnose
C- right pleural effusion
Abdominal radiograph summary
-
Introduction
- patient and identification
- date of radiograph
- previous radiograph
-
Comment on quality of film
- Supine or erect (AP)
- erect may distinguish an air fluid level
- Exposure- diaphragm → pubic symphysis in frame
- Penetration- soft tissue differences
- Supine or erect (AP)
-
BBC
- bowel gas pattern
- bones
- calcified artefacts
-
Review areas
- lung bases
general approach
- follow the bowel up from the rectum looking for air
- liver on right and spleen on left
- split abdomen into 4
- look for the course of the ureters
BBC
- Bowel gas pattern
- Bones
- Calcified artefacts
- E.g. renal calculi/phleboliths
large bowel vs small bowel
diagnose
B- Small bowel obstruction
- Plica circularis
- Central
diagnose
- C- sigmoid volvulus
- Coffee bean sign
diagnose
- E- Perforation
- Rigler sign – when bowel wall becomes very defined
Musculoskeletal approach
- Introduction
- Patient identification
- date of radiograph
- Body part (side)
- Are there x2 views (lateral and AP)
- comparison to previous imaging
- ABCS
- alignment
- bone texture
- cortices
- soft tissue
*
A- MSK xray
- Alignment of bones and joint spaces- dislocation
B- MSK XRAY
bone texture
e.g. osteoporosis
C-MSK XRAY
Cortices
- any breaks int he cortex - trace finger around looking for ‘step’
S- MSK XRAY
soft tissue- joint effusion or soft tissue swelling
RA XRAY
example of disruption of normal bone texture/trabeculae
example of disruption of the cortex
pelvic x-ray joint space/aligment
example of cortex on pelvic x-ray
remember: SHENTONS LINE$
diagnose
