Radiology Pictures Mid-Term Flashcards
Pathology
None
-Normal Male Chest X-Ray
Pathology
None
-Normal Female Chest X-ray
Pathology
None
-Normal Lateral Chest X-Ray
10 steps for Review of Basic Structures for Chest Films
1) Diaphragm domes ok?
2) Pleura NOT thick?
3) Lung field has equal transparency?
4) Symmetrical bronchovascular branching?
5) Mediastinum is NOT enlarged?
6) Narrow Tracheal band?
7) Hili are NOT enlarged?
8) Normal Cardiac Silhouette?
9) Skeleton parts normal?
10) Soft tissue of the chest wall normal?`
Pathology
Right Upper Lobe Pneumonia
Pathology
Azygous Fissure
-Right increased “teardrop” shape lateral to the midsternum
Air-space or interstitial disease of the lung?
Air-space
- Can NOT see accentuated thickening of the connective tissues of the lung field (like a leafless tree)
- Overall appearance is dull and hazy (like a bush) which indicates air-space disease and NOT intertitium disease
Is this an air-space disease or interstitial lung disease?
Interstitial Lung Disease
- Accentuation of the connective tissue structures (Fibrosis) leads to a leaf less tree appearance
- No general soft dullness throughout the lung field rules out air space disease (look for a bush)
Is this an interstitial or air-space pattern of lung disease?
Interstitial
- “Leaf less Tree” appearance
- Air-space would be a “bush like” appearance
Air space of interstitial pattern of lung disease?
Air-Space
- “Bush like” appearance
- NOT “Leaf less tree” like appearance
What Sign is seen on the X-ray that indicates a pathology is present?
Silhouette Sign
- Loss of a normal radiodense border secondary to a radiodense pathology positioned contiguous with the normal structure
- Difficult to appreciate the right heart border = + Silhouette Sign
Radiographic Sign
Silhouette Sign
-Left cardiac border
Significant Finding
-What is a likely cause?
Complete loss of costophrenic angle bilaterally
- Means there is probably significant pleural effusion
- Lateral Chest will show no posterior costophrenic angle as well (always first to fill up)
What Sign can help us locate if this tumor is in the anterior or posterior part of the lung?
-Is this mass in the anterior or posterior lung?
Cervicothoracic Sign
-If seen above the clavicles = located in the posterior part of the lung
This mass is above the clavicles, so it must be located in the posterior part of the lung
Sign (Black arrows)
-What does it indicate?
Air Bronchogram Sign
- If the lung is filled with a water-based pathology, the air filled bronchi appear radiolucent densities in the middle of the radiodense fluid filled lung. (normal = not visible because the air in the bronchi are the same density as the rest of the air space in the lung)
- Indicates an air-space disease/process, most commonly being pneumonia
Pathology
Right Lung Atelectasis
- Increased density over the entire lung (less air = increased density)
- Mediastinum shift to the right
- Right hemidiaphragm is significantly higher than the left
Pathology
-What anatomic structure are the red arrows pointing to?
Right Upper Lung Atelectasis
-Arrows are pointing to the Horizontal (Minor) Fissure which will migrate to wherever the collaped lung is (in this case, it went superior)
T/F Based on this X-ray, the abnormality is present and is therefore an “Aunt Minnie” for Bronchial Asthma
FALSE.
Bronchial Asthma is mainly a clinical finding with no significant associated radiology findings (NO AUNT MINNIE!!!!)
-Acute may show hyperinflation while chronic may appear normal or show interstitial pattern of lung disease
(non-specific)
Pathology
-What radiographic appearance is present?
Bronchiectasis
-chronic irreversible dilation of bronchi (thick bronchial walls with altered lung volume)
Dx: Honeycomb appearance
Pathology
-What condition may this mimic (and can be ruled out with if the costophrenic angles are normal)
Congenital Bronchogenic Cyst
-May mimic atelectasis, but since costophrenic angles are normal and the hemidiamphragm levels are normal, atelectasis is not likely.
Pathology
Bronchopulmonary Sequestration
-Congenital malformation of the firegut causes a separate portion of lung from the bronchial tree
Radiographic Sign
-What is the Dx?
Rabbit Ear Sign
-Dx: Bronchopulmonary sequestration
Pathology
Emphysema
- Bilateral/flat hemidiaphragm (or stair stepping appearance)
- Overinflated lungs
- Increased radiolucency
- Prominent hilar vasculature
- Increased retrosternal space (EARLIEST INDICATOR)
Pathology
-What is the name of the area under the Arch of the Aorta that allows us to view the hilar vasculature
Emphysema
-Aortic Window
Pathology
Bullous Emphysema
-big cyts like spaces secondary to emphysema
(Advanced form of Emphysema)
Pathology
Atrial calcification and enlargment with dilated pulmonary arteries see in patient with pulmonary hypertension in rheumatic heart disease
Pathology
Thoracic Aortic Aneurysm
Pathology
Thoracic Aortic Aneurysm
Pathology
Pleural Effusion on the Right
- Loss of right costophrenic angle
- Ovall density of the right lung is consistent with the left lung (rules out atelectasis)
Radiographic Sign
-Indicates excess pulmonary fluid in the interstitium
Kerley’s Lines
-Indicates pulmonary edema
A = Apex of the lung
B = Base of the lung
C = Center of the lung
Radiographic finding
-What does it indicate?
Hampton’s Hump
-Indicates a pleural based radiodensity due to a pulmonary throboembolism infarct
What type of imaging is this?
-What is it used to look for/confim Dx of?
Ventilation/Perfusion Scan
-Used to look for Pulmonary Thromboembolisms
What is the artifact in the film?
Inferior Vena Cava Filter
“Stone Catcher”
-Used ot filter out clots in the IVC and dissolve them before they get to the heart
Pathology
Lingular Pneumonia
What is the main finding?
-What is the Dx?
Ranke Complex = hilar and peripheral granuloma
-Associated with TB infections
Pathology
Tuberculosis
Pathology
-What endocrine condition can this mimic?
Bronchial Carcinoid Tumor
- RARE
- MC primary tumor in patients under 16
- Can mimic Cushing’s Syndrome
Pathology
Bronchogenic Carcinoma
Pathology
Bronchogenic Carcinoma
Pathology
Pancoast Tumor
Pathology
Pancoast Tumor
Pathology
-Labs show Reed-Sternberg Cells
Hodgkin’s Lymphoma
Pathology
Metastatic Lung Disease
“Cannon Ball Metastasis”
Perferred imaging to evaluate tumors (evaluates glucose uptake in the body)
PET Scan
Pathology
(NOT Atelectasis)
Mesothelioma
-Cancer of the pleural cells = thickened pleural lining on X-ray
Pathology
Teratoma
-Composed of multiple embryo layers
MC in gonadal or sacrococcygeal locations, 3rd is intrathoracic
Pathology
Thoracic Teratoma
-3rd MC location
Pathology
-Person has facial muscle weakness
Thymoma
-Associated with Myasthenia Gravis
