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Module 5 > X Ray Findings > Flashcards

X Ray Findings Flashcards

1
Q

Air space opacification (more spec than consolidation)

A

Infection or pulmonary oedema

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2
Q

Types of opacification

A

Hazy or patchy

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3
Q

Differentiating between pulmonary oedema and infection

A

PO typically bilateral and spares the upper lobes, infection can be unilateral and lobar of any part of the lung

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4
Q

Atelectasis

A

Collapse of a part of the lung due to a decrease in the amount of air - creates increased volume and increased density

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5
Q

Key findings of consolidation

A

ill-defined homogenous opacity obscuring vessels, silhouette sign, air bronchogram, no volume loss, extension to pleura or fissure but doesn’t cross it

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6
Q

Silhouette sign

A

Loss of lung/soft tissue interface - blurring of lines

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7
Q

White out

A

Whole lung dense opacification

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8
Q

Clips on trachea/ hilum

A

surgical clips

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9
Q

Checking for hyperinflation

A

Count anterior ribs - 5-7th rib should intersect diaphragm. Is Diaphragm normal curved shape? flat = hyperinflation

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10
Q

Meniscus sign

A

Pleural effusion - concave surface of white opacification

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11
Q

Looking for rotation

A

Look at clavicle and spinous processes are they in line - clavicle moves away from spine on side of rotation

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12
Q

AP portable film be aware

A

Patient sick bed bound - technical quality likely poor

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13
Q

Look thoroughly around the edge of the pleura for

A

Pneumothorax

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14
Q

Pushed tracheal deviation

A

Anything that increases pressure or volume in the hemithorax - will push trachea and mediastinum - hyperinflation and pneumothorax

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15
Q

Pulled tracheal deviation

A

Any disease which causes volume loss in one hemithorax will pull the trachea over towards that side - collapse

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16
Q

Bilateral symmetrical hilar enlargement suspicious of

A

Sarcoidosis - particularly when there is paratracheal enlargement, or lung parenchymal shadowing. DDx - pulmonary arterial hypertension

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17
Q

Asymmetric hilar enlargement

A

TB importantly

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18
Q

Lung infarction

A

PE usually has a normal CXR, could see peripheral consolidation in region of emboli - haemorrhage

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19
Q

Congestive heart failure

A

bilateral perihilar consolidation with air bronchograms and ill-defined borders
an increased heart size
subtle interstitial markings
probably a large vascular pedicle (distance from lateral border of SVC and subclavian artery origin)

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20
Q

Bronchopneumonia

A

multi focal, ill-defined densities progresses to diffuse consolidation

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21
Q

Batwing appearance

A

Bilateral perihilar consolidation - sparing at the peripheries due to better lymphatic drainage

22
Q

Stage 0 sarcoidosis

A

Normal CXR

23
Q

Stage 1 sarcoidosis

A

Hilar or mediastinal nodal enlargement (white opacities around hilar rest of lung normal)

24
Q

Stage 2 sarcoidosis

A

Nodal enlargement and parenchymal disease (opacities are more diffuse into pulmonary vessels - larger white area)

25
Q

Stage 3 sarcoidosis

A

Parenchymal disease (less intense opacity in centre, still diffuse opacity)

26
Q

Stage 4 sarcoidosis

A

Pulmonary fibrosis (reticular shadowing, small lung volume)

27
Q

Idiopathic pulmonary fibrosis (usual interstitial pneumonia)

A

Reticulonodular infiltrates on chest xray -basilar, peripheral, bilateral, asymmetrical

28
Q

Non-specific interstitial pneumonia

A

Ground glass opacity

29
Q

Pneumoconiosis - silicosis and coal worker’s lung

A

progressive upper zone calcified ‘egg shell calcification’, progressively affects all zones

30
Q

Pneumoconiosis - silicosis and berilliosis

A

Upper zone linear interstitial fibrosis

31
Q

Acute and sub-acute hypersensitivity pneumonitis (low specificity)

A

patchy nodular infiltrates

32
Q

Chronic HSP (low specificity)

A

Fibrosis

33
Q

TB

A

Fibronodular opacities in upper lobes (sharply defined opacities found in clusters) with or without cavitation.

34
Q

Atypical TB

A

Opacities in lower lobes

35
Q

HAP

A

opacity, blurring of diaphragm or heart borders

36
Q

CAP

A

consolidation, effusion, cavitations

37
Q

bronchiectasis

A

round black circles surrounded by dense opacity - thin walled ring shadows. tubular opacities. may be normal, or show skewed hemidiaphragm

38
Q

lobectomy

A

changed shape or volume of the lung - typically raised

39
Q

Lung abscess

A

consolidation in lobar distribution with central cavitation cavity wall thick and irregular,

40
Q

Asthma

A

normal or hyper inflated - excludes other pathologies

41
Q

COPD

A

rules out other pathologies. Hyperinflation, flattened diaphragm, increased intercostal spaces, hyperlucent lungs

42
Q

small cell lung cancer

A

central mass, lymphadenopathy, pleural effusion

43
Q

non-small cell lung cancer

A

single or multiple pulmonary nodules, mass, pleural effusion, lung collapse, mediastinal or hilar fullness

44
Q

tension pneumothorax

A

heart trachea and mediastinum can be shifted to one side, in combination with a black space containing no lung markings and a collapsed lung - grey shape with convex border

45
Q

pneumothorax

A

a black space containing no lung markings and a collapsed lung - grey shape with convex border(plueral line)

46
Q

pleural effusion

A

a dense white shadow with a concave upper edge.

47
Q

small pleural effusion

A

can cause no more than blunting of a costophrenic angle

48
Q

large pleural effusion

A

can cause a ‘white out’ of an entire hemi-thorax, with shift of the mediastinum to the opposite side

49
Q

If patient is only able to be in supine when imaging PTX or pleural effusion..

A

a lateral decubitus film should be performed

50
Q

Sail sign

A

Left lower lobe diagonal line like a sail obscuring portion of heart - suggests lower lobe collapse

Module 5 (6 decks)

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