X-ray interpretation (Johns)

Question 1

What is the pneumonic for viewing X-rays?

Answer 1

A= airway

B= bones

C=cardiac

D = diphagram

E = everything around lung fields

F = lung fields

Question 2

Describe what is seen.

Answer 2

Normal Chest x-ray

Question 3

Describe what is seen.

Answer 3

• Trachea displacement
• Bones good
• Cardiac silhouette large
• mediastinal mass
• See mass behind heart

Dx - lymphoma, lung cancer.

Question 4

Describe what is seen.

Answer 4

Airway curved.

Flat diaphragm - may see with chronic obstruction.

swallowed something. - may be a coin

Question 5

Describe what is seen.

Answer 5

• cardiomegaly
• can’t see diaphgram clearly
• lots of fluid infiltrate

likely pleural effusion on both sides.

Question 6

Describe what is seen.

Answer 6

• more vascular markings on upper left

TB - looks more white and tends towards upper lobe.

Question 7

Describe what is seen.

Answer 7

• quality is not good - likley over penetrated
• see lymph nodes on each side of the mediastinum
• side shows very dense mass right over mediastinum.

Dx = lymphoma, sarocoid, lung cancer.

Question 8

Describe what is seen.

Answer 8

• trachea shift left - could be positioning.
• all others good.
• see interstitial infiltrates in lungs.
  
  • alveoli have air in them and everything else around them is white.

possible causes = intersitial pneumonia or interstitial fibrosis

Question 9

Describe what is seen.

Answer 9

• bad quality - under penetrated
• cardiomegaly
• bulbous formation on aorta
• trachea deviated
• see air bubble up higher

dx = hiatal hernia

Question 10

Describe what is seen

Answer 10

• fluid in left lung - not good costophrenic angles.

need history - pnemonia or lung cancer.

Question 11

Describe what is seen.

Answer 11

• significant vascular markings
• cardiac slightly enlarged
• dx = CHF

Question 12

Describe what is seen.

Answer 12

• Air bronchogram
  
  • there is air in the bronchi and density everywhere else.
• fisher line - sign for pneumonia.
• with loss of lung volume, worry about central mass with tumor

Question 13

Describe what is seen

Answer 13

• left pleural efffusion
• Causes
  
  • CHF
  • infection
  • tumor

Question 14

Describe what is seen.

Answer 14

• lungs black but not overpenetrated - not enough tissue in lungs.
• flat diaphragm.
• huge airspace in front indicates significant obstructive aiway disease
• lungs lose tissue?
  
  • findings for emphysema
  • COPD
  • big pneumothorax

Question 15

Describe what is seen.

Answer 15

• Air is present below the diaphgram. SHOULD NOT BE THERE.
• Dx = peforated viscous in abdomen - diverticuli or gastric ulcer.

Question 16

Describe what is seen.

Answer 16

• Findings are inside chest but outside lung.
• pleura looks white and dense indicating calcification.
• Dx = asbestosis