X-rays Flashcards
CXR: what may cause white shadowing in the lungs?
- consolidation
- pleural effusion
- collapse
- pneumonectomy
- specific lesions e.g. tumours
- fluid e.g. pulmonary oedema
CXR: if there is a ‘white-out’ of a hemithorax, it is useful to assess what?
the position of the trachea- is it central, pulled or pushed from the side of opacification
CXR: what might cause the trachea to be pulled towards a white out?
- Pneumonectomy
- Complete lung collapse e.g. endobronchial intubation
- Pulmonary hypoplasia
CXR: what condition may the trachea be central in?
- Consolidation
- Pulmonary oedema (usually bilateral)
- Mesothelioma
CXR: what may cause the trachea to be pushed away from the white-out?
- pleural effusion
- Diaphragmatic hernia
- Large thoracic mass
CXR: features of pulmonary oedema?
- interstitial oedema
- bat’s wing appearance
- upper lobe diversion (increased blood flow to the superior parts of the lung)
- Kerley B lines
- pleural effusion
- cardiomegaly may be seen if there is cardiogenic cause
What are commonly used to check the position of NG tubes?
CXR
How to check the position of NG tube on CXR?
identify that the end of the tube is below the diaphragm in the stomach
Failure to recognise that NG tube is not correctly positioned eg. with CXR can have what consequences?
aspiration pneumonia, death so get radiologist to report on CXR before using NG tube
CXR: most common cause of mediastinal widening on CXR?
technical factors such as patient rotation
CXR: causes of actual mediastinal widening? (not technical factors eg. pt rotation)
- vascular problems: thoracic aortic aneurysm
- lymphoma
- retrosternal goitre
- teratoma
- tumours of the thymus
How to determine cause of mediastinal widening?
CT
can use lateral view of CXR to determine whether mass is anterior or posterior; CT better
Lung mets are seen with what cancers?
wide variety eg:
- breast
- colorectal
- renal cell
- bladder
- prostate
What are ‘cannonball metastases’?
multiple round, well-defined lung secondaries (mets); most commonly seen with renal cell ca but may also occur secondary to choriocarcinoma and prostate ca
CXR: is calcification in lung mets common?
uncommon except in chondrosarcoma or osteosarcoma
CXR: common causes of lobar collapse?
- lung ca (most common in older adults)
- asthma (due to mucous plugging)
- foreign body
CXR: general signs of lobar collapse on CXR?
- tracheal deviation towards the side of collapse
- mediastinal shift towards side of collapse
- elevation of hemidiaphragm
CXR: cavitating lung lesion differentials?
- abscess (Staph aureus, Klebsiella and Pseudomonas)
- squamous cell lung cancer
- TB
- Wegener’s granulomatosis
- PE
- rheumatoid arthritis
- aspergillosis, histoplasmosis, coccidioidomycosis
What is a cavitating lung lesion on CXR?
area within the lung that shows a cavity or hollowed-out space, typically caused by the destruction of lung tissue. Cavities form when a part of the lung becomes necrotic (dies) and then liquefies, leaving behind an air-filled space or a fluid-filled cavity.
What may a cavitating lung lesion look like on CXR?
round or irregular area with a dark (lucent) center, representing the air or fluid-filled space
surrounded by denser tissue, often representing an area of infection, inflammation, or malignancy.
The cavity may have a visible thick or thin wall around it, which can give clues about the underlying cause.
Sometimes, the cavity might have a fluid level, which appears as a horizontal line indicating air above and fluid below.
