Radio Lecture 2 (Dr. Adamu) PDF

LECTURE 2 OUTLINES  Introduction to chest x-ray, interpretation and common pathologies  Plain abdominal x-ray CHEST X-RAY  One of the most commonly requested plain radiography.  Often difficult to interpret.  A systematic approach is needed.  Indications;  Infectious /inflammato...

LECTURE 2 OUTLINES  Introduction to chest x-ray, interpretation and common pathologies  Plain abdominal x-ray CHEST X-RAY  One of the most commonly requested plain radiography.  Often difficult to interpret.  A systematic approach is needed.  Indications;  Infectious /inflammatory/neoplastic lung pathologies  Chest trauma(hemothorax, rib fracture..  COPD,ILD  Cardiac pathologies PATIENT POSITION PA: standard view Lateral: localizes an abnormality seen on PA view AP, Supine:: valuable infants and ill patients. It is not possible to asses heart size on this view Erect: detects gas under diaphragm CONT.. Oblique: Useful to demonstrate pleural chest wall and rib abnormality Apical view: bone free of lung apices. Expiratory: air trapping and pneumothorax becomes more prominent Lateral decubitus: Small pleural effusions or sub pulmonic effusions are recognized more easily with affected site dependent. INTERPRETATION 1.Request form should include;- Name, age, sex, date, MRN and pertinent clinical information 2.Technical factors; Centring, patient position ,marker, exposure, degree of inspiration Technical factors  Inspiratory film-in good inspiratory film at least 10 posterior and 6 anterior ribs are seen and we can clearly see base of lungs.  Poor inspiration of the lugs may cause a normal sized heart to appear enlarged.  Centring; spinous process vs medial end of clavicles  Penetration; bodies of 1 to 4 thoracic vertebrae 3.Trachea;position, outline 4.Heart and mediastinum 5.Diaphragm Outline, shape, relative position 6.Pluera;Position of horizontal fissure Costophrenic angle, cardiophrenic angle 7. Lung fields; Local, generalized abnormality comparison of translucency and vascular markings of the lungs 8. Hidden areas apices, posterior sulcus Mediastinum, hila, bones 9. Hilum; Density, position, shape 10.Below diaphragm; Gas shadows, Calcifications 11. Soft tissues; Mastectomy, gas, densities etc FROM INSIDE OUTWARD  Trachea and mediatinum  Heart and great vessels  Lungs  Costophrenic angles  Pleura  Diaphragm  Bones and soft tissues  Cardiothoracic ratio  Normal is 5cm PNEUMOPERITONEUM  Pneumoperitoneum ;is free air in the peritoneal cavity.  Can be caused by;  Viscus perforation  Externally administered in post op patients.  Foreign body in the abdomen THE END!!!