Radiology PDF

RADIOLOGY Content Contributors Mohamed Mamdouh Youssef Essam Design & Organization Ali Saad Eldin https://t.me/questionspt8 PT8 ‫ودعوة حلوة لكل الناس اللي تعبت في الملف‬  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Density in lower l...

RADIOLOGY Content Contributors Mohamed Mamdouh Youssef Essam Design & Organization Ali Saad Eldin https://t.me/questionspt8 PT8 ‫ودعوة حلوة لكل الناس اللي تعبت في الملف‬  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Density in lower left lung field Loss of left heart silhouette Diaphragmatic silhouette intact No shift of mediastinum Blunting of costophrenic angle Consolidation Diagnosis Pneumonia Differential Diagnosis Pneumonia Pulmonary edema Pulmonary hemorrhage Adenocarcinoma Tumor  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Density in right upper lung field Lobar density Loss of ascending aorta sihouette No shift of mediastinum Transverse fissure not significantly shifted Air bronchogram Consolidation Diagnosis Pneumonia Differential Diagnosis Pneumonia Pulmonary edema Pulmonary hemorrhage Tumor  CT CHEST Finding Pulmonary consolidation in the upper, middle and inferior right lobe and inferior left lobe with Air bronchogram Consolidation Diagnosis Pneumonia Differential Diagnosis Pneumonia Pulmonary edema Pulmonary hemorrhage Tumor  CT CHEST Finding Opacity in left upper, lower lobe Consolidation Diagnosis Pneumonia Differential Diagnosis Pneumonia Pulmonary edema Pulmonary hemorrhage Tumor  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Opacity of lower lobe of right and left lung Trachea shift to right Diagnosis Atelectasis Differential Diagnosis Atelectasis Pleural effusion Pneumonia  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Homogenous density right hemithorax Mediastinal shift to right Smaller right hemithorax Right heart and diaphragmatic silhouette are not identifiable Diagnosis Right lung atelectasis Differential Diagnosis Atelectasis Pleural effusion Pneumonia  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Inhomogeneous cardiac density Left hilum pulled down Non-visualization of left diaphragm Triangular retro cardiac atelectatic LLL Diagnosis Left lower lobe atelectasis Differential Diagnosis Atelectasis Pleural effusion Pneumonia  CT CHEST Finding Loss of volume Pulling adjacent bronchovascular bundles Associated pleural thickening Small amount of effusion Diagnosis Atelectasis Differential Diagnosis Atelectasis Pneumonia Pleural effusion  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Patchy airspace opacities Interstitial thickening in both lungs Nodular opacity Diagnosis Bronchopneumonia in both lungs Differential Diagnosis Bronchopneumonia TB Pulmonary Rheumatoid manifestations  CT CHEST Finding Multilobar & bilateral sub pleural ground glass opacities Lobar & rounded morphology mostly in periphery of both lungs Diagnosis Pneumonia (caused by COVID-19) Differential Diagnosis Pneumonia Pulmonary embolism Mediastinal mass or lymphadenopathy Atelectasis or lung collapse Infections (TB, fungal) – Consolidation or nodules in the lung Interstitial lung disease Pleural effusion or thickening  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Bilateral Multiple Fluid level Diagnosis Lung abscess Differential Diagnosis Lung abscess Carcinoma TB  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Anterior segment of LUL Aspiration lung abscess Thick wall Fluid level Diagnosis Lung abscess Differential Diagnosis Lung abscess Carcinoma TB  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding LUL cavities RUL infiltrate Bilateral upper lobe disease Fibrosis, atelectasis Diagnosis TB Differential Diagnosis TB Carcinoma-SCC Abscess fungal/bacterial Vascular-septic emboli Inflammatory-rheumatoid nodules Trauma-resolving contusion Young-bronchogenic cysts  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding LUL cavity Cavity behind clavicle ( increase density of clavicle in the region over lying cavity) Pleural effusion on right Diagnosis TB Differential Diagnosis TB Solitary pulmonary nodule/mass Infectious process Vascular lesion Trauma or foreign body  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Interstitial nodules distributed randomly ( uniform size) (Sharper edges) Diagnosis Miliary TB Differential Diagnosis Miliary TB Mets Sarcoid Pneumoconiosis  CT CHEST Finding Cavity Extensive endobronchial spread particularly in LUL Tree-in-bud Diagnosis Chronic , old TB Differential Diagnosis Chronic , old TB Bronchiectasis Infiltration of leukaemia Lymphoma  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Rounded lung nodules Demonstrated cavitation Fungal ball Diagnosis Fungal infection Differential Diagnosis Fungal infection Metastasis Rheumatoid nodules Cavitating pneumonia TB Calcified nodules  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Rounded lung nodules Demonstrated cavitation Fungal ball Diagnosis Fungal infection ( fungal ball ) Differential Diagnosis Fungal infection Metastasis Rheumatoid nodules  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Right lung obscuration Homogenous density Meniscus maximum in axilla Loss of cardiophrenic angle Loss of diaphragmatic and right cardiac silhouette. Diagnosis Pleural effusion. Differential Diagnosis Pleural effusion Atelectasis Pneumonia  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Both lungs obscuration Homogenous density Loss of cardiophrenic angle Loss of diaphragmatic and cardiac silhouette. Diagnosis Pleural effusion. Differential Diagnosis Pleural effusion Atelectasis Pneumonia  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Left hemi opacification Massive left lung obscuration Massive shift of mediastinum to right Tracheal shift to right No fibrosis or atelectasis in left lung Diagnosis Massive pleural effusion. Differential Diagnosis Pleural effusion Atelectasis Pneumonia CHEST X-RAY POSTERIOR ANTERIOR VIEW LATERAL DECUBITUS Finding Right lung obscuration Homogenous density Loculated loss of cardiophrenic angle Loss of lateral portion of diaphragmatic silhouette Diagnosis Loculated pleural effusion Differential Diagnosis Pleural effusion Atelectasis Pneumonia Post-pneumonectomy / agenesis  ULTRASOUND (SONAR) Finding Minimal right side pleural effusion Diagnosis Pleural effusion Differential Diagnosis Pleural effusion Atelectasis Pneumonia Post-pneumonectomy / agenesis  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding lung obscuration. Loss of costophrenic angle Loss of cardiophrenic angle Loss of cardiac border silhouette Rising to axilla Diagnosis Pleural effusion Differential Diagnosis Pleural effusion Atelectasis Pneumonia Post-pneumonectomy / agenesis  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding No vascular markings on right. No shift of mediastinum to left. Deep sulcus. Atelectatic right lung. Increased haziness on left: Diversion of entire cardiac output Small fluid level near costophrenic angle (Hydro- pneumothorax) Diagnosis Pneumothorax Differential Diagnosis Poland syndrome/Pneumothorax Oligemia/Obstruction (PE) Emphysema Mastectomy Swyer James  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding No vascular markings on right Shift of mediastinum to left Deep sulcus Atelectatic right lung Increased haziness on left: Diversion of entire cardiac output Diagnosis Tension pneumothorax Differential Diagnosis Poland syndrome/Pneumothorax Oligemia/Obstruction (PE) Emphysema Mastectomy Swyer James  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Air in the pleural cavity. Lung margin visible. Bilateral fluid level: Anytime you see a horizontal fluid level, it means that there is air and fluid in the pleural space. Diagnosis Hydropneumothorax Differential Diagnosis Poland syndrome/Pneumothorax Oligemia/Obstruction (PE) Emphysema Mastectomy Swyer James  CT CHEST Finding Lymph nodes in middle mediastinal Middle mediastinal mass Diagnosis Bronchogenic cysts Differential Diagnosis Bronchogenic cysts Lymphadenopathy Aneurysms Esophageal duplication  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Opacity in posterior mediastinum Middle mediastinal mass Diagnosis Extramedullary hematopoiesis Differential Diagnosis Extramedullary hematopoiesis Lymphadenopathy Spinal pathology Diaphragmatic hernia Neurogenic tumors  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Anterior mediastinum masses Wide superior mediastinum Para tracheal masses Diagnosis T-cell Lymphoma Differential Diagnosis Lymphoma Thymoma Teratoma Substernal thyroid  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Diffuse haziness Tracheal shift to right Blunted costophrenic angle Lines not corresponding to fissures Diagnosis Pulmonary fibrosis Differential Diagnosis Pulmonary fibrosis TB Mediastinal mass Atelectasis Pulmonary embolism  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Hyperinflation Hyperlucency(darkness jed black) Low set flat diaphram Vertical heart Pre and infra cardiac lungs Cephalization of upper lung fields is not evident Diagnosis Emphysema Differential Diagnosis Emphysema Poland syndrome/Pneumothorax Oligemia/Obstruction (PE) Swyer James  CT CHEST Finding Increase A-P diameter Transmediastinal herniation Hyperinflation Ill-defined transducency Focal lucencies (emphysematous spaces) Diagnosis Emphysema (centrilobular) Differential Diagnosis Emphysema Poland syndrome/Pneumothorax Oligemia/Obstruction (PE) Swyer James  CT CHEST Finding Sub pleural blebs (Bullae) Small focal lucencies Spontaneous pneumothorax Diagnosis Emphysema (paraceptal) Differential Diagnosis Emphysema Poland syndrome/Pneumothorax Oligemia/Obstruction (PE) Mastectomy Swyer James  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Bilateral airspace opacities Bilateral perihilar fluffy opacity Diagnosis Pulmonary edema Differential Diagnosis Pulmonary edema Miliary TB  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Unilateral Diffuse Coalescing Air bronchogram Asymmetrical opacification Diagnosis Pulmonary edema Differential Diagnosis Pulmonary edema Miliary TB  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Diffuse Bilateral Opacities Butterfly pattern Cardiomegaly Air bronchogram Increased vascular markings Diagnosis Pulmonary edema Differential Diagnosis Pulmonary edema Miliary TB  CT CHEST Finding Diffuse ground glass opacity Confluent airspace densities Subpleural sparing Diagnosis Pulmonary edema Differential Diagnosis Pulmonary edema Miliary TB  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Bilateral, diffuse Soft fluffy lesions Air bronchogram Butterfly pattern Diagnosis Pulmonary edema (acute diffuse alveolar damage) Differential Diagnosis Pulmonary edema Miliary TB Pneumonia  CT CHEST Finding Sizable left lower lobe mass Diagnosis Lung cancer Differential Diagnosis Mets/carcinoma/lymphoma TB/granuloma wegeners Rheumatoid nodules/ Round pneumonia Fungal Sarcoid Septic pulmonary emboli  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Peri hillar mass Cavitation Atelectasis Air bronchogram LUL anterior segment lesion Diagnosis Alveolar cell carcinoma Differential Diagnosis Carcinoma/Congenital Hamartoma/ Hematoma AVM/ Abscess Neoplasm-mets Granuloma TB pneumonia  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Calcified nodes (silicosis) Right apical mass Cavitating mass Para tracheal nodules 2nd rib destruction Diagnosis Alveolar cell carcinoma Differential Diagnosis Carcinoma/Congenital Hamartoma/ Hematoma AVM/ Abscess Neoplasm-mets Granuloma TB pneumonia  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Cavitation Atelectasis Air bronchogram Large mass RUL Diagnosis Large cell cancer Differential Diagnosis Lung Cancer: Large cell Round or oval Sharp margin Homogenous No respect for anatomy  CT CHEST Finding Large mass in apical segment RLL Pleural base Without transgressing the limits of the fissure Diagnosis Large mass cell cancer in RLL Differential Diagnosis Lung Cancer: Large cell Round or oval Sharp margin Homogenous No respect for anatomy  CT CHEST Finding Mediastinal lymph nodes Micro nodules randomly distributed Diagnosis Micronodular lung disease (SARCOID) Differential Diagnosis Metastasis Sarcoid Pnemoconosis Miliary TB  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Unilateral hyperlucent lung Diagnosis Foreign body inhalation Differential Diagnosis Pulmonary embolism Pneumothorax Emphysema  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Apical shadow Posterior rib destruction Diagnosis Bronchogenic carcinoma ( Pancoast tumor ) Differential Diagnosis Bronchogenic carcinoma ( Pancoast tumor ) Actinomycosis Blastomycosis Multiple myeloma  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Patchy airspace opacities Interstitial thickening in both lungs Nodular opacity Diagnosis Staph pneumonia Differential Diagnosis Staph Strep TB Klebsiella  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Left side opacity Loss cardiophrenic angle Loss of diaphragmatic and cardiac silhouette Diagnosis Dissecting aortic aneurysm Differential Diagnosis Dissecting aortic aneurysm Pancreatitis Esophageal pathology Pleural effusion CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Posterior anterior findings: I. Opacification in the left lower lung zone. II.The left hemidiaphragm is obscured Lateral View Findings: I. The opacification appears in posterior lower chest region II.Loss of the clear definition of the posterior costophrenic angle Diagnosis Hamartoma Differential Diagnosis Hamartoma Histoplasmoma TB granuloma Round pneumonia Round atelectasis  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Multiple nodules >3cm Multiple rounded opacity Diagnosis Carcinoma Differential Diagnosis Metastasis Carcinoma Lymphoma TB granuloma Round pneumonia Fungal Sarcoid Wegenrs Rheumatoid nodules  CHEST X-RAY POSTERIOR ANTERIOR VIEW & CT CHEST Finding Well defined nodule ( coin lesion ) smaller than 3cm Diagnosis Carcinoma Differential Diagnosis Carcinoma Hamartoma Abscess Granuoma TB Pneumonia  CHEST X-RAY POSTERIOR ANTERIOR VIEW & CT CHEST Finding On X-Ray : I.Rounded opacity with Cavitation in RLL II.Lesion have irregular border On CT chest : I.Consolidation or infiltrates around lesion II.Lung parenchymal markings appear alterd Diagnosis Lung abscess Differential Diagnosis Carcinoma Abscess Vascular septic embolism Inflammatory rheumatoid nodules Trauma resolving contusions Young Bronchogenic cyst Fangal / bacterial / TB  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Bilateral, symmetrical HILAR ADENOPATHY Diagnosis Sarcoid Differential Diagnosis Sarcoid TB Lymphoma and Bronchogenic carcinoma Metastasis  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Rounded or oval mass Sharp magin No recpect for anatomy Diagnosis Lung cancer ( large cell ) Differential Diagnosis Lung cancer TB Sarcoid Lymphoma  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Small cavitary lung lesions Diagnosis Rheumatoid nodules Differential Diagnosis Septic emboli Rheumatoid nodules Metastasis Wegener’s Granulomatosis  CHEST X-RAY POSTERIOR ANTERIOR VIEW Finding Cavities containing masses Diagnosis Aspergillosis Differential Diagnosis Aspergillosis Cavitating Bronchogenic carcinoma TB Hydatid cyst