FRCA Final X-Rays

FRCA Final X-Rays Methodology  Check identity Date & Hospital Projection     PA/AP Lateral  Patient position Methodology  Side marker Penetration   Vertebral bodies just visible behind cardiac silhouette  Rotation  Medial aspect of clavicles symmetrically  Inspiration  Diaphragm at level of 6th/7th rib anteriorly Methodology  Large airways Lungs Pleura Heart     Mediastinum Methodology  Diaphragm Bones     Ribs Thoracic spine Clavicles, scapula, humeri  Soft tissues    Chest wall Neck breasts  Large L.sided tension pneumothorax Mediastinal shift to right Depression of L.hemi diaphragm     25yo male Sudden onset L.chest pain, SOB Spontaneous pneumothorax   Tooth fragments in RUL bronchus & LLL bronchus   35yo male Cough, fever, purulent sputum RLL pneumonia    Loss of R.costophrenic angle Air bronchograms   72yo smoker Haemoptysis & cough LLL collapse Likely bronchogenic malignancy    RLL collapse Loss of R.lung volume Hypertranslucent R.hemithorax    RUL collapse Mass at R.hilum merges with collapsed lobe – ‘Golden sign’ Neoplastic hilar mass    RML collapse  density in R.lower zone Blurred R.heart border    46yo on ITU NGT in R.lung   Sup. Mediastinal mass Retrosternal thyroid Tracheal deviation    Middle mediastinal mass Bilateral hilar lymphadenopathy Sarcoidosis    Hiatus hernia Gas shadow through cardiac silhouette   Pulmonary oedema LVF Enlarged heart Upper lobe blood diversion Septal lines (interstitial oedema)      Mitral Valve Disease  RA enlargement (double heart border) RV enlargement Post. displacement of oesophagus    Mitral valve calcification Kerley’s B lines   54yo ventilated on ITU ETT/CVP ARDS    Bilateral perihilar airspace shadowing  Alveolar cell carcinoma Dual chamber pacemaker     68yo man SOB 4/12 Clubbing  Fibrosing alveolitis   Interstitial pattern Fine linear/nodular  density in lower zones  Cystic Fibrosis Widespread interstitial pattern shadowing R.sided portacath R.apical pneumothorax     46yo smoker Emphysema Hyperexpansion  Flat diaphragms   lung markings α1 antitrypsin-def  Bullae  Cardiac enlargement  Enlarged pulmonary A      54yo male Chronic productive cough Malaise & haemoptysis Bronchiectasis Pulmonary abscess      64yo man SOB 3st weight loss  Multiple pulmonary masses Metastases     28yo male Arrived from Africa SOB, febrile, sweats  Miliary TB  Multiple miliary nodules  Kyphoscoliosis  Alveolar hypoventilation   Atelectasis Segmental collapse  Restrictive pattern   68yo electrician 6/12 chest pain Mesothelioma    Asbestos exposure Pleural effusions common    76yo man Life-long smoker Cough / haemoptysis L.lung collapse     Underlying bronchogenic malignancy Volume loss Mediastinal shift  2/52 old neonate on PICU Malpositioned ETT    Collapse of RUL & L.lung Due to hypoventilation   1/7 old infant Resp distress Diaphragmatic hernia    Loops of bowel in L.chest R.mediastinal shift  Erect CXR Pneumoperitoneum    24yo male RTA Paradoxical R.chest movts Flail chest     ++ R.rib # Surgical emphysema Pulmonary contusions  29yo male RTA Open-book pelvic #    Diastasis of symphisis pubis & sacro-iliac jnt L.femur dislocation  24yo man RTA Femoral diaphysis # Fat Embolism     Bilateral diffuse pulmonary infiltrates 24-48hrs postinjury  85yo patient Cerebral atrophy    54yo female Sudden headache SAH   Blood in sulci, both sylvian fissues, & 4th ventricle Temporal horns of lat.ventricles dilated - hydrocephalus   Cerebral angiogram Berry Aneurysm at bifurcation of middle cerebral Artery   56yo alcoholic fallen over Acute SDH        High-density Crescentic Extra-cranial Concave inner margin Convex outer margin Mass-effect: midline displacement  36yo HI: GCS Acute EDH         Lens-shaped Biconcave High-density Extra-axial R.parietal region Min.mass effect Some air  Middle meningeal A  76yo man: HI & on warfarin ICH    Acute haematoma Surrounding oedema  Meningioma  Densely calcified   1) IJV 2) CCA    65yo male CABG Difficult intubation Tooth in R.lower zone    80yo male Fever, productive cough, haemoptysis, weight loss Active pulmonary TB   Bilateral upper lobe cavities   30yo male Cough, SOB, weight loss PCP   50yo on ITU coagulopathic Malpositioned subclavian CVC into RIJ vein R.neck soft tissue swelling Mediastinal haematoma     Repeated cannulation attempts  Asymptomatic middleaged man Bamboo spine Ankylosing Spondylitis    35yo with long Hx of productive cough Dextrocardia Situs Invertus Kartagener’s syndrome     RLL bronchiectasis  Trauma – heavy overhead object fell on patient Bilateral 1st rib #   Swallowed foreign object   24yo man RTA L.chest trauma Aortic rupture Multiple rib # Haemothorax     L.mastectomy  Normal C-spine