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Introduction to the CXR

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Intro to Chest Radiology Develop a System Helps you remember things to check  Mneumonic vs anatomic  Basics  Technique – PA & Lateral – AP or Portable       Indication Identification Rotation Penetration Inspiration Comparison Techniques  PA & Lateral – More information – Two views – Standardized  Distance  Portable – – – – Quick Anywhere One shot No standardization – Pt needs to be stable Basics    Indication – The more information, better read Identification of patient Penetration – See vertebral bodies through the heart?   Rotation – Clavicular heads in relation to vertebral spine Inspiration – Count 8-9 posterior ribs Things to see    ABCDE… Airways – Trachea, endotracheal tube, etc Bones – Clavicles, ribs, etc…    Cardiac Diaphragm (Right hemidiaphragm slightly higher (~1.5 cm) Everything else (tubes), effusions Abnormals Lung findings  Darker areas – – – – radiolucent Pneumothorax Cysts/bulla Air bronchograms  Lighter areas – Opacities – “infiltrates”  Blood  Pus  Water – Nodules or mass Opacities Lobar or not….  Pneumonia  Pulmonary Edema  – “fluffy,” diffuse, “bat wing” distribution  Hemorrhage – Cant tell by xray, need bronch Next Step… COMPARE, COMPARE, COMPARE…  New or old  Any growth  Pattern of calcification  Next Imaging step vs. other test  Summary ABCDE…  Point out abnormalities  Compare to old films  Give your impression 

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