Intro to Chest Radiology

Develop a System Helps you remember things to check Helps you remember things to check Mneumonic vs anatomic Mneumonic vs anatomic

Basics Technique Technique –PA & Lateral –AP or Portable Indication Indication Identification Identification Rotation Rotation Penetration Penetration Inspiration Inspiration Comparison Comparison

Techniques PA & Lateral PA & Lateral –More information –Two views –Standardized  Distance –Pt needs to be stable Portable Portable –Quick –Anywhere –One shot –No standardization

Basics Indication Indication –The more information, better read Identification of patient Identification of patient Penetration Penetration –See vertebral bodies through the heart? Rotation Rotation –Clavicular heads in relation to vertebral spine Inspiration Inspiration –Count 8-9 posterior ribs

Things to see ABCDE… ABCDE… Airways Airways –Trachea, endotracheal tube, etc Bones Bones –Clavicles, ribs, etc… Cardiac Cardiac Diaphragm (Right hemidiaphragm slightly higher (~1.5 cm) Diaphragm (Right hemidiaphragm slightly higher (~1.5 cm) Everything else (tubes), effusions Everything else (tubes), effusions

Abnormals

Lung findings Darker areas Darker areas –radiolucent –Pneumothorax –Cysts/bulla –Air bronchograms Lighter areas Lighter areas –Opacities –“infiltrates”  Blood  Pus  Water –Nodules or mass

Opacities Lobar or not…. Lobar or not…. Pneumonia Pneumonia Pulmonary Edema Pulmonary Edema –“fluffy,” diffuse, “bat wing” distribution Hemorrhage Hemorrhage –Cant tell by xray, need bronch

Next Step… COMPARE, COMPARE, COMPARE… COMPARE, COMPARE, COMPARE… New or old New or old Any growth Any growth Pattern of calcification Pattern of calcification Next Imaging step vs. other test Next Imaging step vs. other test

Summary ABCDE… ABCDE… Point out abnormalities Point out abnormalities Compare to old films Compare to old films Give your impression Give your impression