100 Chest X Rays for Study Group. by Dr. Suneet Khurana

Transcription

1 100 Chest X Rays for Study Group by Dr. Suneet Khurana

2 Approach to - Chest X Ray (shadow of the viscera on a photographic plate) Gas appears Black Fat appears Dark Grey Water Appears as Light Grey Bone appears White

3 Approach to Chest X Ray Views 1)Postero Anterior (PA) - Standard 2)Antero Posterior (AP) 3)Apical Lordotic (Apex of lungs) 4)Oblique 5)Lateral Decubitus (pleural effusions)

4 Steps to Systematic Approach 1) Scan patient data and Determine the Film Quality ( Exposure, Inspiration, Position) 2) Examine the Chest Wall a) Vertebral Column b) Ribs c) Clavicles & Proximal Humeri d) Skin and Subcutaneous Tissues + Soft Tissues e) Breasts

5 Steps to Systematic approach 3) Examine the Abdomen 4) Examine the Diaphragm 5) Examine the Pleura 6) Examine the Heart 7) Examine the Mediastinum 8) Examine the Hila 9) Examine the Lungs

6 Mediastinal Masses Thyroid goitre/carcinoma, Lymphoma, Neural tumours Tuberculosis, Histoplasmosis Metastatic lymphadenopathy Germ cell tumours, Sarcoidosis Thymoma, Hiatal hernia, Aortic aneurysm Pericardial fat, Esophageal diseases Metastatic lymphadenopathy

7 Case 1 Foreign Body Right Lower Lobe

8 Case 2 Foreign Body Sword Swallow

9 Case 3 Bilateral Hilar Adenopathy

10 Case 4 Previous Thoracotomy Left Lung

11 Case 5 - B/L Lower Lobe Pneumonia

12 Case 6 R Lower Lobe Consolidation TB in HIV

13 Case 7 TB with Cavitation

14 Case 8 Ruptured Liver Abscess in Pleural Cavity

15 Case 9 Ruptured Liver Abscess (Shock, Fever x 4 days)

16 Case 10 Retrosternal Goiter (Asymptomatic 70 y F)

17 Case 11 Retrosternal Goiter

18 Case 12 Pneumonia (Fever, Cough, Sputum 35y M)

19 Case 13 Mediastinal Emphysema

20 Case 14 Mediastinal Emphysema

21 Case 15 Interstitial Emphysema

22 Case 16 Mediastinal & Interstitial Emphysema

23 Case 17 Mediastinal Lipomatosis

24 Case 18 Anomalous Pulmonary Venous Drainage

25 Case 19 Posterior Mediastinal Mass Neurogenic Origin

26 Case 20 Posterior Mediastinal Mass Sarcomatoid Carcinoma

27 Case 21 Active Pulmonary Tuberculosis

28 Case 22 Squamous Cell Carcinoma with Malignant Pleural Effusion (arising from R bronchus)

29 Case 23 Broncholithiasis in Previously Treated TB

30 Case 24 Displaced Pulmonary Artery Catheter (MI management in CCU)

31 Case 25 Bronchiolitis Obliterans Organizing Pneumonia

32 Case 26 Bamboo Spine Ankylosing Spondylitis

33 Case 27 Mediastinal Hematoma (Malpositioned Central Venous Catheter, Neck Hematoma)

34 Case 28 Silicosis with Massive Pulmonary Fibrosis

35 Case 29 Bronchiectasis

36 Case 30 AML with Pulmonary Angio Invasive Aspergillosis

37 Case 31 Invasive Pulmonary Aspergillosis

38 Case 32 Right Upper Lobe Collapse (Golden Sign)

39 Case 33 Westmark Sign of Acute Pulmonary Embolism

40 Case 34 Left Primary Spontaneous Pneumothorax

41 Case 87 Radiation Fibrosis of R Lung

42 Case 31 Miliary Tuberculosis

43 Case 35 Right Pneumothorax (COPD with bullae)

44 Case Pack yr (5y Dyspnea) COPD (hyperinflation)

45 Case 37 B/L First Rib Fractures

46 Case 38 Mediastinal Lipomatosis

47 Case 39 Bronchogenic Cyst

48 Case 40 Dissecting Thoracic Aortic Aneurysm

49 Case 41 Chronic Eosinophilic Pneumonia (Cough, Fever, Raised Eosinophils x 3 months)

50 Case 42 L Upper Lobe Collapse due to Lung Cancer (Hemoptysis, Loss of Wt x 2 months)

51 Case 43 Severe Pneumonia

52 Case 44 Osler Weber Rendu (AVM, Epistasis) Hereditary Hemorrhagic Telengiectasia

53 Case 45 - Pulmonary Edema

54 Case 46 Eisenmenger Syndrome due to PDA

55 Case 47 Right Pleural Effusion (Cirrhosis of liver)

56 Case 48 - Hamartoma

57 Case 49 Asbestosis

58 Case 50 Acute Respiratory Distress Syndrome (Secondary to Pancreatitis)

59 Case 51 - Acute Respiratory Syndrome

60 Case 52 - Massive Left Pleural Effusion

61 Case 53 Chiladiti Sign (Transverse Colon between Liver and Right Hemidiaphragm)

62 Case 54 Malignant Mesothelioma

63 Case 55 - R Lower Lobe Consolidation due to TB in HIV

64 Case 56 Right Sided Aortic Arch

65 Case 57 - Chronic Eosinophilic Pneumonia

66 Case 58 Eventration of Right Hemidiaphgram

67 Case 59 - Traumatic Aortic Disruption

68 Case 60 Pneumothorax

69 Hydatid Cyst (Echinococcosis)

70 Case 61 Posterior Mediastinal Mass - Neuoroblastoma

71 Case 62 Bronchiectasis

72 Case 62 Solitary Pulmonary Nodule

73 Case 63 Lung Sequestration Right Heart Border (Hemoptysis)

74 Case 64 Crush Injury - Left Diaphgramatic Hernia

75 Case 65 Calcified Left Ventricular Aneurysm (Post MI)

76 Case 66 - Metastasis from Colorectal Cancer

77 Case 67 - Dextrocardia

78 Case 68 Fracture Clavicle & Scapula

79 Case 69 - Boerhaave s Syndrome

80 Boerhaave s Syndrome (Esophageal Perforation)

81 Case 70 - Phrenic Nerve Palsy

82 Case 71 Tracheal Tumor (Adenoid Cystic CA)

83 Case 72 - Pulmonary Pesudo-nodules due to Nipple Shadows

84 Case 73 Cryptogenic Fibrosing Alveolitis

85 Case 74 Pericardial Cyst

86 Case 75 Cardiac Tamponade

87 Case 76 - Mediastinal Lymphadenopathy secondary to Lymphoma

88 Case 77 - Malpositioned Nasogastric Tube

89 Case 78 Azygous Lobe (Tear drop shaped accessory lobe of the R Lung)

90 Case 79 Silicosis (Sand Quandry Worker)

91 Hydropneumothorax Vs Pleural Effusion

92 Case 80 B/L Calcified Pleural Plaques (Asbestosis)

93 Case 81 Lytic Lesion Right Humerus

94 Case 82 - Loculated Pleural Effusion R Lung

95 Case 83 Hiatus Hernia

96 Case 85 - Massive Cardiomegaly (End Stage Valvular Ds) D/D of Pleural Effusion (Thoracentesis Contraindicated)

97 Case 86 Left Lower Lobe Lobectomy

98 Case 87 - Chronic Calcific Pericarditis

99 Case 88 Collapse of Left Lung

100 Case 89 Aspergilloma (Post Rx TB R Lung)

101 Case 90 - Fractured Ribs with Callus

102 Case 91 Oligemia of R Lung (Carcinoid tumor of Right Main Stem Bronchus)

103 Case 92 Pneumoperitoneum

104 Case 93 - Cardiomegaly

105 Case 94 Thoracoplasty (1950 removal of upper TB infected lung, with subsequent pleural calcification)

106 Case 95 Left Lower Lobe Collapse

107 Case 96 Tracheal Stenosis due to Tracheopathia Osteochondroplastica

108 Case 97 Mass in Bronchus (Collapse of Middle, and Lower Lobe R Lung

109 Case 98 Primary Pulmonary Hypertension

110 Case 99 Lung Abscess

111 Case Lung Cancer with Lymphangitis Carcinomatosis

112 Case 101 Pneumocystis Carinii Pneumonia

113 Case 102 Pericardial Fat Pad (No Change in cardiac shadow over a period of 16 months)

114 Case 103 Accessory Cervical Ribs

115 Thank You