10/16/2013 Charles Q. Li, MD UCSD Radiology PGY-2 UCSD SOM c/o 2012.

Chest Radiography 10110/16/2013Charles Q. Li, MDUCSD Radiology PGY-2UCSD SOM c/o 2012

Contents• Indications• Normal anatomy• How to read & pathology

Indications• Dyspnea• Chest pain• Trauma• Cough• Fever• Follow-up: PTX, effusion

Indications• NOT• Rule-out ANYTHING• Suspicion for lung mass• Lung cancer screening in asymptomatic patients• Metastatic workup• Interstitial lung disease evaluation• Supine imaging for PTX or effusion• Frontal view only for foreign body

Normal anatomy• http://www.radiologymasterclass.co.uk/tutorials/tu

torials.html

Normal anatomy

Normal anatomy

http://drsvenkatesan.wordpress.com/2008/10/06/what-is-the-anatomical-relationship-between-pulmonary-artery-and-pulmonary-veins/

Normal anatomy - airways

Normal anatomy - airways

Normal anatomy – pulmonary vasculature

Normal anatomy – pulmonary vasculature

Normal anatomy – lateral view

http://www.radiologyassistant.nl/en/p497b2a265d96d/chest-x-ray-basic-interpretation.html

How to read• Quality assessment• Penetration• Rotation• Inspiration• Motion

• Tubes, Lines & Drains• Search pattern – “ATMLL”• Abdomen• Thorax• Mediastinum• Lung (individual)• Lungs (both)

How to read – quality assessment

Well penetrated Over penetrated

http://www.med-ed.virginia.edu/courses/rad/cxr/technique6chest.html

Under penetrated

How to read – quality assessment

Centered Rotated

How to read – quality assessment

Well-expanded Poorly-expanded

How to read – quality assessment

Still Moving

Tubes, Lines & Drains

Search pattern – “ATMLL”

Abdomen

http://clinicalcases.org/

Thorax

Mediastinum

http://en.wikipedia.org/

Mediastinum

http://radiopaedia.org/

Mediastinum

http://www.learningradiology.com/

Normal anatomy – pulmonary vasculature

Normal anatomy – pulmonary vasculature

Mediastinum

http://www.learningradiology.com/

Lung

Lung

Lung

Lung

http://www.mypacs.net/cases/ (case 3398198)

Lung

Lung

http://en.wikipedia.org/

Lung

Lung

Lung

http://emedicine.medscape.com/article/355524-overview

Lung

Lung

http://radiopaedia.org/

Lung

http://www.statdx.com/

Lung

http://www.med-ed.virginia.edu/courses/rad/cxr/pathology1Achest.html

Lung

http://radiopaedia.org/articles/*******-atelectasis

ATMLL

Thanks!• Charles Q. Li• CharlesQLi@ucsd.edu

• Good learning resources:• radiopaedia.org• radiologyassistant.nl/en/• radiologymasterclass.co.uk