cxr 101

chest x-ray 101

methodology - look at

bones, soft tissues, heart/mediastinum, lungs, airways, upper abdomen

pa view preferred because doesn't magnify the heart

spine sign - decreasing intensity of spin as you go caudal on the lateral view xray

silhouette sign - loss of margins bc two structures of similar densities sitting next to each other

atelectasis - incomplate expansion of portion of lung

sail sign - silhouetteing of left diaphragm for left lower lobe atelactasis, mass

s sign of golden - right upper lobe collapse, (anterior collapse), reverse s sign on pa, right side - obstructive mass causing collapse

pneumonias -

PCP pneumonia seldom if ever cause pleural effusion

with PCP you get sharp costophrenic angles and possible cystic structures (PCP)

septic emboli - rh valves peripheral thrombophlebitis etc.. predominant peripheral lung disease, ct more sensitive than cxr, see nodles, feeding vessel sign, cavitation, wedge lesions

tb can look like anything!

ghon complex, cavitary, miliary, they appear everywhere- (spread by blood)

left hilum normally higher than right hilum, if reversed indicates potential atelectasis

intersitial edema - kerley b lines (transverse near lower lung fields, septal lines)

alveolar edema - begin to lose vessels