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How to interpret CXRs for OSCEs

How to interpret CXRs for OSCEs

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Systematic approach to interpreting Chest X-Rays for medical school OSCE exams
Systematic approach to interpreting Chest X-Rays for medical school OSCE exams

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Published by: Prarthana Thiagarajan on Jun 04, 2008
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05/19/2013

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How to interpret CXRs for the ICE
1.Dim room lighting
2.
Check patient information- name, age, sex, date of radiograph
3.
Identify radiographic technique- AP/PA film, exposure, rotation,patient position (supine, sitting or erect)
4.
5.
Soft tissues– foreign bodies (metal), thickness, contours, presenceof gas, masses, mastectomy
6.
Lungs(parenchyma)- look for abnormal densities (opacity orlucency) or Pneumothorax-Look at lung volumes (hyperinflated in COPD)
-
Look at each lobe and compare (esp. apices)
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Linear atelectasis-If shadowing: look for air bronchograms
7.
Hila- position, masses or lymphadenopathy
8.
Heart- size and shape
9.
Pulmonary vessels- artery or vein enlargement (follow outwards)
10.
Bones– density, lesions or fractures. Clavicle, scapula, ribs.
11.
Pleura- thickening, calcification, effusion or Pneumothorax
12.
 Trachea- midline or deviated, wall, lumen diameter
13.
Mediastinum- width and contour, discreet masses
14.
Check review areas- apices, especially right upper lobe,retrocardiac area, the peripheral lung margins, posteriorcostophrenic sulci, and thediaphragm.
CXR signs of heart failure:
1.Alveolar oedema2.Kerley B lines3.Cardiology4.Distended upper lobe vessels5.Pleural effusionsCauses of consolidation: infection, pulmonary oedema, sarcoidosis, neoplasm,infarction (following PE), haemorrhage.

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