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    20 views14 pages

    CXR PDF

    Uploaded by

    Alif Faizal

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
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    of 14
    Nodule iit: St y/o Asymptomatic Male ‘The riame and date have been verified - Previous films ive been obtained for t comparison. This is a PA view. The patient has tken a nearsadequate inspiration. There are 8 visible posterior ribs inthe right hemithorax. ‘The film is slightly underpenetrated but there is adequate lung detail. The trachea is midline and the clavieles are equidistant from the trachea. The patient is well-positioned, b ‘What can be seen of the soft tissues and bony structures appears to be symmetric. There is no calcification or mass. There is no bony deformity, fracture, lytic lesion or dislocation, ‘The mediastinum is narrow with no obvious deferities ‘There is a nodular tesion adjacent to the heart in the left hemithorax. The nodule has white, punctated deasities that represent calcifications. The densities are distributed in peculiar “popcorn” pattern. It measures 6 em in size. The nodule does not obliterate the heart border, | ‘The width of the heart is less than 30% of the width of the ribcage. ‘The hemidiaphragm margins are sharp, clear and at & reasonable height. There is o evidence of pleural fluid ‘There are no visible sifhouette signs, air-beonchograms or fluid menisci. There is no. ‘evidence of atelectasis or lobar collapse. ‘On the lateral view, this large module is seen beneath the oblique fissure. is ‘well-circumscribed, with sharp margins and 1 spiculations. It is 6 cm in diameter. Based on our CXR findings we can make the diagnosis of @ large wodule ln the superior Segment of the left lower lobe. The ‘calcification, smooth borders and wellcircumscribed features suggest that this és a benign lesion. The “popeorn” patiern of ‘calcification is consistent with a hamartoma This hamartoma is quite targe as most are Jess than 4-cmt in diameter, but this lesion bs 6 ‘em. The character of the calcification is what suggests the diagnosis of hamartoma. ‘Remember ta correlate these findings with the differential diagnosis from the Nistory and physical (ériengutation)!! Aelectasis #1: 25 y/o female with non-productive cough and wheezing ‘The name and date have been verified. Previous films: have been ‘obtained for comparison. The first film is a PA view. The patient has ‘taken an adequate inspiration. There are 9 visible posterior ribs in ‘the right hemithorax. The film is well penetrated with adequate lung detail, The trachea is midline and the clavieles are equidistant from ‘the trachea. The patient is well-positioned, ‘The soft tissues and bony structures are symmetric. There is no ‘calcification or mass, There is no bony deformity, fracture, lytic lesion or dislocation. ‘The mediastinum is narrow with no deformities. The width of the heart is less than 50% of the width of the ribcage, ‘There is an area of increased density om the left side of the heart shadow which blurs the edge of the descending thoracic aorta (silhouetie sign). Also, if you look carefully, you will note that the feft mainstem broschus and the left hilar vessels are displaced downwards. This may be easier te see if you compare with the right side, ‘The medial portion of the left hemidiphragm Is obscured (silhouette sign). The right hemidiaphragm margins are sharp are clear, The diaphragms are at a reasonable height. There is no evidence of pleural fluid, ‘The left upper lung appears “blacker” than usual with increased spreading of the vessels. There ane no visible, air-bronchograms, nodules oF fluid menisci. On the Lateral view, the left posterior diaphragm is obseured which is consistent with our findings on the PA (silhouette sign). Based on our CXR findings we cam make the diagnosis of atelectasis of the left lower lobe. The collapsed lobe is contiguous with the mediat (posterior) diaphragm and the descending thoracic aorta, The collapse leads to shift of the left mainstem bronchus and left hilar vessels as well as hyperacration of the left upper lobe. ‘A'59-year-old woman with hypertension and diabetic nephropathy presented with a sudden onset of dyspnoes after discontinuing her medications, Physical examination revealed hypenension (BP 225/122 mmlg), tachycardia (HR. 112 bpm). tachypnoes (24 breaths per minute), and hypoxemia (Sa02 = 94% despite treatment wit supplementary oxygen). The patient also had elevated IVP, bilateral rales, and oedema of the legs. The level of BNP was elevated (780.8 pg/ml. Normal level < 18.4). A chest radiograph showed an enlarged cardiac sihouctter a dilated azygous vein adn peribronchial euffing, in addition to Kerley's A, B, and C lines: Kerley A lines (arrows) are linear opacities extending form the periphery to hila, they are caused by distention of anastomotic

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