This is a skiagram of skull in Lateral view showing widening of diploic space and calcification of emissary vein

traversing through that space, giving hair-end on appearance.

So, this is a case of chronic haemolytic anemic - Thalassemia
G-6-PD
Sickle cell anemia
Hereditary Spherocytosis

This is a skiagram of skull in lateral view showing radiolucent

punched out lesion.
D/D : ALL
Histiocytosis-X
Bony metastasis
Neuroblastoma (Few cases)

This is a skiagram of chest in PA view showing a homogenous

opacity of lower zone of left lung, trachea is shifted to the right side
and no costo-phrenic & cardio-phrenic angle is visible on left side.
So, it is a case of left-sided Pleural Effusion.

This is a skiagram of chest in PA view showing increased translucency of the right hemithorax with no broncho-
vascular margin, trachea is shifted towards the left side.
This is a case of right-sided Pneumothorax(Can’t be commented as Tension Pneumothorax).

This is a skiagram of chest in PA view showing a straight fluid level at right

mid-zone of lung field, above the Line there is increased translucency with
no visible broncho-vascular markings and below there is homogenous
opacity & right-sided costo-phrenic and cardio-phrenic angle is not visible.
It is a case of right sided hydro-pneumothorax.
Rx : 100% O2

Left sided hydro-pneumothorax

Note : Corticosteroids is given in all serous cavity TB along

with ADT (Except-Abdominal Tb because it can lead to
perforation)

This is a skiagram of chest PA-view showing a homogenous opacity

on upper zone and some parts of middle zone of right lung, trachea is
in mid-line.
This is a case of right sided consolidation of lung.

This is a skiagram of chest in PA view showing white homogenous

opacity occupying the middle and lower zone of the left lung,
trachea is in central position, cardiac size is normal and there is no
other soft tissue shadow.
It is a case of left sided consolidation of lung(Pnemonia with pleural
effusion)

Primary Pulmonary TB (Right side Hilar opacity)

This is a skiagram of chest AP view showing multiple millet shaped

opacities spreading over both hemi-thorax, trachea is in mid-line.
This is a case of milliary mottling.
D/D : Miliary Tb
Sarcoidosis
Pneumoconiosis
Aspergillosis
Tropical eosinophilia
Loeffler syndrome
Hypersensitive pneumonitis

This is a skiagram of chest PA view showing cardiomegaly with up-

turned apex with normal lung field, trachea is central in position.
This may be a case of Tetralogy of Fallot.
Boot-shaped heart → TOF
Ebstein anomaly

This is a skiagram of chest PA view showing globular shaped

heart with narrow base, suggestive of pericardial effusion.
Causes : TB
Cardiac tamponade
ARF

TVGA, Tricuspid atresia

Egg on string/egg on side appearance

This is a skiagram of chest PA view showing globular shaped heart

with narrow base giving the appearance of water flask with normal
lung field, trachea is central in position.
This is a case of Pericardial Effusion.
Rx : Cardiocentesis
Percussion dull in left lower interscapular and infrascapular ; bronchial breath sound and increase vocal resonance

Water bottle appearance of heart

(Pericardial effusion)

This is a skiagram of abdomen in straight view showing multiple air fluid level.
This is a case of intestinal obstruction.
Normal air fluid level → I-3
Medical causes : Worm infestations
Intestinal Tb
Lead poisoning
Surgical causes : Mid gut obstruction (Malnutrition, Volvulus)
Not intussusception because it occurs at ileocaecal junction/large intestine

This is a skiagram of lower part of forearm, wrist joint and some parts of hands,
showing cupping/splaying/Fraying.
Cupping → Increase concavity of metaphysical plate
Splaying → widening of metaphyseal plate
Fraying → Irregularity and widening of epiphyseal growth plate
Suggestive of Active Rickets
Investigations : Serum Ca (low), Serum phosphate (low), Akaline phospatase (High)
Note - Alkaline phosphatase decreases the osteoblast activity
Rx : Inj. Vit.D (i.m) in gluteal region up to 1yr 3lac IU single dose
>1yr 6lac IU single dose
along with normal maintainence dose of vit.D, Ca, Phosphate.
Evidence of healing by 2wks in zone of preparatory calcification [ZPC](White line of
frinkle)
Repeat the same dose after 3wks, if ZPC not seen
If after 2nd dose, ZPC not seen then consider as vit.D resistant ricket.

This is a skiagram of knee joint in PA view, lower end of femur & upper
end of tibia and fibula showing pencil thin cortex.
This is suggestive of Scurvy.

Scurvy → X-ray: 1. white line of frankly (pencil like thinning of cortex)

2. Trumford Zone.