Medical Imaging Approach to Chest X-Rays

Lordotic

Lordotic view allows evaluation of upper lungs because it "raises" the clavicles out of the way. Therefore the beam is shot diagonally from below the waist towards the shoulders.

Review Densities

Different Views

Posterior-Anterior Lateral Anterior-Posterior Lordotic Lateral Decubitus

Technical Factors

Patient ID Side Markers Rotation Penetration Degree of Inspiration

Bones & Soft Tissues

Identify PA Bone Anatomy Review Bone Anatomy Review Fractures Lesions Decreased Bone Density

Pleura & Diaphragm

Parietal & Visceral Pleura Costophrenic Sulcus Diaphragm Diaphragm - Elevation Diaphragm - Depression Diaphragm - Free Air Evaluate for Appearance Effusion - Meniscus Effusion - Blunted Angles/Thickening Effusion - Fluid Pooling Effusion Mediastinal Shift Pneumothorax - Lung/Air Contrast Pneumothorax - Sulcus Sign Pneumothorax - Mediastinal Shift

Identify Structures #1 Identify Structures #2 Identify Structures #3 Identify Structures #4 Heart Size Pericardial Effusion Right Atrial Enlargement Left Atrium Enlargement Right Ventricle Enlargement Left Ventricle Enlargement Calcifications

Sillhouette Sign (Localizing Path)

Upper Airway/Trachea #1 Upper Airway/Trachea #2 Upper Airway/Trachea #3 Right Upper Lobe - Anatomy Right Middle Lobe - Anatomy Right Lower Lobe - Anatomy Left Upper Lobe - Anatomy Left Lower Lobe - Anatomy Right Upper Lobe - Evaluate Right Middle Lobe - Evaluate Right Lower Lobe - Evaluate Lingula - Evaluate Left Lower Lobe - Evaluate

Lung Parenchyma

Consolidation - Air Bronchogram Consolidation - Airspace Nodules Interstitial Disease Interstitial Disease - Reticular Pattern Interstitial Disease - Nodular Pattern Interstitial Disease - Recticulonodular Pattern Interstitial Disease - Kerly B Lines Pulmonary Edema - Peribronchial Cuffing Pulmonary Edema - Indistinct Pulmonary Vasculature Pulmonary Edema - Kerly B Lines Pulmonary Edema - Reticulonodular Pattern Pulmonary Nodules Atelectasis

Mediastinal Mass

Mediastinal Mass - Anterior Mediastinal Mass - Middle Mediastinal Mass - Superior Mediastinal Mass - Posterior

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