Chest X-Rays for Medical Students (eBook)

CHRISTOPHER CLARKE, Consultant Radiologist at Nottingham University Hospitals NHS Trust, Nottingham, UK. He is a member of the British and European Societies of Gastrointestinal and Abdominal Radiology. ANTHONY DUX, Former Consultant Radiologist and Honorary Senior Lecturer at the University Hospitals of Leicester NHS Trust, Leicester, UK.

Preface to the 2nd Edition ix

Acknowledgements xi

Learning objectives checklist xiii

About the companion website xv

Part I Introduction to X-rays 1

1 Introduction to X-rays 3

What are X-rays? 3

How are X-rays produced? 3

How do X-rays make an image? 4

The five densities on an X-ray 4

How are X-ray images (radiographs) stored? 4

Hazards and precautions 5

2 Chest X-ray views 7

PA erect chest X-ray 7

Other views 8

3 Radiograph quality 9

Inclusion 9

Rotation 10

Inspiration 11

4 Normal anatomy on a PA chest X-ray 13

Right and left 13

Lung zones 14

The mediastinum 14

Normal pulmonary vasculature 15

General anatomy 16

Bronchial and lobar anatomy: Figure 4.8 17

5 Presenting a chest radiograph 19

Example of presenting a normal chest X-ray 19

Part II The ABCDE of chest X-rays 21

6 A - Airway 23

How to review the airway 23

What to look for 24

Tracheal deviation 24

Carinal angle 25

7 B - Breathing 27

How to review the lungs 27

What to look for 28

Consolidation/airspace opacification 29

Air bronchogram 31

Collapse (atelectasis) overview 32

Pneumonectomy 41

Solitary mass lesion 44

Multiple mass lesions 47

Cavitating lung lesion 48

Fibrosis 50

Pneumothorax 53

Tension pneumothorax 55

Hydropneumothorax 56

Pleural effusion 57

Pulmonary oedema 60

Septal lines 64

Asbestos-related lung disease 65

8 C - Circulation 69

How to review the heart and mediastinum 69

What to look for 69

Dextrocardia 69

Cardiomegaly (enlarged heart) 70

Left atrial enlargement 71

Widened mediastinum 72

Hilar enlargement 76

Hiatus hernia 78

9 D - Disability 79

How to review the bones 79

What to look for 80

Fractures 80

Sclerotic and lucent bone lesions 81

10 E - Everything else (review areas) 83

How to look at the review areas 83

What to look for 83

Gas under the diaphragm (pneumoperitoneum) 84

Subcutaneous emphysema/surgical emphysema 86

Mastectomy 87

Medical and surgical objects (iatrogenic) 88

Foreign bodies 99

Part III Common conditions and their radiological signs 101

11 Common conditions and their radiological signs 103

Pulmonary embolism (PE) 103

Primary lung malignancy 103

Pneumonia 104

Chronic obstructive pulmonary disease (COPD) 104

Heart failure 105

Tuberculosis 106

Glossary 111

Index 119