HOW READ CHEST XR -14

ANAS SAHLE ,MD

Brief review

PATCHY

INFILTIRATION

NODULE

MASS

CAVITARY

OPACITY

Consolidation

Infection causes

Pneumonia Non-infection causes

Lymphoma

Broncho-

alveolar

carcinoma

COP

WEGNER disease

Sarcoi

d

Cardiac

failure

Solitary Pulmonary Nodule(SPN)

Comparison with a previous x-ray toAssess growth over time.

Cavitary lesion

Air + tissueAir-fluid level

StraightAbscess

Wavy ruptured

Hydatid cyst

Air only

ThickIrregular

inner wall

Cavitating

neoplasm

Regular

inner wall

Chronic

abscess

ThinPeriph

eral Emphesemato

us bulla

Centralpneu

matocele

Wall thickness

site1. Fungal ball.2. Rupture hydatid cyct3. Necrotic tumor4. Blood glot

LINEAR PATTERN

LINEAR PATTERNPerihilar and peripheral basal septal lines,changes acutely and resolves with diuretics

LEFT VENTRICULAR FAILURE

Coarsening of lung markings in lower zones, nochange on review of recent films

Normal ageing

Coarse nodular and linear thickening ofmarkings, known malignancy, often associatedwith pleural effusion, rapid clinicaldeterioration of patient

Lymphangitis

LINEAR PATTERNLINEAR PATTERN

Short thin lines, often basal, new on review ofprevious films

Atelectasis

Longer thicker bands, often perihilar or basal,suggest recent infection or infarction

Subsegmentalcollapse

Any length, persist over time unchanged

Volume loss is key, persists over time

Scarring

Fibrosis

Causes of fibrosisMid zone lung Lower zone lung Upper zone lung

tuberculosis Drug indused fibrosis(most common)

sarcoidosis

Chronic extrinsic allergic alveolitis

UIP

Radio-therapy Asbestose-related fibrosis

Ankylosing spondylitis

Progressive massive fibrosis

histoplasmosis

Mediastinum

MEDIASTINAL ANATOMY 

Superior: Upper of T4Inferior: Lower of T4( T4-T8)