Chest x-ray - Revision history

Aidan at 14:41, 27 March 2026

2026-03-27T14:41:22Z

← Older revision		Revision as of 14:41, 27 March 2026
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	* Heart borders: they should be clear and well-defined		* Heart borders: they should be clear and well-defined
	** If obscured, it suggests pathology of the adjacent lung		** If obscured, it suggests pathology of the adjacent lung
			* Hila:
	* ~~Hila: should~~ be similar density bilaterally, with left hilum at ~~the same level~~ as the right ~~hilum or slightly higher~~		** Should be similar density bilaterally, with left hilum never lower than the right
			** Look for the "little fingers" of the pulmonary arteries bilaterally; when lost, can suggest atelectasis of adjacent lower lobe
	* Bones		* Bones
	* Overlooked sites: lung apex, superimposed on the heart, around each hilum, under the diaphragm		* Overlooked sites: lung apex, superimposed on the heart, around each hilum, under the diaphragm

Aidan at 14:07, 27 March 2026

2026-03-27T14:07:23Z

← Older revision		Revision as of 14:07, 27 March 2026
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	== ~~Interpretation~~ ==		== Two Views ==

	=== ~~Assess~~ ~~Quality~~ ===		=== Frontal View ===

			==== Assess Quality ====
	* May be PA (preferred, taken at a standard 1.8 m distance) or AP (done for patients who are unable to go to imaging department or to position for PA)		* May be PA (preferred, taken at a standard 1.8 m distance) or AP (done for patients who are unable to go to imaging department or to position for PA)
	** PA will magnify the mediastinum		** PA will magnify the mediastinum
	** AP more often done at an upward angle, which can blunt the left dome of the ~~diaphram~~		** AP more often done at an upward angle, which can blunt the left dome of the diaphragm
	* Inspiration: at least 6 anterior ribs should be above the left dome of the diaphragm		* Inspiration: at least 6 anterior ribs should be above the left dome of the diaphragm
	** Shallow inspiration can result in enlarged cardiac diameter, crowding of lung vessels, and basal atelectasis		** Shallow inspiration can result in enlarged cardiac diameter, crowding of lung vessels, and basal atelectasis
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	** AP rotated left can also make aortic arch more prominent		** AP rotated left can also make aortic arch more prominent

	=== Assess Pathology ===		==== Assess Pathology ====

	* Cardiothoracic ratio: should be less than 50% on a PA x-ray		* Cardiothoracic ratio: should be less than 50% on a PA x-ray
	** If greater, it suggests cardiomegaly		** If greater, it suggests cardiomegaly
	* Domes of the diaphragm: they should be clear and well-defined		* Domes of the diaphragm: they should be clear and well-defined
	** If obscured, it ~~could suggest~~ pathology of the adjacent lung		** If obscured, it suggests pathology of the adjacent lower lung
	* Heart borders: they should be clear and well-defined		* Heart borders: they should be clear and well-defined
	** If obscured, it ~~could suggest~~ pathology of the adjacent lung		** If obscured, it suggests pathology of the adjacent lung
	* Hila: should be similar density bilaterally, with left hilum at the same level as the right hilum or slightly higher		* Hila: should be similar density bilaterally, with left hilum at the same level as the right hilum or slightly higher
	* Bones		* Bones
	* Overlooked sites: lung apex, superimposed on the heart, around each hilum, under the diaphragm		* Overlooked sites: lung apex, superimposed on the heart, around each hilum, under the diaphragm

			=== Lateral View ===

			* Vertebral bodies: should become more transparent as they descend
			** If they fail to do so (i.e. become whiter, or stay the same density), it suggests lower lobe disease
			* Domes of the diaphragm: they should be clear and well-defined
			** The right dome is visible front to back, while the left dome delineation fades anteriorly, where it merges with the cardiac shadow
			** If obscured, it suggests pathology of the adjacent lower lung
			* Hila: assess the size/density (should be normal) and the borders (should be well-defined rather than bumpy or irregular)
			* Cardiac shadow: any well-defined or abrupt change could suggest pathology
			* Lungs: assess for lung densities, paying particular attention to the cardiac shadow, posterior to heart, and in the costophrenic recess

			== Parenchymal Changes ==

			=== Alveolar and Interstitial Changes ===

			* Something radiodense (pus, blood, water, protein, debris) can fill the alveoli, or the interstitial tissue that supports and surrounds the alveoli can become radiodense (from edema, inflammation, fibrosis)
			* However, it can be very difficult to categorize into one or the other category

			{\| class="wikitable"
			!
			!Alveolar
			!Interstitial
			\|-
			\|Common findings
			\|
			* Fluffy or blobby opacity with ill-defined edges
			* May be coalescent
			* May follow segmental or lobar distribution
			\|
			* May have small nodules or linear/reticular/reticulonodular opacities
			\|-
			\|Occasional findings
			\|
			* Air bronchograms may be seen
			\|
			* Honeycombing (in advanced disease)
			* Decreased lung volumes (in advanced disease)
			\|}
	[[Category:Investigations]]		[[Category:Investigations]]
	[[Category:Respirology]]		[[Category:Respirology]]

Aidan at 19:45, 24 March 2026

2026-03-24T19:45:16Z

← Older revision		Revision as of 19:45, 24 March 2026
Line 23:		Line 23:
	* Hila: should be similar density bilaterally, with left hilum at the same level as the right hilum or slightly higher		* Hila: should be similar density bilaterally, with left hilum at the same level as the right hilum or slightly higher
	* Bones		* Bones
	* ~~Specific~~ sites: lung apex, superimposed ~~over~~ the heart, around each hilum, ~~below~~ the diaphragm		* Overlooked sites: lung apex, superimposed on the heart, around each hilum, under the diaphragm

	[[Category:Investigations]]		[[Category:Investigations]]

Aidan: Created page with "== Interpretation == === Assess Quality === * May be PA (preferred, taken at a standard 1.8 m distance) or AP (done for patients who are unable to go to imaging department or to position for PA) PA will magnify the mediastinum AP more often done at an upward angle, which can blunt the left dome of the diaphram * Inspiration: at least 6 anterior ribs should be above the left dome of the diaphragm ** Shallow inspiration can result in enlarged cardiac diameter, crow..."

2026-03-24T19:34:16Z

Created page with "== Interpretation == === Assess Quality === * May be PA (preferred, taken at a standard 1.8 m distance) or AP (done for patients who are unable to go to imaging department or to position for PA) ** PA will magnify the mediastinum ** AP more often done at an upward angle, which can blunt the left dome of the diaphram * Inspiration: at least 6 anterior ribs should be above the left dome of the diaphragm ** Shallow inspiration can result in enlarged cardiac diameter, crow..."

New page

== Interpretation ==

=== Assess Quality ===

* May be PA (preferred, taken at a standard 1.8 m distance) or AP (done for patients who are unable to go to imaging department or to position for PA)
** PA will magnify the mediastinum
** AP more often done at an upward angle, which can blunt the left dome of the diaphram
* Inspiration: at least 6 anterior ribs should be above the left dome of the diaphragm
** Shallow inspiration can result in enlarged cardiac diameter, crowding of lung vessels, and basal atelectasis
* Rotation: spine of the vertebral bodies should be midline between the heads of the clavicles
** Can make one lung appear lighter/darker compared to the other
** PA rotated right can result in prominent aortic arch on the right, simulating mediastinal mass
** AP rotated left can also make aortic arch more prominent

=== Assess Pathology ===

* Cardiothoracic ratio: should be less than 50% on a PA x-ray
** If greater, it suggests cardiomegaly
* Domes of the diaphragm: they should be clear and well-defined
** If obscured, it could suggest pathology of the adjacent lung
* Heart borders: they should be clear and well-defined
** If obscured, it could suggest pathology of the adjacent lung
* Hila: should be similar density bilaterally, with left hilum at the same level as the right hilum or slightly higher
* Bones
* Specific sites: lung apex, superimposed over the heart, around each hilum, below the diaphragm

[[Category:Investigations]]
[[Category:Respirology]]