http://www.drkhanblogs.com/2015/06/understanding-chest-x-rays-chest-x-rays.html Dr Khan Health Blogs.

1. Basic
Interpretation of
Chest X.rays And
common diseases

3. Five Radiographic Opacities
Air Fat Soft tissue Bone Metal
least opaque to most opaque
most lucent to least lucent
Black to White

4. ANATOMY

5. Lobes
• Right upper lobe:

6. • Right middle lobe:

7. • Right lower lobe:

8. • Left upper lobe with Lingula:

9. • Left lower lobe:

20. Portable (AP or Antero-
posterior)
FILM

22. PA (Postero-anterior)
FILM

24. PA vs AP views
PA view
 Scapula is seen in
periphery of thorax
 Clavicles project
over lung fields
 Posterior ribs are
distinct
AP view
 Scapulae are over
lung fields
 Clavicles are above
the apex of lung
fields
 Anterior ribs are
distinct

29. Rotation

31. 9

135. • Lobar consolidation:
– Alveolar space filled
with inflammatory
exudate
– Interstitium and
architecture remain
intact
– The airway is patent
– Radiologically:
• A density corresponding
to a segment or lobe
• Air bronchogram, and
• No significant loss of lung
volume
Consolidation

136. Consolidation

168. COMMON CHEST
X.RAYS

169. Congestive Heart Failure
 Increased heart size:
cardiothoracic ratio
>0.5

170. CongestiveHeartFailure
 Alveolar edema
(Bat’s wings)
 Kerley B lines
(Interstitial edema)
 Cardiomegaly
 Dilated prominent
upper lobe vessels
 Pleural effusion

172. ARDS
 Congestion
 Interstitial and
alveolar edema
 Collapsed or
distended alveoli
 Bilateral

173. Pneumothorax

174. Right side
tension
pneumothorax

175. Pleuraleffusion

176. Right Side
Pleural
Effusion

177. RLL
Pneumonia

178. ?????????????????????

179. A single, 3cm relatively thin-walled cavity is noted in the left
midlung.This finding is most typical of squamous cell carcinoma
(SCC). One-third of SCC masses show cavitation

180. ???????????????

181. Right Middle and Left Upper Lobe Pneumonia

182. ????????????

183. Cavitation : cystic changes in the area of consolidation due to the
bacterial destruction of lung tissue. Notice air fluid level.

184. Cavitation

185. ????????????

186. Tuberculosis

187. ??????????

188. COPD: increase in heart diameter, flattening of the diaphragm,
and increase in the size of the retrosternal air space. In addition
the upper lobes will become hyperlucent due to destruction of
the lung tissue.

189. ????????

190. CHF:a great deal of accentuated interstitial markings,
Curly lines, and an enlarged heart. Normally indistinct
upper lobe vessels are prominent but are also masked
by interstitial edema.

191. 24 hours after diuretic therapy

193. Chest wall lesion: arising off the chest wall and not the lung

194. Pleural effusion: Note loss of left hemidiaphragm. Fluid
drained via thoracentesis

196. Lung Mass

198. Small Pneumothorax : LUL

200. Right Middle Lobe Pneumothorax: complete lobar collapse

201. Post chest tube insertion and re-expansion

205. Tuberculosis

206. Pleural Effusion

207. Pulmonary Fibrosis

208. Cavitating lesion

209. Miliary shadowing

210. 5. 65 yo male admitted for sepsis. CHF or ARDS?