1. HOW READ CHEST XR -14
ANAS SAHLE ,MD

2. Brief review

3. POSITION
PA AP
QUALITY
ROTATION PENETRATION INSPIRATION
LESION
OPACIT
OPACITY
Homo
Heterogenous Wellill defined Zone
Centralperipher
Silhouet sign
al
Y Necrotic
PATCHY
HILUMMEDIASTINAL
NODULE Central deviasionwided
MASS
COSTO-PHRENIC ANGEL
Freeoblitern
CAVITARY
OTHER
INFILTIRATION
Bone soft tissuediaphragm

4. Consolidation
Infection
causes Non-infection causes
Broncho-
WEGNER Cardiac
Pneumonia Lymphoma alveolar COP Sarcoid
disease failure
carcinoma

5. Solitary Pulmonary Nodule(SPN)
Appearance
Margin Calcification cavitation
Comparison with a
Size
previous x-ray to >8mm
<8mm
Assess growth over
time. Location
Upperhillar zone Lowerbasesup-pleural
Associated abnormalities
Lymph node enlargement Rib destruction/erosion

6. Cavitary lesion
Air +
Air-fluid level Air only
tissue
Wall thickness
Straight Wavy Thick Thin
1. Fungal ball.
2. Rupture hydatid cyct site
3. Necrotic tumor
ruptured
4. Blood glot Hydatid
Abscess Irregular Regular
Peripheral Central
inner wall inner wall
cyst
Emphesemato
Cavitating Chronic us pneumatoc
neoplasm abscess ele
bulla

7. LINEAR PATTERN
LINEAR PATTERN
LEFT VENTRICULAR FAILURE Perihilar and peripheral basal septal lines,
changes acutely and resolves with diuretics
Normal ageing Coarsening of lung markings in lower zones, no
change on review of recent films
Lymphangitis Coarse nodular and linear thickening of
markings, known malignancy, often associated
with pleural effusion, rapid clinical
deterioration of patient

8. LINEAR PATTERN
LINEAR PATTERN
Atelectasis Short thin lines, often basal, new on review of
previous films
Subsegmental Longer thicker bands, often perihilar or basal,
collapse suggest recent infection or infarction
Scarring Any length, persist over time unchanged
Fibrosis Volume loss is key, persists over time

9. Causes of fibrosis
Mid zone lung Lower zone lung Upper zone lung
tuberculosis Drug indused fibrosis sarcoidosis
(most common)
Chronic extrinsic allergic UIP
alveolitis
Radio-therapy Asbestose-related fibrosis
Ankylosing spondylitis
Progressive massive
fibrosis
histoplasmosis

10. Mediastinum

11. MEDIASTINAL ANATOMY
Superior: Upper of T4
Inferior: Lower of T4( T4-T8)