The Chest X-Ray: A Survival Guide
Simon Morley, Laurence Berman, Gerald de Lacey
Format: PDF / Kindle (mobi) / ePub
Featuring a practical, clinical approach - and written in a quick-access style - this portable, economical reference helps you build a strong foundation in chest x-ray interpretation. Three radiologists with years of clinical and teaching experience present fundamental principles and key anatomical concepts…walk you through examples of classic chest x-ray features that provide subtle evidence of abnormality…and explore a variety of problems and dilemmas common to everyday clinical practice. High-quality drawings and digital chest x-rays - combined with secrets from the radiologists’ toolbox, helpful differential diagnoses, handy checklists, and key references - deliver all the assistance you need to enhance your interpretation skills.
- Provides a strong foundation of essential knowledge for an informed, systematic approach to accurate chest x-ray interpretation.
- Features the work of three radiologists who offer you the benefit of their many years of clinical and teaching experience.
- Emphasizes common errors and misdiagnoses to help ensure correct image readings.
- Presents step-by-step guidance in a bulleted, quick-access format, in short chapters focused on clinical problems, to make it easy to master the information that you need to know.
- Makes difficult anatomic concepts easier to grasp by pairing radiographs with color line drawings.
- Explains the nomenclature special to the field through a glossary of important terms.
- Highlights the most important concepts in diagnosis/interpretation via Key Points in each chapter.
thymus / thymic remnant, heart, ascending aorta Middle Trachea, bronchi, lymph nodes, oesophagus, descending aorta Posterior Paravertebral soft tissues 110 PART A: CORE KNOWLEDGE CXR APPEARANCES — NORMAL FRONTAL CXR In adults the normal mediastinal shadow is in effect the cardiac outline, the thoracic aorta, the superior vena cava, and the vessels arising from the aortic arch. In young adults neither the aortic arch nor its vessels are prominent and they contribute very little to the
commonly in children. R A pneumatocoele is a gas Älled space in the lung adjacent to an area of consolidation. On the CXR it appears as a round lucent area (Fig. 9.3). A pneumatocoele is a transient CXR appearance. 132 PART A: CORE KNOWLEDGE ASPIRATION PNEUMONIA This may result from inhalation of gastric or oropharyngeal Åuids, pus from infected sinuses, or inhalation of external Åuid. If aspiration is the likely cause of the pneumonia then intravenous cephalosporin / metronidazole is added
consolidation is extensive Unilateral lymph node enlargement (in 95%) Pleural effusion (in 10%) Apical / posterior segments of an upper lobe Apical segment of a lower lobe Pitfall. CXR changes in post-primary PTB have a strong predilection for the apical or posterior segments of the upper lobes and also for the apical segments of the lower lobes. Sometimes post-primary tuberculosis shadowing will occur in the anterior segment of an upper lobe or in a basal segment of a lower lobe. This
798–802. 2. Lorentz GBA, Quekel MD, Kessels AGH et al. Miss rate of lung cancer on the chest radiograph in clinical practice. Chest 1999; 115: 720–724. 3. O’Connell RS, McLoud TC, Wilkins EW. Superior sulcus tumor: radiographic diagnosis and workup. AJR 1983: 140: 25–30. 4. Renner RR, Pernice NJ. The apical cap. Semin Roentgenol 1977; 12: 299–302. 5. Epstein DM. Bronchioloalveolar carcinoma. Semin Roentgenol 1990; 25: 105–111. 6. Aronchick JM. Lung cancer: Epidemiology and Risk Factors. Semin
CARDIAC DISEASE 151 Potential pitfalls: Two incidental appearances on a frontal CXR are not pathological: 1. A conÅuence of normal veins entering the left atrium outlined by air in the right lung (Fig. 11.7). The appearance is of a density behind the right side of the heart1,2. This can be mistaken for an enlarged left atrium, or a mediastinal mass, or a paravertebral soft tissue swelling. This normal structure is not seen on the left side. Some regard this opacity as part of a normal left