Items tagged “cxr”
33 results found
Article
Azygo-esophageal recess deviation
Deviation of the azygo-esophageal recess can be normal or pathological.
The azygo-esophageal recess is formed by the interface between the right lung and the mediastinal reflection of the azygos vein and esophagus. The line has a variable appearance 1:
in its upper third, it deviates to the ri...
Article
Chest radiograph assessment using ABCDEFGHI
ABCDEFGHI can be used to guide a systematic interpretation of chest x-rays.
Assessment of quality / Airway
The quality of the image can be assessed using the mnemonic PIER:
position: is this a supine AP file? PA? Lateral?
inspiration: count the posterior ribs. You should see 10 to 11 ribs wi...
Article
Normal contours of the cardiomediastinum on chest radiography
A detailed understanding of the structures that make up the normal contours of the heart and mediastinum (cardiomediastinal contour) on chest radiography is essential if abnormalities are to be detected.
Frontal view (PA/AP)
Right cardiomediastinal contour
From superior to inferior:
right p...
Article
Normal position of hemidiaphragms on chest radiography
The normal position of hemidiaphragms on chest radiography reflects the presence of the heart and subdiaphragmatic organs. Therefore, the hemidiaphragms are not at the same level on frontal erect inspiratory chest radiographs, but are usually within one rib intercostal space height (~2 cm) of ea...
Article
Flattening of the diaphragm
Flattening of the diaphragm is the most sensitive sign on chest radiographs for the presence of hyperinflation of the lungs, usually due to emphysema 1,2.
On a lateral chest radiograph, the normal dome of each hemidiaphragm should rise at least 1.5 cm above a line connecting the costophrenic an...
Article
Apical cap
Apical caps cover the lung apices and often bilateral. They can be chronic, due to fibrosis or acute due to pleural or extra-pleural fluid.
Epidemiology
The frequency of chronic apical pleural thickening increases with age 3. There may be a slightly greater male predilection 7.
Pathology
Api...
Article
Right atrial enlargement
Right atrial (RA) enlargement is less common, and harder to delineate on chest radiograph, than left atrial (LA) enlargement.
Pathology
Etiology
Enlargement of the right atrium (RA) can result from a number of conditions, including:
raised right ventricular pressures
pulmonary arterial hype...
Article
Right ventricular enlargement
Right ventricular enlargement (also known as right ventricular dilatation (RVD)) can be the result of a number of conditions, including:
pulmonary valve stenosis
pulmonary arterial hypertension
atrial septal defect (ASD)
ventricular septal defect (VSD)
tricuspid regurgitation
dilated card...
Article
Left ventricular enlargement
Left ventricular enlargement can be the result of a number of conditions, including:
pressure overload
hypertension
aortic stenosis
volume overload
aortic regurgitation
mitral regurgitation
wall abnormalities
left ventricular aneurysm
hypertrophic cardiomyopathy / dilated cardiomyopathy...
Article
Left atrial enlargement
Left atrial enlargement (LAE) may result from many conditions, either congenital or acquired. It has some characteristic findings on a frontal chest radiograph. CT or MRI may also be used for diagnosis.
Clinical presentation
An enlarged left atrium can have many clinical implications, such as:...
Article
Adult chest radiograph in the exam setting
A chest radiograph in the exam setting may contain a vast variety of pathology. However, consider the history and correlate the likely diagnoses that may be demonstrated on film. Furthermore, check your review areas to ensure that the abnormality is not at the corner of the film.
Locating patho...
Article
Chest radiograph zones
The chest radiograph zones are useful when describing the location of pathology on a frontal chest radiograph.
The chest radiograph is a 2D representation of a 3D structure. Since the interfaces between the lobes are oriented obliquely, it is often not possible to determine which lobe pathology...
Article
Chest x-ray lines and stripes
Chest x-ray lines and stripes are important to recognize on chest radiographs.
Lines are usually less than 1 mm in width and are comprised of tissue outlined on either side by air and typically represent pleural-covered structures within the middle and superior mediastinum 1,2:
anterior junct...
Article
Cardiothoracic ratio
The cardiothoracic ratio (CTR) aids in the detection of enlargement of the cardiac silhouette, which is most commonly from cardiomegaly but can be due to other processes such as a pericardial effusion.
Terminology
Some report cardiothoracic ratio as a percentage, however this is incorrect, as...
Article
Interstitial lung pattern (radiograph)
An interstitial lung pattern is a regular descriptive term used when reporting a plain chest radiograph. It is the result of the age-old attempt to make the distinction between an interstitial and airspace (alveolar) process to narrow the differential diagnosis.
A re-read of the timeless work o...
Article
Retrosternal airspace
The retrosternal airspace is seen as a normal lucency between the posterior aspect of the sternum and anterior aspect of the ascending aorta on lateral chest radiographs. This space normally measures less than 2.5 cm in width. Increased retrosternal airspace is a sign of pulmonary emphysema, whi...
Article
Anterior junction line
The anterior junction (or junctional) line is a feature of frontal chest radiographs and chest CTs. It is a result of the parietal and visceral pleura meeting anteromedially. It normally contains a small amount of fat in between but can form a stripe of variable thickness if there is a lot of fa...
Article
Vertical fissure line in the lung
The vertical fissure line commences in or near the costodiaphragmatic recess and heads superomedially towards the hilum and terminates before or at the horizontal fissure. More commonly occurs on the right and may indicate partial volume loss of the lower lobe 1.
Article
Left upper lobe collapse in the exam
Getting a film with left upper lobe collapse in the exam is one of the many exam set-pieces that can be prepared for.
Description
This frontal chest radiograph shows hazy (or veil-like*) opacification of the left hemithorax that is associated with superior displacement of the left hilum and a ...
Article
Posterior wall of bronchus intermedius
The posterior wall of bronchus intermedius, also known as the intermediate stem line, is a stripe formed by the interface of the posterior wall of bronchus intermedius and the air within the azygo-esophageal recess 1.
It normally measures between 0.5-2 mm in thickness but is not considered abno...
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