System for interpretation of the CXR

7 System for interpretation of the CXR


This chapter is a checklist of all the places to look on a CXR once you have checked the technical quality of the radiograph. A sound knowledge of anatomy is vital and key anatomical structures are highlighted.


Always look for old films of your patient for comparison. This will help you determine if an abnormality is an acute or chronic problem. CXR abnormalities which have been there for years are seldom of any importance. You will see examples of the importance of looking at old films in the ensuing chapters.


After checking the technical quality, ensure any lines and tubes are correctly positioned. Malposition of tubes or lines may be the cause of other abnormalities on the film. See the ‘Lines and tubes’ section for examples.


If any abnormality is obviously present, at this point, describe it fully.


Important areas for review are described in this chapter.


There are many mnemonics to remember what to check – just as long as you look at everything it does not matter which one you use, if any.


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Fig 7.1 Areas of importance will be discussed using this CXR for reference.


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Fig. 7.2 Look at the lungs. In particular, look at the apices. There are a lot of overlapping bony structures here which can make interpretation difficult. Tumours are often missed here (see Chapter 15). Some pathologies have a predilection for the apices, such as TB (see Chapter 11).


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Fig. 7.3 The costophrenic angles are another important place to look. Many pathologies start here. Septal lines in early heart failure are found here (see Chapter 26), as are pleural effusions, which blunt the costophrenic angles (see Chapter 20).

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Aug 20, 2016 | Posted by in ULTRASONOGRAPHY | Comments Off on System for interpretation of the CXR

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