Chest x-ray Normal and abnormal findings أشعة خامسة طب أسيوط

1. CHEST AND HEART
X-RAY
BY
DR. MOHAMED ABDEL-TAWAB
LECTURER OF RADIOLOGY - ASSIUT UNIVERSITY

2. CRITERIA OF GOOD
XR FILM
• ID
• Side RT, LT
• PA view
• Erect, Supine
• Penetration; contrast
• Field

4. CRITERIA OF GOOD
XR FILM
• ID
• Side RT, LT
• PA view
• Erect, Supine
• Penetration; contrast
• Field

5. NORMAL ANATOMY
CARDIAC BORDERS

6. NORMAL ANATOMY
CARDIAC BORDERS

7. LOBES

8. REPORTING

9. 1- PLAIN X RAY
Barium swallow: left atrial ++ indents
esophagus

10. 2- VIEW OF X – RAY
Lateral XR

11. 3- CENTRALIZATION
IN THE X – RAY
Medial clavicle at equidistance from spinous
process

12. 4- BONY
THORAX
Fracture ribs  pneumothorax

13. 5- DIAPHRAGM
Right copula > left copula

14. 6- MEDIASTIUM
Bilateral hilar adenopathy
Sarcoidosis

15. 7- HEART

16. 8- LUNG FIELDS
APICAL, UPPER, MIDDLE, LOWER

17. REPORT ITEMS + SUMMARY OF LESIONS
• Clear both lung fields
• Clear costophrenic angles = No pleural effusion.
• Normal cardiac size and shape.
• No hilar adenopathy or mediastinal masses
• Intact bony thorax. No bony cervical ribs
Impression
NORMAL CHEST X-RAY

19. CARDIOMEGALY

20. CARDIOMEGALY

21. CARDIOMEGALY

22. CARDIOMEGALY
Mitralization due to mitral stenosis

23. CARDIOMEGALY
WITH
CHARACTERISTIC
SHAPE

24. FLASK SHAPED HEART
WATER BOTTLE
SIGN
Pericardial
effusion

25. EGG ON SIDE = TRANSPOSITION OF GREAT
VESSELS

26. BOOT SHAPED HEART (COEUR EN SABOT) =
FALLOT’S TETRALOGY HEART IN FRENCH
enlarged RV
dilated aorta (RT)
exaggerated waist

27. DUMBBELL SHAPED HEART
• Aneurysmal dilatation of both
pa in primary pulmonary
hypertension, cor pulmonale

28. COLLAPSE

29. COLLAPSE

30. COLLAPSE -
CT

31. PNEUMONIA

32. PNEUMONIA

33. PNEUMONIA

34. PNEUMONIA
Lobar pneumonia

35. PNEUMONIA
Bronchopneumonia

36. LUNG
ABSCESS

37. T.B.
GHONS FOCUS

38. T.B.
POST-PRIMARY

39. T.B.
MILIARY TB

40. PLEURAL
EFFUSION

41. PNEUMOTHORAX
TENSION

42. PNEUMOTHORAX

43. PNEUMOTHORAX

44. BRONCHIECTASIS

45. EMPHYSEMA

46. EMPHYSEMA
• marked hyperinflation of the
lungs
• flattened diaphragm,
• increased retrosternal air space
• hyperlucency of the lungs
• distorted parenchymal
architecture.
• Ribbon shaped heart

47. IDIOPATHIC
PULMONARY
FIBROSIS

48. ???

49. MEDIASTINAL
MASS

50. LUNG CANCER

51. LUNG
CANCER

52. LUNG
CANCER

53. METASTASIS
LUNG CANCER

54. METASTASIS
MILIARY
Cholangiocarcinoma
Thyroid
Breast

55. METASTASIS
CANNON BALL

57. METASTASIS
CANNON BALL
•renal cell carcinoma
•choriocarcinoma
•prostate carcinoma
•endometrial carcinoma