CXR Interpretation - Improving care in ED
CXR Interpretation
Views
PA: Preferred view
Lat: Helps delineate and localize masses, lesions or consolidation – esp if they are obscured by heart and diaphragm
ÂP: Magnifies heart and mediastinum
Associated with rotational artefact
Expiratory: helpful for small pneumothroax / gas trapping with FB
[pic]
[pic] [pic]
L image, L lung: oblique fissure, as shown
R image, R lung: horizontal and oblique fissures, as shown
eg.
[pic] [pic]
Reading a CXR
Patient and CXR data
Trachea
Lungs
Pulmonary vessels
Hila: mass, LN
Heart
Mediastinal contour: width, mass
Pleura: effusion, thickening, calcification
Bones: lesions or fractures
Soft tissues: don’t miss mastectomy
Tubes
Interpretation
[pic]
Name and DOB
Date of radiograph
Projection
Posture
Adequacy of exposure – easily visible mid-thoracic IV spaces
Degree of inspiration – diaphragm at levels of 8th -11th ribs posteriorly
5th - 6th ribs anteriorly
Degree of rotation – central spinous processes of thoracic vertebrae, equidistant from
medial ends of clavicles
Trachea – central; slight deviation to R as crosses aortic arch
Pushed away: large pleural effusion
large/tension pneumothorax
aortic aneurysm
mediastinal mass
Pulled towards: collapse
Consolidation
pul fibrosis
lobectomy, pneumonectomy
Superior mediastinum – width ................
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