3. Chest X-Rays
• Patent ID and date
• Projection----PA/AP/LAT
• Centering----Rotated /Non-rotated
• Exposure----Adequate /Poor
• Inspiratory effort
4. A The cardiomediastinal contour is significantly
magnified on this AP film. This needs to be
appreciated and not overcalled.
B On the PA film, taken only an hour later, the
mediastinum appears normal.
6. • A well centred x-ray. Medial
ends of clavicles are
equidistant from the
spinous process.
• This patient is rotated to the
left. Note the spinous
process is close to the right
clavicle and the left lung is
‘blacker’ than the right, due
to the rotation.
9. • The cardiothoracic ratio should be less than 0.5.
• i.e. A/B<0.5.
• A cardiothoracic ratio of greater than 0.5 (in a good quality
film) suggests cardiomegaly.
19. • Bronchiectasis. There is widespread bronchial wall abnormality in both
lungs, but particularly in the right lung. In the right lower zone, there is
marked bronchial wall thickening (remember that the normal bronchial
wall should be ‘pencil line’ thin) with ‘tram lines’ visible.
20. • Carcinoma with rib destruction. Dense opacification of
the left upper lobe with associated destruction of the
left second and third anterior ribs.
22. • Chronic obstructive pulmonary disease. The lungs are
hyperinflated with flattening of both hemidiaphragms. On the lateral view,
the chest appears ‘barrel-shaped’ due to an increase in the retro-sternal
air space.
27. • Flail chest – case 2. Double fractures of the
left posterior fifth and sixth ribs.
28. • Simple pneumothorax. The right lung edge is
faintly visible on the inspiratory film. However,
the pneumothorax becomes clearly evident on
the expiratory film.