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Monday 18 April 2011

Chest x-rays



Eosinophilic pneumonitis:

Peripheral consolidations with upper lobe predominance

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Signs of pulmonary TB

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Azygous lobe




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Sclerotic coronary

Which one could it be?

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Met from a cervix tumor

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Lung cyst

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Sclerotic areas in the thyroid gland on a trachrea air-stripe image

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Golden S sign: indicated by the red arrows, is a sign of right upper lobe atelectasia, dystelectasia. The blue arros are pointing to the pleural line - PTX. The purpule circle is showing a small amount of HTX in the left lateral sinus.


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Mediastinitis that developed after a thoracotomy.
Take note of the blurring of mediastinal contours on both sides, and left sided HTX.

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Ptx on the right sided that developed after the insertion of a central canule into the right jugular vein.



Ptx l.u.


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Bilateral PTX following a Nuss operation of pectus excavatum, take notice of the two pectus metal plates that are inserted subcutaneously.

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Enlarged RV:

The enlarged RV pushes the heart elevating its apex up from the diaphragm.
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Hydrothorax:
Th left lung appears to have a decreased transperancy when compared to the contralateral side, this film was taken in an AP projection.

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Hiatus hernia:

Red arrows indicating the double contuor, blue arrows showing the fluid level, gastric content level.

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The increased interstitial pattern, and peribronchial drawing are signs of chronic bronchitis

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- Post irradiation pneumonia: This patient is suffering from a gastric malignancy, and had undergone radiotherapy as a palliative treatment.

WBC: 26000(4000-10000) Neutrophyl 88 (37-80) Lymphocyte 7 (10-50) RDW 18%(11-16)
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Solitary pulmonary nodule (SPN) - a CT exam has been advised for this pt, but has not been performed yet.
The nodule is located in the vicinity of the minor fissure, therefore it could also be fluid inside the fissure, after diuresis it has not changed shape, or size, therefore to exclude malignancy a CT has to be performed.
The HTX is frequently seen in malignant SPN's.
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Cloud like interstital shadowing of both lungs - lung edema
WBC- 17700 Neutrophyl: 88(37-80) Lymphocyte 3,5 (10-50) - therefore pneumonia cannot be ruled out.
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Where does the drain tube end?
This radiograph shows the importance of lateral images, on the PA image the tube seems to be ending in the trachea, but when we take a closer look at the lateral image we find that the drain tube is posterior to the tracheal air stripe.
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-Air-fluid levels indicating the presence of a hydroptx.
- Arrows showing thin pleural line
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The patient has undergone a left upper lobe lobectomy
-PTX on the left side
-Elevated left hemidiaphragm
-Trachea pulled to the left
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Atelectetic line on the left side, commonly seen in post op. patients due to poor inspiration.
Small fissure on right side.
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PTX l.d.
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Pneumonia l.d. in the right lower lobe
CRP: 102 WBC: 6200 Neutrophyl: Lymphocyte:

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Subcutaneous emphysema
PTX l.d.
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HTX l.s., left dorsal sinus
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(Images: Pécs University Department of Radiology)

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