Chest%20X-ray

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Chest X-ray

• Esam Alhamad, MD,FCCP, FACP
• Division of Pulmonary Medicine
• College of Medicine

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Is this film centered?
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Why do you have to know whether it is PA or AP
film
?
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Is this a PA or AP film?
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Is the exposure appropriate?
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Mediastinal Masses

• Anterior mediastinal masses (4Ts)
• Thymoma
• Teratoma
• Thyroid
• Terrible lymphoma

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Middle Mediastinal Masses

• 3 As
• Adenopathy
• Aneurysm/vascular
• Abnormalities of development
• Bronchogenic cyst
• Pericardial cyst
• Esophageal cyst

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Posterior Mediastinal Masses

• Neural tumor
• Neurobalstoma, ganglioneuroma,
• Ganglineuroblastoma
• Nerve root tumors
• Schwannoma, neurofibroma

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Airbronchogram

• Indicates that the opacity is parenchymal not
  mediastinal or pleural
• DDx
• Consolidation ,Hemorrhage, Edema, Bronchoalveolar
  Cell Carcinoma, Lymphoma, Sarcoidosis, Alveolar
  Proteinosis

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Pulmonary Hemorrhage

• Pulmonary-renal syndrome
• Wegeners granulomatosis
• SLE
• Goodpastures syndrom
• Polyarteritis nodosa
• Henoch Shonlein purpura

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Pulmonary Hemorrhage

• Without renal disease
• Anticoagulation
• Pulmonary infection
• Pulmonary embolism
• Trauma
• Bone marrow transplantation

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Pleural effusion

• Infection
• Neoplasm
• CHF
• Cirrhosis
• Pancreatitis
• Uremia
• Subdiaphragmatic abscess
• CTD ( SLE, RA)
• Hypothyrodism
• Pulmonary embolism

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Pleural effusion

• ITCH Large unilateral pleural effusion
• Infection
• Tumor
• Chylous ( ruptured thoracic duct lymphoma)
• Hemorrhage

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Pneumothorax

• Spontaneous
• Primary
• COPD
• Asthma
• Cystic fibrosis
• Cavitary pneumonia
• Sarcoidosis
• Pleural metastases

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Pericardial effusion

• Serous
• CHF, Hypoalbuminemia, CTD, Hypothyroidism
• Bloody
• Acute MI, Trauma, Neoplasm, CRF
• Purulent
• Bacterial, Viral ,Tuberculosis, Fungal

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