Interpreting Chest X-Rays

Radiological imaging is now accessible to a wide range of healthcare workers, many of whom are increasingly taking on extended roles. This book will equip all healthcare professionals, including medical students, chest physicians, radiographers and radiologists, with the techniques and knowledge required to interpret plain chest radiographs.


It is not an exhaustive text, but concentrates on interpretive skills and pattern recognition – these help the reader to understand the pitfalls and spot the clues that will allow them to correctly interpret the chest X-rays they will encounter in their daily practice.


The book features over 300 high quality images, along with a range of case story images designed to enable readers to test and develop their interpretation skills.


Interpreting Chest X-Rays is a handy ready reference that will help you to avoid making errors interpreting chest X-rays and decide, for example:

* if a temporary pacing wire has been inserted correctly
* whether the shadows you can see are real abnormalities
* if all chest tubes and lines are located appropriately in an ITU patient
* what further imaging may assist interpretation of an apparent abnormality
* whether a post-surgical chest is significantly abnormal
* what organism might be causing an infection
* why a patient is short of breath
* whether patient positioning accounts for an abnormal appearance on a chest X-ray
* what impact radiographic technique has had on the appearance of pathology


Contents


1. Technique
1.1 Techniques available

2. Anatomy
2.1 Frontal CXR
2.2 Lateral CXR
2.3 Normal variants

3. In-built errors of interpretation
3.1 The eye–brain apparatus
3.2 The snapshot
3.3 Image misinterpretation
3.4 Satisfaction of search
3.5 Ignoring the ribs

4. The fundamentals of CXR interpretation
4.1 The silhouette sign
4.2 Suggested scheme for CXR viewing
4.3 Review areas
4.4 Pitfalls

5. Pattern recognition
5.1 Collapses
5.2 Ground glass opacity
5.3 Consolidation
5.4 Masses
5.5 Nodules
5.6 Lines
5.7 Cavities

6. Abnormalities of the thoracic cage and chest wall
6.1 Pectus excavatum
6.2 Scoliosis
6.3 Kyphosis
6.4 Bone lesions
6.5 Chest wall / thoracic inlet
6.6 Thoracoplasty

7. Lung tumours
7.1 CXR features of malignant tumours
7.2 CXR features of benign tumours
7.3 Metastases
7.4 Bronchial carcinoma
7.5 The solitary pulmonary nodule

8. Pneumonias
8.1 Pulmonary tuberculosis
8.2 Pneumococcal pneumonia
8.3 Staphylococcal pneumonia
8.4 Klebsiella pneumonia
8.5 Eosinophilic pneumonia
8.6 Opportunistic infections

9. Chronic airways disease
9.1 Asthma
9.2 Chronic bronchitis
9.3 Emphysema
9.4 Bronchiectasis

10. Diffuse lung disease
10.1 Interstitial disease – the reticular pattern
10.2 LAM
10.3 Langerhan’s cell histiocytosis
10.4 Pulmonary sarcoid
10.5 Hypersensitivity pneumonitis

11. Pleural disease
11.1 Effusion
11.2 Pneumothorax
11.3 Pleural thickening
11.4 Pleural malignancy
11.5 Benign pleural tumours

12. Left heart failure

13. The heart and great vessels
13.1 Valve replacements
13.2 Cardiac enlargement
13.3 Ventricular aneurysm
13.4 Pericardial disease
13.5 Coarctation of the aorta
13.6 Aortic aneurysm
13.7 Atrial septal defect
13.8 Pacemakers

14. Pulmonary embolic disease

15. The mediastinum
15.1 The ‘hidden’ areas of the mediastinum
15.2 The hila
15.3 Stents

16. The ITU chest X-ray
16.1 Adult respiratory distress syndrome
16.2 The CXR following thoracic surgery

17. The story films

Further reading
Index