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Dr Faezeh Sakhinia
FY2
Aims
Basics of CXR interpretation OSCE approach Images with explanation Quiz!!
Initial Approach Details:
Correct patientCorrect dateCorrect examination (CXR)Correct view
○ AP/PA○ Supine/portable/lateral
Projections
PA AP LATERAL
Picture Quality
Rotation
Inspiration
Picture
Exposure
(Penetration)
Order of View Airway– is it deviated?
Breathing – Lungs
Circulation – Heart (normal<½ cardiothoracic ratio in PA view)
Diaphragm – R>L by ~ 1 intercostal space, cardiophrenic and costophrenic angles
Extras – pneumoperitoneum? air under the skin (surgical emphysema), fractures, lines (NG,ECG, chest drains, pacemaker)
OSCE Approach
OSCE Example:
“This is a plain chest xray of John Smith in a PA view. The film is adequately exposed and orientated.”
○ The main findings are:○ Starting off with the airways....
Normal Xray
Pleural Effusion
Consolidation with Air Bronchograms
COPD
Pneumothorax
Left Lower Lobe Collapse
Left Upper Lobe Collapse
Right Lower Lobe Collapse
Right Upper Lobe Collapse
Lung Cancer
Heart failure
QUIZ!!!
Easy......Odd!
Consolidation & Collapse (pneumonia)
Pneumothorax (COPD)
Mastectomy
Dextocardia with Situs Inversus
Valve Replacements
Nipple Ring!
If you can answer these...a career in radiology is for you!!!
Pneumonectomy
Surgical Emphysema Secondary to Chest Drain
Asbestos Related Pleural Plaques
Quiz Done...and Relax!!!
Summary
Thank You!!