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Chest X-rays - Basics to few uncommons 18 07-2013
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XraysBy Mohit Goyal
Guide: Sr. Prof. Dr. V. K. GoyalDept. of Medicine, R.N.T. Medical College, Udaipur
18-07-2013
The 1901 Nobel for Physics was awarded to Wilhelm Conrad Röntgen "in recognition of the extraordinary services he has rendered by the discovery
of the remarkable rays (in 1895) subsequently named after him".
Electrons are liberated from the heated filament and
accelerated by a high voltage towards the metal
target. The X-rays are produced when the electrons
collide with the atoms and nuclei of the metal.
On the table for the day
Normal Röntgenogram Chest PA & Lateral
Some common Chest X-rays
Unusual Chest X-rays
Miscellaneous spot films
A young female came to his hospital for pre-
employment checkup. After seeing the picture on
the X-ray, the GP sent a reference to the resident
Internist. What one question should the Internist
ask to this lady?
What’s your differential diagnosis for this
skiagram?
The differential diagnosis of very dense miliary opacities
includes :
Healed varicella pneumonia
Pulmonary haemosiderosis, e.g. mitral stenosis
Repeated haemorrhage, e.g Goodpasture syndrome
Silicosis (exposure to pure silica)
Pulmonary alveolar microlithiasis
Calcified metastases, e.g. osteosarcoma
Idiopathic
It is common to believe that coins seen end-on (sagittal plane)
in the middle of the chest on A-P radiographs are in the
trachea, whereas coins in the oesophagus will have a disk
appearance on antero-posterior chest radiographs. This
radiograph demonstrates that this is not always the case.
Larry Mellick, Professor of Emergency Medicine, Medical College of Georgia
Conners GP, Hadley JA. Esophageal coin with an unusual radiographic
appearance. Pediatric Emerg Car. 2005;21:667-669
Raney LH, Losek JD. Child with esophageal coin and atypical radiograph. J Emerg
Med 2008;34:63-66
Thank youH a p p y I n t e r p r e t I n g!