DR GORDHAN DAS FCPS

2

The 12-Step:

1: Name 2: Date 3: Old films 4: What type of view(s) 5: Penetration 6: Inspiration 7: Rotation 8: Angulation 9: Soft tissues / bony structures 10: Mediastinum 11: Diaphragms 12: Lung Fields

Quality Control

Findings

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Different tissues in body absorb X-rays at different extents:

• Bone- high absorption (white)

• Tissue- somewhere in the middle absorption (grey)

• Air- low absorption (black)

•Looks whether is well centralized or not,...check for medial end of Clavicle ...both should be at equil level from spine.if not then it is difficult to comment about ardiomegalyc, mediastinal deviation.. whichever one end is more close to spine-----mediastinum is deviated on that side. •check for right and left side•look for exposure....if u see for spinal process then its well exposed...if over exposed then it looks translucent( like emphysema)•Looks for cardio and costophrenic angle...all should be acute...if not then it is abnormal....also look for Diaphragmatic contour...if flattened ---then probably some lung disease...

•check Apical area ...esp behind the Clavicle for TB lesion then check lower lung filed for all 4 angle,,•check trachea...and trace it upto carina...should be patent•Cardiac: Let side border is made by Aortic knucle , pulmonary conus, left atrium and Lt ventricle while right side border is made by SVC and right atrium•Vascular markings: Lower lobe vessels are more prominent compare to Upper lobe coz of Gravity...If not then Cardiac problem.. Right side vessels look more prominent than left side.

PA

Chest X-Ray Markings

NORMAL HEARTBORDERS

Chest xray PA viwe

AP view

Chronic bronchitis