What is the radiation dosage of a chest x-ray?
Second lowest dosage (to CT)
What is the normal projection of chest x-rays?
- PA unless really poorly
- Allows us to:
- see lung bases
- check heart is not enlarged (as x-rays hit this last)
What anatomy should be included in a chest x-ray for it to be adequate?
How can we tell there is no rotation on towards the detector on a chest x-ray?
Spinous processes and the clavicles line up
What should be seen on the x-ray to ensure the patient has fully inspired?
Why is it important that they take a full breathe in?
In what circumstances might we see incomplete inspiration or exaggerated expansion?
- If don't take full breath in may think some area is consolidation when it's not
- Incomplete inspiration on big heart
- Exaggerated expansion on obstructive airways diseases
What should the lung bases look like on a chest x-ray? What patholgy could be suggested by flattened lung bases or asymmetrical lung bases?
- Should be dome shaped
- If flattened and can see 8 or 9 ribs could be emphysema or
-If asymmetrical flattening tension pneumothorax
How can you tell there has been adequate penetration on a chest x-ray?
- Vertebrae just visible through the heart
- Complete left hemidiaphragm visible
List some artefacts that can appear on a chest x-ray?
- Surgical lines
- Pace makers
Identify the following anatomical structures
What should you see on a chest x-ray when assessing the trachea?
Left hilar point should always be higher than right, if altered then pathology
What are the different lung zones on a chest x-ray?
What fissure can you see on a chest x ray?
Horizontal in the right lung running towards right hilum
How can you overcome seeing nipple markings on a chest x ray?
Stick paperclips on nipples so don't mistake nipples for a mass
What might be the pathology if the 1st rib is not visible on chest x ray?
Pancoast tumour as it erodes the first rib
How do you systematically review a chest x-ray?