Plain X-ray Chest & heart-1

:Postero-anterior view(PA) showing

Multiple osteolytic lesions on ribs & humerous & clavicle & fracture on rt .
.(humerous due to hyperparathyroidism (hypercalcemia

Fracture posterior end of right 6th-7th ribs-2

:Plain X-ray Chest &heart Postero-anterior view(PA) showing

.Fracture of the posterior parts of 6th and 7th rib on the right side

.D: fracture ribs

( Bilateral cervical ribs (biforked ribs-3

:Plain X-ray Chest Postero-anterior view(PA) showing

The first rib is bilaterally attached to transverse process of 7th cervical

.vertebrae which are directed downwards

.D:bilateral cervical rib

‫الغوايش فى السفل على اليمين‬

Bilateral gas under diaphragm-4

:Plain X-ray Chest & heart Postero-anterior view(PA) showing

. Bilateral elevation of both copula of the diaphragm

D: gas under diaphragm for D.D perforated viscus-pneumoperitoneium-

gas forming organism

Bilateral gas (air) under diaphragm-5

Plain X-ray Chest & heart Postero-anterior view(PA) showing:

Bilateral gas (air) under diaphragm, With normal position of the diaphragm
at 10th rib posteriorly, ( Without elevation of both copula of the
.diaphragm ) due to perforated viscus

1
Elevated Left copula of the diaphragm-6

:Plain X-ray Chest & heart Postero-anterior view(PA) showing

Unilateral elevation of the left copula of the diaphragm for D.D

Diaph. Paralysis-

subphrenic abscess-

huge splenic mass-

huge gastric mass-

Elevated Right copula of the diaphragm-7

:Plain X-ray Chest & heart Postero-anterior view(PA) showing

Unilateral elevation of the right copula of the diaphragm for D.D

unilateral diaphragmatic paralysis-

subphrenic abcess-

huge hepatic mass-

Massive left-sided pleural effusion-8

:Plain X-ray Chest Postero-anterior view(PA) showing

Massive unilateral homogenous opacity in the left side (lung) &

obliterating costophrenic angle with shift of mediastinum (trachea)to
opposite (rt.)side

Right-sided hydropneumothorax with collapsed lung-9

:Plain X-ray Chest Postero-anterior view(PA) showing

Localized homogenous opacity at the lower zone of rt. Lung , obliterating

rt. Costophrenic angle with fluid level & collapsed lung tissue at the hilum
below & jet black hypertranslucency above

D: Rt. sided hydropneumothorax

Left encysted (localized) pleural effusion-10

:Plain X-ray Chest Postero-anterior view(PA) showing

Localized homogenous wedge shaped opacity at lateral aspect of the lt.

.Lung obliterating lt. Costophrenic angle & rising to axilla

1
(Right middle lobe (localized) pneumonia (consolidation-11

:Plain X-ray Chest Postero-anterior view(PA) showing

Localized homogenous wedge shaped opacity at medial aspect of lower

zone the rt. Lung & with central mediastinum

.(D.D it from localized ( collapse or effusion or infarction

Pulomnary embolism on rt lung-12

:Plain X-ray Chest Postero-anterior view(PA) showing
Localized homogenous wedge (triangular) shaped opacity at lateral aspect
of middle zone of the rt. Lung with peripheral base & central apex

:Plain X-ray Chest Postero-anterior view(PA) showing-13

Localized homogenous coin shaped opacity at the medial aspectof the
.lower zones of the right lung
.D.D localized pneumonia, carcinoma, adenoma, abscess, F.B,cyst

Resolving pneumonia or bronchopneumonia in left middle-14

( lobe(correct comment for slide no. 14 in powerpoint
:Plain X-ray Chest & heartPostero-anterior view(PA) showing

massive heterogenous opacity taking middle & lower zones

(most)(periphery) of the lt. Lung with central trachea

Cannon ball metastases-15

:Plain X-ray Chest Postero-anterior view(PA) showing
Homogenous large coin shaped opacities on medial aspect of the lower
zone of rt lungis about 5cm & 2 at lt lung the 1st at the upper zone is
about 10 cm & the 2nd at middle , lower zones is about 5-7 cm

:Plain X-ray Chest Postero-anterior view(PA) showing-16

Multiple homogenous small rounded pinpoint opacities on both lung
.fields
.D.D
.Miliary T.B
Sarcoidosis, pneumoconiosis

Apical fibrocavitary lesion-17

:Plain X-ray Chest Postero-anterior view(PA) showing

Multiple nonhomogeneous opacities of fibrocavitary lesion of different

sizes giving picture of fluffy-cotton appearance on both apices of the lungs

.Diagnosis: TB pulmonary fibrosis

1
Bilateral Emphysema and Emphsematous bullae-18

:Plain X-ray Chest Postero-anterior view(PA) showing

.bilateral and diffuse Jet Black hypertranslucency of lung shadows-

.with horizontal ribs and wide intercostal spaces_

and bilateral depression of both copula of diaphragm-

with 2 large emphysematous bullae on the right side-

D:Bilateral emphysema with bullae, differentiate from deep respiration

:Plain X-ray Chest & heart Postero-anterior view(PA) showing-19

Jet black hyper translucency in Rt. Side e` collapsed lung in the hilum &
trachea is shifted to the rt. side
-: Diagnosis
Rt. Side pneumothorax with lung collapse

Chronic lung abcess-20

:Plain X-ray Chest Postero-anterior view(PA) showing
Localized translucency on medial aspect of lower zone of rt. Lung with
very thick wall & fluid level

Chronic lung abcess-21

:Plain X-ray Chest & heart Postero-anterior view(PA) showing

Localized translucency on lateral aspect of lower zone of rt. Lung with

thick wall & fluid level

Multiple chronic lung (cavities) abcesses-22

:Plain X-ray Chest Postero-anterior view(PA) showing

Localized translucency on lateral aspect of lower zone of rt. Lung with
. thick wall
Diagnosis: TB cavity

Honey-comb appearance of Bronchiectasis-23

:Plain X-ray Chest & heart Postero-anterior view(PA)showing

multiple small rounded translucency (cavities) equal on both sides at basal

zones of both lungs giving picture of Honey-comb appearance

Aortic aneurysm and bilateral emphysema-24

:Plain X-ray Chest & heart Postero-anterior view(PA)showing

Fusiform swelling of superior mediastinum ( aortic aneurysm) & ribbon

shaped heart and bilateral emphysema

1
Trifestoned(TB) hilar lymphadenopathy-25

:Plain X-ray Chest & heart Postero-anterior view(PA) showing

Multiple rounded small (tripple fused) trifestone opacities at hilum (medial

(aspect) of rt. Lung (called trifestones

Artificial Pacemaker in right ventricle-26

:Plain X-ray Chest & heart Postero-anterior view(PA) showing

Metallic F.B. attached by wire to the right side of the heart

:Plain X-ray Chest & heart Postero-anterior view(PA) showing-27

Simple dextrocardia heart is on the right side

free costophrenic angles on both sides 3-Cardiophrenic angle on rt & lt-1

. side is acute 4-normal C/T ratio

Abnormal site of the heart

the heart lies mainly to the rt side-1

the cardiac apex is on the rt side-2

lt border formed by rt atrium ,Rt. BORDER by pulm.artery, la ,lv-3

(stomach is in normal site (gastric air bubbles on lt side-4

:Plain X-ray Chest & heart Postero-anterior view(PA) showing-28

Situs inversus totalis

&Heart is shifted to Rt. Side equal in both side

&Trachea is central
Gastric air bubble in the right
-:Diagnosis
Situsinversus totalis
‫( ركز على الهواء الموجود بالمعدة على الناحية اليمين‬fundus air on right side)

1
Same comment as above )Plain X-ray Chest & heart)ž
:Postero-anterior view(PA) showing

free costophrenic angles on both sides 3-Cardiophrenic angle-1ž

on rt & lt side is acute 4-normal C/T ratio

Abnormal site of the heartž

the heart lies mainly to the rt side but equal in both side-1ž

the cardiac apex is on the rt side-2ž

lt border formed by rt atrium , rt by pa, la ,lv-3ž

stomach is in abnormal site (gastric air bubbles on rt-4ž

side)while liver shadow is on lt side

Plain X-ray Chest & heart Postero-anterior view(PA) -29 ž

:showing

Pericardialeffusionž
. 1-Flask shape

Increase C/T ratio equally on both sides with broad cardiac-2ž

base. 3-Well defined border of
shadow(stenciled) with symmetrical bulge on both borders but
cardiac borders are ill-defined & same density of the contour.
.4-No double contour

free costophrenic angles on both sides-5ž

Cardiophrenic angle on lt & rtside is acute(6ž

.normal pulmonary vascular markings-7ž

Diagnosis :-Massive pericardial effusion To be D.D.Multivulular#
. lesion &Dilated cardiomyopathy

‫žعلمة خطين فى العلى على اليمين‬

Left ventricular enlargement-30 ž

Plain X-ray Chest & heart Postero-anterior view(PA)ž

:showing
Huge Increase C/T ratio at both Rt. & Lt. side e` no double -1
.contour
. (++ Obtuse Lt. cardio -phrenic angle.( Lt. V-2
broad shaped heart-3
Prominent aortic Knuckle-3
-:Diagnosis
.Cardiomegally due to Lt. ventricular & Rt. atrial enlargement

1
:Plain X-ray Chest & heart Postero-anterior view(PA) showing-31
free costophrenic angles on both sides 3-Cardiophrenic angle on lt side-1
is acute 4-increased C/T ratio . 4-bulge of lt & rt borders of the
heart & double contour ,not prominent PA
diagnosis: Cardiomegaly due to LAD, rt.VH

:Plain X-ray Chest & heart Postero-anterior view(PA) showing -32

Increase C\T ratio 2-obtuse c\ph angle 3-double contour-1
diagnosis: Cardiomegaly Lt. A &Lt. V enlargement
‫ في اليمين في العلى‬2 ‫في علمة‬

:Plain X-ray Chest & heart Postero-anterior view(PA) showing-33

increase cardiothoracic ratio,2- acute lt. cardiophrenic angle,3- double-1
.contour
:Diagnosis
.cardiomegally due to lt. ventricluar enlargement & LAD

:Plain X-ray Chest & heart Postero-anterior view(PA) showing-34

Increase cardiothorathic ratio-1
Cardiophrenic angle is acute-2
No double contour-3
. Diagnosis :- Rt. At. & Rt. Vt. ++.Pulmonary artery dilatation
‫ في أعلى اليمين‬8 ‫علمة‬

:Plain X-ray Chest & heart Postero-anterior view(PA) showing-35

Homogenous opacity at lt. 2nd Space & normal sized heart

(diagnosis : ( Pulmonary artery dilatation due to p.hpn
.To be differentiated from Mass in posterior mediastinum, Pericardial cyst
‫فيها خط أسود يمر في القلب‬

:Plain X-ray Chest & heart Postero-anterior view(PA) showing-36

Aneurismal dilatation of pulmonary artery on both sides take (Dumpbell)

.shape
.Most probably due to Bilharzial core pulmonal

:Plain X-ray Chest & heart Postero-anterior view(PA) showing-37

Dumpell-shape Pulmonary artery dilatationAneurismal dilatation of
.pulmonary artery on both sides take (Dumpbell) shape, due to p.hpn
.Most probably Bilharzial core pulmonal

1
Multiple radio-opaque shadows in right hypochondrium-38

-: Plain X ray abdomen show

.Multiple small opacities (radio-opaque stones) in Rt. Hypochondrium
Kidney stone \ gall bladder stone ( need lateral view to differentiate
( .gall stone anterior to vertebral column while renal stones on it

Intestinal obstruction-39

-: Plain x ray abdomen erect position show

( Multiple air fluid level (more than >3) due to(intestinal obstruction

Intestinal obstruction & perforated viscous-40

-: Plain x ray abdomen erect position show
( Multiple air fluid level (more than >3) due to(intestinal obstruction
( Bilateral gas under diaphragm due to ( perforated viscous

-:Oral cholesystogram show-41

.Multiple, small, rounded filling defect in gall bladder
-: Diagnosis
.Calcular cholecystitis with radio translucent gall stones
D.D: cancer gall bladder & acalcular cholecystitis artifact

‫في خط معدى فيها‬

T-tube cholangiogram with missed stone in common bile duct-42

-: T- tube cholangiogram show

Multiple radio translucent opacities (filling defects) stones in C.B.D &
.C.H.D
. with dilatation of biliary tree
-: Diagnosis
Missed stone

Achalasia of lower esophageal sphincter-43

-: Barium Swallow Show

Short small smooth narrowing of lower part of the esophagus with
.(smooth small dilatation Above ( funnel shaped
-: Diagnosis
Acahlasia of the Cardia

1
-: Barium swallow show-44
Short smooth narrowing with irregular filling defect with shouldering of the
lower 1/3 of oesophagus, with rat tail appearance & mild abnormal
. irregular dilatation above
-: Diagnosis
Cancer lower 1/3 esophagus

-: Barium swallow show-45

.Large abnormal irregular filling defect in middle & lower oesophagus
-:Diagnosis
.Cancer mid & lower 2 thirds of oesophagus

Esophageal varices-46

-: Barium swallow show

Multiple small rounded irregular filling defect in middle & lower

.Oesophagus giving picture of grape like

-: Barium meal show-47

Gastric rougae pass through esophageal hiatus (diaphragm) into the
.chest. herniation of part of the stomach to or through the oesophogus
-: Diagnosis
Sliding hiatus hernia

-:Barium meal show-48

Huge dilatation of stomach giving picture of soap dish appearance &
retograde passage of barium into oesophogus when patient is in
.tredlenberg’s position
-: Diagnosis

.Chronic pyloric (out let) stenosis (obstruction) & GERD

Hour-glass stomach(cancer stomach) with persistent duodenal-49

ulcer niche

-: Barium meal show

Hour glass constriction of stomach & multiple irregular filling defect s in
.the lower 1\2 of stomach & deformed duodenal cap
-: Diagnosis
& Infiltrating gastric carcinoma
Persistent ulcer niche on 2nd part (D.U.) ( chronic cicatrizing
.(duodenal ulcer

-:Barium meal show-50

leather bottle appearance due to cancer stomach taking all lumen leaving
.just narrow area above
diagnosis : huge cancer stomach

1
 -:Barium meal show-51
normal C shape duodenal cap & out pouches in 3rd part of duodenum
. giving picture of ( mashroum shaped) doudenal diverticulum
-: Diagnosis
.duodenal diverticulum

-:Barium meal show-52

Wide C shape deformity of duodenal cap & out pouches in 3rd part of
.( duodenum ( flame-like doudenal diverticulum
-: Diagnosis
.Cancer head of pancreas with duodenal diverticulum

Trifolate duodenal cap-53

-: Barium meal show

persistent Trifoliate deformity in duodenal cap
-: Diagnosis
.Chronic ( cicatricial ) duodenal ulcer

Ulcerative colitis complicated by cancer transverse colon-54

-:Barium enema show

Diffuse narrowing of the colon & Loss of haustration giving ribbon shaped
appearance & smooth filling defect in rt. side of the transverse colon
-: Diagnosis
.Ulcerative colitis complicated by cancer of transverse colon

Colonic diverticulosis-55

-: Barium enema show

Multiple small out pouches in sigmoid colon
.giving saw tooth appearance
-: Diagnosis
. Chronic diverticulosis coli

Congenital megacolon-56

-: Barium enema show

.Huge dilatation of the colon sparing rectum
-: Diagnosis
.(Congenital mega colon (hirschsprung

-: Barium enema show-57

Arrested barium enema in the middle of transverse colon stones,
calcification.gas under diphragm, multiple fluid level
. D.D. intusseption ,Cancer , obstruction, hard fecal mass

1
Acromegalic hand-58

-:Plain X ray on hand showing

Increase soft tissue shadow

.Tufting of terminal phalanges, mushroom shaped

Acromegalic skull-59

-:Plain X ray on skull showing

Ballooning ( widening ) of sella turcica 2- erosion of dorsum sell .-1
3-Prognathism 4- pneumatization of air sinuses 5-thickened cortex,
.prominent occiput & mastoid

.Diagnosis: Acromegalic skull with (intrasellar) pituitary tumor

(Multiple osteolytic lesions in skull(Multiplte Myeloma-60

-: Plain x ray on skull lateral view show

Multiple eqaul sized (small rounded filling defects) radiolucent osteolytic

bone metastasis in the vault of skull mostly multiple myeloma

‫الفم مغلق‬

Osteosclerotic metastasis in occipital skull bone-61

-: Plain X ray on skull lateral view showing

Radio- opaque large shadow in occipital region
(osteosclerotic bone metastasis)
.D.D. cancer prostate &breast

( ‫ مكتوب تحت‬3 ‫)رقم‬

Cod-fish spine-62

-:Plain X ray abdomen (spine) lateral view Showing

Diffuse rarefaction of lumbar spine & code fish appearance ( biconcave -
.(vertebrae
Diagnosis :- osteomalacia or Osteopenia for D.D. ( osteoporosis /
( osteomalacia

1
.Cervical spondylosis-63
-:Plain X ray, cervical spin Lateral view Show
Narrowing of disc (joint) space between C4 & C5. with osteophyte &
sclerosis of adjacent vertebrae
Diagnosis:- Spondylosis
D.D. T.B &Disc prolapsed

.Cervical spondylosis-64
-:Plain X ray, cervical spin Lateral view Show
Narrowing of disc (joint) space between C4 & C5. with osteophyte &
sclerosis of adjacent vertebrae
Diagnosis:- Spondylosis
D.D. T.B &Disc prolapsed

.Cervical spondylosis-65
-:Plain X ray, cervical spin Lateral view Show
Narrowing of disc (joint) space between C4 & C5 , C5 & C6 with
osteophyte & sclerosis of adjacent vertebrae
Diagnosis:- Spondylosis
D.D. T.B &Disc prolapsed

.Cervical spondylosis-66
-:Plain X ray, cervical spin Lateral view Show
Narrowing of disc (joint) space between C6 & C7. with osteophyte &
sclerosis of adjacent vertebrae
Diagnosis:- Spondylosis D.D. T.B &Disc prolapsed

(Diffuse osteosclerosis of spine (Hypoparathyrodism-67

-:Plain X ray abdomen (spine) show

Diffuse sclerosis of lumbar vertebrae
.D.D
.Hypoparathyroidism & Paget disease

:Plain x ray on Rt. Femur show-68

multiple cysts & healed pathological fracture
.D.D
Ostietisfibrosacystica
Hyperparathyroidism

Hour-glass myelogram-69

-: Myelogram Show
Hour glass constriction in lumber region giving picture of saddle shaped
block
Diagnosis
. Extradural extramedullary compression of spinal cord