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The 12-Step:
1: Name Pre-read 2: Date 3: Old films 4: What type of view(s) 5: Penetration 6: Inspiration Quality Control 7: Rotation 8: Angulation 9: Soft tissues / bony structures 10: Mediastinum Findings 11: Diaphragms 12: Lung Fields
Is heart enlarged or normal? Signs of heart failure and fluid overload? Does patient have pneumonia or collapsed lung? Is there evidence of emphysema? Are there findings of an aortic aneurysm? Is there fluid in the sac that surrounds the lung? Is there free air under the diaphragm? Is there a tumor in the lung that could represent cancer?
3
PA
LATERAL
Two (2) projections are needed for most x-rays to locate structures in 3 planes (1)Right or Left , (2) Anterior or Posterior) or (3) Superior or Inferior.
POSTERIOR
4
ANTERIOR
P A
LT.
HORIZONTAL FISSURE
RT. HEMI DIAPHRAGM RT. LT. HEMI DIAPHRAGM COLON GAS LT.
TRACHEA
MIDDLE
lobes
LOWER
12
INTERESTING CASES
INFECTION
NEOPLASTIC
CARDIOVASCULAR TRAUMA
13
RUL pneumonia
15
RML pneumonia
16
RLL pneumonia
17
LUL pneumonia
18
LLL pneumonia
19
Pulmonary Fibrosis
20
Miliary TB
21
TB
22
23
Cavitating lesion
24
CaVity
25
Hilar Lymphadenopathy - BL
26
PNEUMOTHORAX
PLEURAL EFFUSION
PLEURAL EFFUSION
NORMAL
28
PLEURAL EFFUSION
29
Pleural Effusion
30
PNEUMOTHORAX
Pneumothorax
33
TENSION PNEUMOTHORAX
TENSION PNEUMOTHORAX
35
Hyperinflation
36
Hemothorax
37
38
RUL collapse
39
LLL collapse
40
41
Hilar mass
42
Emphysema
43
Subcutaneous emphysema
44
ARDS
Congestion Interstitial and
45
Bulla
46
SARCOIDOSIS
Granulomatous Inflammation
Bilateral &
47
ATELECTASIS
No ventilation to lobe beyond the obstruction Trapped air absorbed by pulmonary circulation Segmental/lobar density
48
49
50
NORMAL HEART
CARDIOMEGLY
Dextrocardia
52
53
Cardiomegaly
CARDIOMEGLY
55
Large hila with indistinct markings Fluid in interlobar fissures Pleural effusions, alveolar edema
56
Heart failure
57
Pericardial effusion
58
Pulmonary Edema
59
Pulmonary Embolism
60
Kerley B line
61
VSD
62
ASD
63
64
Aortic dissection
65
66
Multiple Masses
67
Free air
68
69
Opacified hemithorax
70
Pneumonectomy
71
Pneumonectomy
72
Hiatus hernia
73
Clavicle dislocation
76
LT.
Rib fracture on the left are associated with a small pleural effusion blunting the costophrenic angle. Compare with normal RT. side.
FRONTAL
LATERAL
Air stripe
Diaphragm rupture
79
80
GOOD LUCK