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Clinical Radiology: The Thorax: Naveen Nair Gangadaran (0402005198)
Clinical Radiology: The Thorax: Naveen Nair Gangadaran (0402005198)
THE THORAX
T
DA
Two films at right angles to one another are Major fissure
needed to determine the true location of any
foreign body or mass within the thorax
The nodule is
in the RML
and calcified
RML
Notice the
absence of
both clavicles.
The heart and
aortic arch are
also on the
right side
(situs
inversus), a
congenital
variant.
2. LOOK AT THE BONES
Examine scapulae, humeri,
1 shoulder joints, clavicles,
2
3 ribs and spine for symmetry
4
5
6
Identify the 1st rib by its
7
anterior junction with the
8 manubrium then count
9
down the posterior ribs
10
The location of an
11 abnormal shadow can be
described by its proximity
12
to a particular rib or
interspace
Healing fracture
Diagnosis: Left
breast cancer
treated with
lumpectomy and
axillary node
dissection
Subcutaneous emphysema and pneumomediastinum
A P
5. LOOK AT THE HEART
The plain film diagnosis of heart disease is limited to determining:
Cardiac enlargement
Congestive failure
Pacemaker
a complication of a
streptococcal infection
resulting in mitral
valve dysfunction
over time
Treated with valve
replacement
Normal
Focal aortic
calcification Note fluid in the pericardial cavity
surrounding the heart
6. LOOK AT THE LUNGS AND
PLEURA
mass
Azygous lobe, a
normal variant
Note the
evidence of
paraseptal
emphysema
(dark air-
filled sacs
along the
lung
periphery)
~ interspace
R
L
R
L
The diaphragm is a The left and right The plane of the right
musculotendinous hemidiaphragms diaphragmatic dome is
sheet separating the are usually well usually about half an
thoracic and seen on PA and interspace higher than
abdominal cavities lateral films the left
Left phrenic nerve paralysis