Items tagged “chest x-ray”

Deviation of the azygo-esophageal recess can be normal or pathological. The azygo-esophageal recess is formed by the interface between the right lung and the mediastinal reflection of the azygos vein and esophagus. The line has a variable appearance 1: in its upper third, it deviates to the ri...

ABCDEFGHI can be used to guide a systematic interpretation of chest x-rays. Assessment of quality / Airway The quality of the image can be assessed using the mnemonic PIER: position: is this a supine AP file? PA? Lateral? inspiration: count the posterior ribs. You should see 10 to 11 ribs wi...

A detailed understanding of the structures that make up the normal contours of the heart and mediastinum (cardiomediastinal contour) on chest radiography is essential if abnormalities are to be detected.  Frontal view (PA/AP) Right cardiomediastinal contour From superior to inferior: right p...

The common causes of an anterosuperior mediastinal mass can be remembered by using the mnemonic: 5 Ts Mnemonic T: thymus T: thyroid T: thoracic aorta T: terrible lymphoma T: teratoma and germ cell tumors - see mediastinal germ cell tumors Testicular cancer metastasis can represent a sixt...

The normal position of hemidiaphragms on chest radiography reflects the presence of the heart and subdiaphragmatic organs. Therefore, the hemidiaphragms are not at the same level on frontal erect inspiratory chest radiographs, but are usually within one rib intercostal space height (~2 cm) of ea...

Flattening of the diaphragm is the most sensitive sign on chest radiographs for the presence of hyperinflation of the lungs, usually due to emphysema 1,2. On a lateral chest radiograph, the normal dome of each hemidiaphragm should rise at least 1.5 cm above a line connecting the costophrenic an...

Right atrial (RA) enlargement is less common, and harder to delineate on chest radiograph, than left atrial (LA) enlargement. Pathology Etiology Enlargement of the right atrium (RA) can result from a number of conditions, including: raised right ventricular pressures pulmonary arterial hype...

Right ventricular enlargement (also known as right ventricular dilatation (RVD)) can be the result of a number of conditions, including: pulmonary valve stenosis pulmonary arterial hypertension atrial septal defect (ASD)  ventricular septal defect (VSD) tricuspid regurgitation dilated card...

Left atrial enlargement (LAE) may result from many conditions, either congenital or acquired. It has some characteristic findings on a frontal chest radiograph. CT or MRI may also be used for diagnosis. Clinical presentation An enlarged left atrium can have many clinical implications, such as:...

A chest radiograph in the exam setting may contain a vast variety of pathology. However, consider the history and correlate the likely diagnoses that may be demonstrated on film. Furthermore, check your review areas to ensure that the abnormality is not at the corner of the film. Locating patho...

The chest radiograph zones are useful when describing the location of pathology on a frontal chest radiograph. The chest radiograph is a 2D representation of a 3D structure. Since the interfaces between the lobes are oriented obliquely, it is often not possible to determine which lobe pathology...

The right paratracheal stripe is a normal finding on the frontal chest x-ray and represents the right tracheal wall, adjacent pleural surfaces and any mediastinal fat between them. It is visible because of the silhouette sign created by air within the trachea medially and air within the lung lat...

Chest x-ray lines and stripes are important to recognize on chest radiographs.  Lines are usually less than 1 mm in width and are comprised of tissue outlined on either side by air and typically represent pleural-covered structures within the middle and superior mediastinum 1,2: anterior junct...

The cardiothoracic ratio (CTR) aids in the detection of enlargement of the cardiac silhouette, which is most commonly from cardiomegaly but can be due to other processes such as a pericardial effusion.  Terminology Some report cardiothoracic ratio as a percentage, however this is incorrect, as...

Left upper lobe collapse has distinctive features but can be challenging to identify on chest radiographs by the uninitiated. Hence it is a classic chest radiograph case for radiology fellowships exams. For a general discussion refer to the article on lobar collapse. Radiographic features Pla...