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Chest X-ray

Esam Alhamad, MD,FCCP, FACP Division of Pulmonary Medicine College of Medicine. Chest X-ray. Is this film centered?. Why do you have to know whether it is PA or AP film. ?. Is this a PA or AP film?. Is the exposure appropriate?. Mediastinal Masses. Anterior mediastinal masses (4Ts)

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Chest X-ray

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  1. Esam Alhamad, MD,FCCP, FACP Division of Pulmonary Medicine College of Medicine Chest X-ray

  2. Is this film centered?

  3. Why do you have to know whether it is PA or AP film ?

  4. Is this a PA or AP film?

  5. Is the exposure appropriate?

  6. Mediastinal Masses Anterior mediastinal masses (4Ts) Thymoma Teratoma Thyroid Terrible lymphoma

  7. Middle Mediastinal Masses 3 As Adenopathy Aneurysm/vascular Abnormalities of development Bronchogenic cyst Pericardial cyst Esophageal cyst

  8. Posterior Mediastinal Masses Neural tumor Neurobalstoma, ganglioneuroma, Ganglineuroblastoma Nerve root tumors Schwannoma, neurofibroma

  9. Airbronchogram Indicates that the opacity is parenchymal not mediastinal or pleural DDx: Consolidation ,Hemorrhage, Edema, Bronchoalveolar Cell Carcinoma, Lymphoma, Sarcoidosis, Alveolar Proteinosis

  10. Pulmonary Hemorrhage Pulmonary-renal syndrome Wegener’s granulomatosis SLE Goodpasture’s syndrom Polyarteritis nodosa Henoch Shonlein purpura

  11. Pulmonary Hemorrhage Without renal disease Anticoagulation Pulmonary infection Pulmonary embolism Trauma Bone marrow transplantation

  12. Pleural effusion Infection Neoplasm CHF Cirrhosis Pancreatitis Uremia Subdiaphragmatic abscess CTD ( SLE, RA) Hypothyrodism Pulmonary embolism

  13. Pleural effusion “ITCH” Large unilateral pleural effusion Infection Tumor Chylous ( ruptured thoracic duct lymphoma) Hemorrhage

  14. Pneumothorax Spontaneous Primary COPD Asthma Cystic fibrosis Cavitary pneumonia Sarcoidosis Pleural metastases

  15. Pericardial effusion Serous CHF, Hypoalbuminemia, CTD, Hypothyroidism Bloody Acute MI, Trauma, Neoplasm, CRF Purulent Bacterial, Viral ,Tuberculosis, Fungal

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