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Basic Radiology for Non
Radiologist
Dr. Muhammad Bin Zulfiqar
PGR II SIMS/SHL
AIMS
• Introduction and basics of
– Plain Radiography (Chest X-Rays)
– CT Scan
– MR Imaging
Chest X-Rays
• Patent ID and date
• Projection----PA/AP/LAT
• Centering----Rotated /Non-rotated
• Exposure----Adequate /Poor
• Inspiratory effort
A The cardiomediastinal contour is significantly
magnified on this AP film. This needs to be
appreciated and not overcalled.
B On the PA film, taken only an hour later, the
mediastinum appears normal.
Lateral View
• A well centred x-ray. Medial
ends of clavicles are
equidistant from the
spinous process.
• This patient is rotated to the
left. Note the spinous
process is close to the right
clavicle and the left lung is
‘blacker’ than the right, due
to the rotation.
Exposure
• The cardiothoracic ratio should be less than 0.5.
• i.e. A/B<0.5.
• A cardiothoracic ratio of greater than 0.5 (in a good quality
film) suggests cardiomegaly.
Hilar Contour
Normal chest
x-ray
Lobes and Fissures
RUL
LUL
RLL
RML
LLL
Left Lateral View Right Lateral View
LUL
LLL
RUL
RML
RLL
http://www.wikiradiography.com/page/Chest+Radiographic+Anatomy
Cervical Rib
Pleural Effusion
Lobulated pleural effusion
Subpulmonic pleural effusion
• Bronchiectasis. There is widespread bronchial wall abnormality in both
lungs, but particularly in the right lung. In the right lower zone, there is
marked bronchial wall thickening (remember that the normal bronchial
wall should be ‘pencil line’ thin) with ‘tram lines’ visible.
• Carcinoma with rib destruction. Dense opacification of
the left upper lobe with associated destruction of the
left second and third anterior ribs.
• Left Hilar Mass
• Chronic obstructive pulmonary disease. The lungs are
hyperinflated with flattening of both hemidiaphragms. On the lateral view,
the chest appears ‘barrel-shaped’ due to an increase in the retro-sternal
air space.
Emphysema
Bulla
Asthma
Post traumatic DH Congenital
• Flail chest – case 2. Double fractures of the
left posterior fifth and sixth ribs.
• Simple pneumothorax. The right lung edge is
faintly visible on the inspiratory film. However,
the pneumothorax becomes clearly evident on
the expiratory film.
Tension pneumothorax
TB
Miliary TB
Retrosternal Goiter
Adult Respiratory Distress Syndrome
CT Brain
ICH
Subarachnoid Hemorrhage
Subdural Hematoma
Extradural Hematoma
Infarction
Pneumocephalous
SOL
Disc Prolapse
Disc Herniation
THANK YOU

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Basic radiology for non radiologist

Editor's Notes

  1. Go over anatomy of Lobes on Chest X-ray with Residents Evaluation of the lobes and fissures allows you to localize the pathology