C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.

jpe Chest X ray Interpretation Chest X-ray Interpretation Dr. Paritosh Jaiswal M.D. Medicine C:\My Documents\My Pictures\Medical pictures\xray2.bmp

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Introduction Introduction .Routinely obtained .Pulmonary specialist consultation .Inherent physical exam limitations .Chest x-ray limitations .Physical exam and chest x-ray provide compliment

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Essentials Before Getting Started Essentials Before Getting Started .Exposure Overexposure Underexposure .Sex of Patient Male Female

C:\My Documents\My Pictures\Medical pictures\pa chest.gif C:\My Documents\My Pictures\Medical pictures\Female chest.gif

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Essentials Before Getting Started Essentials Before Getting Started .Path of x-ray beam PA AP .Patient Position Upright Supine

C:\My Documents\My Pictures\Medical pictures\pa chest.gif C:\My Documents\My Pictures\Medical pictures\ap chest.gif

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Essentials Before Getting Started Essentials Before Getting Started .Breath Inspiration Expiration

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Systematic Approach Systematic Approach .Bony Framework .Soft Tissues .Lung Fields and Hila .Diaphragm and Pleural Spaces .Mediastinum and Heart .Abdomen and Neck

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Systematic Approach Systematic Approach .Bony Fragments Ribs Sternum Spine Shoulder girdle Clavicles

C:\My Documents\My Pictures\Medical pictures\chest.gif http://www.vh.org/Providers/Lectures/icmrad/chest/parts/Osseous.jpg

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Systematic Approach Systematic Approach .Soft Tissues Breast shadows Supraclavicular areas Axillae Tissues along side of breasts

C:\My Documents\My Pictures\Medical pictures\Female chest.gif

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Systematic Approach Systematic Approach .Lung Fields and Hila Hilum .Pulmonary arteries .Pulmonary veins Lungs .Linear and fine nodular shadows of pulmonary vessels Blood vessels 40% obscured by other tissue

C:\My Documents\My Pictures\Medical pictures\chest.gif

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Systematic Approach Systematic Approach .Diaphragm and Pleural Surfaces Diaphragm .Dome-shaped .Costophrenic angles Normal pleural is not visible Interlobar fissures

C:\My Documents\My Pictures\Medical pictures\cxr_16.jpg

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Systematic Approach Systematic Approach .Mediastinum and Heart Heart size on PA Right side .Inferior vena cava .Right atrium .Ascending aorta .Superior vena cava

C:\My Documents\My Pictures\Medical pictures\Chest Heart.gif

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Systematic Approach Systematic Approach .Mediastinum and Heart Left side .Left ventricle .Left atrium .Pulmonary artery .Aortic arch .Subclavian artery and vein

C:\My Documents\My Pictures\Medical pictures\Chest Heart.gif

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Systematic Approach Systematic Approach .Abdomen and Neck Abdomen .Gastric bubble .Air under diaphragm Neck .Soft tissue mass .Air bronchogram

C:\My Documents\My Pictures\Medical pictures\Female chest.gif

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Summary of Density Summary of Density .Air .Water .Bone .Tissue http://www.meddean.luc.edu/lumen/MedEd/medicine/pulmonar/images/apd/nlrcxr2.jpg Tissue

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Pitfalls to Chest X ray Interpretation Pitfalls to Chest X-ray Interpretation .Poor inspiration .Over or under penetration .Rotation .Forgetting the path of the x-ray beam

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Lung Anatomy Lung Anatomy .Trachea .Carina .Right and Left Pulmonary Bronchi .Secondary Bronchi .Tertiary Bronchi .Bronchioles .Alveolar Duct .Alveoli C:\My Documents\My Pictures\Medical pictures\lung disect.jpg C:\My Documents\My Pictures\Medical pictures\bronctr.jpg

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Lung Anatomy Lung Anatomy .Right Lung Superior lobe Middle lobe Inferior lobe .Left Lung Superior lobe Inferior lobe

C:\My Documents\My Pictures\Medical pictures\lungs.jpg C:\My Documents\My Pictures\Medical pictures\frontmrk.jpg C:\My Documents\My Pictures\Medical pictures\rhtsidvw.jpg

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Lung Anatomy on Chest X ray Lung Anatomy on Chest X-ray .PA View: Extensive overlap Lower lobes extend high .Lateral View: Extent of lower lobes

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Lung Anatomy on Chest X ray Lung Anatomy on Chest X-ray .The right upper lobe (RUL) occupies the upper 1/3 of the right lung. .Posteriorly, the RUL is adjacent to the first three to five ribs. .Anteriorly, the RUL extends inferiorly as far as the 4th right anterior rib http://www.vh.org/Providers/Textbooks/LungAnatomy/RadImages/RULPA.jpg http://www.vh.org/Providers/Textbooks/LungAnatomy/RadImages/RULLAT.jpg

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Lung Anatomy on Chest X ray Lung Anatomy on Chest X-ray .The right middle lobe is typically the smallest of the three, and appears triangular in shape, being narrowest near the hilum http://www.vh.org/Providers/Textbooks/LungAnatomy/RadImages/RMLPA.jpg http://www.vh.org/Providers/Textbooks/LungAnatomy/RadImages/RMLLAT.jpg

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Lung Anatomy on Chest X ray Lung Anatomy on Chest X-ray .The right lower lobe is the largest of all three lobes, separated from the others by the major fissure. .Posteriorly, the RLL extend as far superiorly as the 6th thoracic vertebral body, and extends inferiorly to the diaphragm. .Review of the lateral plain film surprisingly shows the superior extent of the RLL. http://www.vh.org/Providers/Textbooks/LungAnatomy/RadImages/RLLPA.jpg http://www.vh.org/Providers/Textbooks/LungAnatomy/RadImages/RLLLAT.jpg

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Lung Anatomy on Chest X ray Lung Anatomy on Chest X-ray .These lobes can be separated from one another by two fissures. .The minor fissure separates the RUL from the RML, and thus represents the visceral pleural surfaces of both of these lobes. .Oriented obliquely, the major fissure extends posteriorly and superiorly approximately to the level of the fourth vertebral body. http://www.vh.org/Providers/Textbooks/LungAnatomy/RadImages/Rtfissure.jpg

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Lung Anatomy on Chest X ray Lung Anatomy on Chest X-ray .The lobar architecture of the left lung is slightly different than the right. .Because there is no defined left minor fissure, there are only two lobes on the left; the left upper http://www.vh.org/Providers/Textbooks/LungAnatomy/RadImages/LULPA.jpg http://www.vh.org/Providers/Textbooks/LungAnatomy/RadImages/LULLAT.jpg

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Lung Anatomy on Chest X ray Lung Anatomy on Chest X-ray .Left lower lobes http://www.vh.org/Providers/Textbooks/LungAnatomy/RadImages/LLLPA.jpg http://www.vh.org/Providers/Textbooks/LungAnatomy/RadImages/LLLLAT.jpg

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Lung Anatomy on Chest X ray Lung Anatomy on Chest X-ray .These two lobes are separated by a major fissure, identical to that seen on the right side, although often slightly more inferior in location. .The portion of the left lung that corresponds anatomically to the right middle lobe is incorporated into the left upper lobe. http://www.vh.org/Providers/Textbooks/LungAnatomy/RadImages/Ltfissure.jpg

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe The Normal Chest X ray The Normal Chest X-ray .PA View: 1.Aortic arch 2.Pulmonary trunk 3.Left atrial appendage 4.Left ventricle 5.Right ventricle 6.Superior vena cava 7.Right hemidiaphragm 8.Left hemidiaphragm 9.Horizontal fissure

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe The Normal Chest X ray The Normal Chest X-ray .Lateral View: 1.Oblique fissure 2.Horizontal fissure 3.Thoracic spine and retrocardiac space 4.Retrosternal space

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe The Silhouette Sign The Silhouette Sign .An intra-thoracic radioopacity, if in anatomic contact with a border of heart or aorta, will obscure that border. An intrathoracic lesion not anatomically contiguous with a border or a normal structure will not obliterate that border. C:\My Documents\My Pictures\Medical pictures\cxr_16.jpg

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Putting It All Together Putting It All Together C:\My Documents\My Pictures\Medical pictures\xray.gif

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\normal chest.jpg

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Understanding Pathological Changes Understanding Pathological Changes .Most disease states replace air with a pathological process .Each tissue reacts to injury in a predictable fashion .Lung injury or pathological states can be either a generalized or localized process

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Liquid Density Liquid Density Liquid density Increased air density Generalized Localized Diffuse alveolar Diffuse interstitial Mixed Vascular Infiltrate Consolidation Cavitation Mass Congestion Atelectasis Localized airway obstruction Diffuse airway obstruction Emphysema Bulla

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Consolidation Consolidation .Lobar consolidation: Alveolar space filled with inflammatory exudate Interstitium and architecture remain intact The airway is patent Radiologically: .A density corresponding to a segment or lobe .Airbronchogram, and .No significant loss of lung volume

C:\My Documents\My Pictures\Medical pictures\consilidation1.jpg C:\My Documents\My Pictures\Medical pictures\consilidation2.jpg

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Atelectasis Atelectasis .Loss of air .Obstructive atelectasis: No ventilation to the lobe beyond obstruction Radiologically: .Density corresponding to a segment or lobe .Significant loss of volume .Compensatory hyperinflation of normal lungs

C:\My Documents\My Pictures\Medical pictures\atelectasis1.jpg C:\My Documents\My Pictures\Medical pictures\atelectasis2.jpg

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Stages of Evaluating an Abnormality Stages of Evaluating an Abnormality 1. Identification of abnormal shadows 2. Localization of lesion 3. Identification of pathological process 4. Identification of etiology 5. Confirmation of clinical suspension .Complex problems .Introduction of contrast medium .CT chest .MRI scan

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Putting It Into Practice Putting It Into Practice

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Case 1 Case 1

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\Scc.gif

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\SCC answer.gif A single, 3cm relatively thin-walled cavity is noted in the left midlung. This finding is most typical of squamous cell carcinoma (SCC). One-third of SCC masses show cavitation

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Case 2 Case 2

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\atelectasis1.jpg C:\My Documents\My Pictures\Medical pictures\atelectasis2.jpg

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\atelectasis1.jpg C:\My Documents\My Pictures\Medical pictures\atelectasis2.jpg LUL Atelectasis: Loss of heart borders/silhouetting. Notice over inflation on unaffected lung

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Case 3 Case 3

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\Case2CXRpneumonia.gif C:\My Documents\My Pictures\Medical pictures\Case2Lateralpneumonia.gif

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\Case2CXRpneumonia.gif C:\My Documents\My Pictures\Medical pictures\Case2Lateralpneumonia.gif Right Middle and Left Upper Lobe Pneumonia

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Case 4 Case 4

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\Abscess1.gif

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\Abscess1.gif Cavitation:cystic changes in the area of consolidation due to the bacterial destruction of lung tissue. Notice air fluid level.

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\cavitation.jpg C:\My Documents\My Pictures\Medical pictures\cavitation2.jpg Cavitation

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Case 5 Case 5

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\Tuberculosis-5.jpg

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\Tuberculosis-5.jpg Tuberculosis

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Case 6 Case 6

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\COPD.jpg

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe COPD: increase in heart diameter, flattening of the diaphragm, and increase in the size of the retrosternal air space. In addition the upper lobes will become hyperlucent due to destruction of the lung tissue. C:\My Documents\My Pictures\Medical pictures\COPD.jpg

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\Chest Xray\emph.jpg Chronic emphysema effect on the lungs

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Case 7 Case 7

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\Pseudotumor.gif

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\Pseudotumor.gif Pseudotumor: fluid has filled the minor fissure creating a density that resembles a tumor (arrow). Recall that fluid and soft tissue are indistinguishable on plain film. Further analysis, however, reveals a classic pleural effusion in the right pleura. Note the right lateral gutter is blunted and the right diaphram is obscurred.

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Case 8 Case 8

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\Pneumonia1.gif

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\Pneumonia1.gif Pneumonia:a large pneumonia consolidation in the right lower lobe. Knowledge of lobar and segmental anatomy is important in identifying the location of the infection

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Case 9 Case 9

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe http://www.vh.org/Providers/Lectures/icmrad/chest/parts/CHF.t1.gif

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe http://www.vh.org/Providers/Lectures/icmrad/chest/parts/CHF.t1.gif CHF:a great deal of accentuated interstitial markings, Curly lines, and an enlarged heart. Normally indistinct upper lobe vessels are prominent but are also masked by interstitial edema.

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe http://www.vh.org/Providers/Lectures/icmrad/chest/parts/AfterCHF.gif 24 hours after diuretic therapy

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Case 10 Case 10

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\chest wall lesion.jpg

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\chest wall lesion.jpg Chest wall lesion: arising off the chest wall and not the lung

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Case 11 Case 11

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\effusion.jpg

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\effusion.jpg Pleural effusion: Note loss of left hemidiaphragm. Fluid drained via thoracentesis C:\My Documents\My Pictures\Medical pictures\effusion2.jpg

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Case 12 Case 12

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\mass 3.jpg C:\My Documents\My Pictures\Medical pictures\mass 4.jpg

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\mass 3.jpg C:\My Documents\My Pictures\Medical pictures\mass 4.jpg C:\My Documents\My Pictures\Medical pictures\mass2.jpg Lung Mass

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Case 13 Case 13

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\pneumo1.gif

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\pneumo1.gif Small Pneumothorax: LUL

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Case 15 Case 15

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\pneumo4.gif

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\pneumo4.gif Right Middle Lobe Pneumothorax: complete lobar collapse

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\post chest tube.jpg Post chest tube insertion and re-expansion

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Case 16 Case 16

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe http://medes3.med.umontreal.ca/MedWeb/Cours/module2130/RX-29.JPEG

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe http://medes3.med.umontreal.ca/MedWeb/Cours/module2130/RX-29.JPEG Metastatic Lung Cancer: multiple nodules seen

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Case 17 Case 17

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\pulm nod1.gif C:\My Documents\My Pictures\Medical pictures\pulm nod2.gif

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\pulm nod1.gif C:\My Documents\My Pictures\Medical pictures\pulm nod2.gif Right upper lower lobe pulmonary nodule

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Case 18 Case 18

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\tb4.jpg

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\tb4.jpg Tuberculosis

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Case 19 Case 19

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\perihilar mass.jpg

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\perihilar mass.jpg Perihilar mass: Hodgkin s disease

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Case 20 Case 20

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\aortic disection.jpg

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\aortic disection.jpg Widened Mediastinum: Aortic Dissection

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Case 21 Case 21

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\pulm art1.gif C:\My Documents\My Pictures\Medical pictures\pulm art2.gif

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe C:\My Documents\My Pictures\Medical pictures\pulm art1.gif C:\My Documents\My Pictures\Medical pictures\pulm art2.gif Pulmonary artery stenosis with cardiomegally likely secondary to stenosis.

C:\Documents and Settings\Bucky Boaz\My Documents\My Pictures\2002-03-16\x-ray-0 1.jpe Questions? Questions?