A-airways

B-bone strx
C-cardiac silhouette
D-diaphragm
E-everything else
F-foreign body

Usually PA for ADULT

During exam: take note of the

dx,RF,transmission,etiology,PE
Normal chest xray findings,significant hx
Pneumonia right base

-hx of cough;crackles
-confluent haziness in R lower lung
is a consolidation(fluids/exudate)
-cardiac border is visible in L side;L
diaphragm is very distinct whereas
the R diaphragm is indistinct
(silhouette sign)
Absence of left
costopherenic angle

Dx: Pneumonia L lower

lung or L base
Etiology:Bacterial,viral,fu
ngal pneumonia
Haziness on both bases

Dx:Pneumonia bases (kasi

both bases)
Dx:Interstitial pneumonia
Pediatric:lateral view
Evaluate the retrocardiac space
(yung nabilugan)—haziness on
both bases and at retrocardiac
space

Dx:Pneumonia bases
L:clear
R:haziness
Lateral: consolidation that is wedge shape in
nature

Dx:Right Middle lobe Pneumonia (wedge

shape-pathog sign..WALANG MIDDLE LEFT!)
WEDGE OR
TRIANGULAR
SHAPE
Bases:almost equal
L apex:black(radioluscent)
R apex:radiopaque

Dx:PTB
Class’n:
Minimal
Moderately advance
Far advance

Etiology:Mycobacterium Tuberculosis bacilli;acid fast

stain positive;aerobic
Costochondral-bet
ribs&bony sternum

Minimal:no cavity
Mod: < 4cm
FA: >4cm
Both apices here are involved
Try to transfer the infiltrates on one
side,approximate it;

In here, it is more than the two

costochondral junction,the dx is PTB
MODERATELY ADVANCED

Kasi pag far advanced,the infiltrate

should fill approx. ONE LUNG FIELD
(ex:1/2 infiltrate is seen in each lung,if
combined,it fills one lung!)
PTB cannot totally r/o pulmonary mass,right upper
lung

Dx: PTB moderately advanced

Pneumonic process-more on basal area;consolidation
Infiltrates-seen at R upper lung

There is a cavitary lesion w/c is <4cm

Dx:PTB moderately advanced

No infiltrates on R lung
L upper lung has infiltrates and cavitary lesions
that are >4cm

Dx:PTB FAR ADVANCED

Filled with miliary seeds
Not >2mm

Mode of spread:hematogenous
Dx:MILIARY TB
Tracheal tube-yung red curve
Lung mass,with calcification
w/c indicates pleurisity
except if minute,chain
calcification in
mammography (malignancy)

Dx:Tuberculoma
In other cases:pulmonary
calcifications are seen in
both lung fields
Diaphragm are almost at the same level
Normally, R is higher
In here,there might be a mass in the L diaphragm
pushing it down;or a mass below the L diaphragm
pushing it up making it same level with the R one

HYPERLUSCENT LUNG(totally black)

HEART-TEARDROP SHAPE of heart

Case:flattened diaphragm, TEARDROP SHAPE of

heart,widened ICS,increased radioluscency

Dx:Barrel chest-PULMONARY EMPHYSEMA

-Barrel chest
Flattened diaphragm
EMPHYSEMA
Tracheal shadow
-d/t presence of air
-trachea deviates to the R

-cardiac shadow is almost

at midline
Tracheal shadow is ok
Trachea deviates to the R

Dx:Atelectasis
Cardiac shadow deviates to L
Trachea deviates to L side
No cardiac shadow on the vertebra,rather it is
on the L

Dx:Atelectasis (affecting the L lung)

Case: pulmonary solitary nodule

Yung arrow, it may be a chronic or

malignant case w/c may develop into
pulmonary mass and progress to
bronchogenic CA

Dxc test to request to r/o malignant or

solitary nodule:CT guided needle
biopsy
Solitary nodule should not
exceed >3cm

If >3cm,pulmonary mass na
RF:smoking
Pulmonary solitary nodule
Nodule parin
Pulmonary mass L lung
R hilar mass
L hilar mass
R hilar mass

Tx:radiotherapy
Nilampasan ni dok
Request for lateral view to check
the exact location of the mass
Mass lies posteriorly
Normodensity of L lung
Radioluscent almost black R lung

Sa bandang R,may mahabang vertical

curve outline dun, mga tinuturo ng blue
arrow..tapos sa division nya yung kabila
may lung markings pa pero sa kabila is
void of lung markings na

Dx: R Pneumothorax
L Pneumothorax
-loss of lung markings sa L
-radioluscency
Complete collapse-PE
findings is no breath
sounds

An emergency case
Tx:reexpand the lung
Lung edema
-fluid in the air sacs
Pulmonary edema

hx:/PE:dyspnea

Dob dt sob
Fluid w/in the thoracic/lung cavity (not
in the air sac)

Request for lateral decubitus view to r/i

fluid
Lie down in affected area for 5-10 mins
before taking xray..fluid will shift to the
portion of the affected lung
Request for L lateral decubitus view
because the affected side is the L
Also L lung
Fluid on R lung

SOB,DOB,as if drowning,prefer to
sleep on sitting position
Lung metastasis
Lung metastasis
Convex density duuuun sa L
lung,yung parang natapyasan dun
na letter C sa L lateral
 Mass is always on the lateral part of
thoracic cage and the base is attached on
thoracic wall vs pulmonary mass w/c is
w/in the parenchyma

PLEURAL MASS
Mass ulit
Pleural mass
The mass is attached
to the ribs
Pneumoperitoneum

Incidental case; “E” case also

Etiology:ruptured ulcer
Hx:normal if underwent laparoscopy
Never seen on lateral
side;always in center
R pneumoperitoneum
Size of the heart is not more than
the half size of the thoracic cage

But if >1/2,consider cardiomegaly

CARDIOMEGALY
>1/2 the length of thoracic cage
SAIL SIGN
-thymus gland is visible in xray of
paediatrics;normally it is in the R,but
some cases is bilateral
Ground glass appearance

Deficient in surfactant
Premature babies

aka RDS
Ground glass plus air bronchogram
-HMD
ET tube
Request instant CXR-thick meconium baby—
risk for meconium aspiration
Foreign body-coin at esophagus

The child will die if it will reach the

trachea d/t obstruction of airways