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  1. X-ray (chest), PA, Metastatic Cancer, Adult Male

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    Description: 1.Multiple bilateral spherical masses (greater than 30 mm diameter) and nodules (less than 30 mm) characteristic of metastatic cancer. Many types of primary cancers metastasize to the lungs but the most common are breast, colon, prostate, and bladder cancer. 2. Fluid meniscus-shaped blunting of left costophrenic angle from pleural effusion. 3. Annotation #3 marks the radio-opaque strip built into an endotracheal tube. The tip of endotracheal tube surrounded by air-filled balloon. The ideal position for the endotracheal tube tip is in the mid trachea, 3-5 cm from the carina, or approximately the mid point between the clavicles and the carina (the division of the right and left mainstem bronchi - just superior to annotation C). The minimal safe distance from the carina is 2 cm because movement of the patient's head can lead to right main stem bronchus intubation. If the tip of the endotracheal tube is too high it can be dislodged by movement of the patient's head leading to extubation. Unrecognized displacement of the endotracheal tube in either direction rapidly becomes a very hazardous situation for the patient. Frequently the exact position of the carina can be difficult to ascertain, particularly on portable AP studies. Its location can be estimated by drawing a line that bisects the midpoint of the aorta at a 45-degree angle running inferiorly to the right (please see second x-ray). 4. Gastric tube with tip in stomach. Once a patient is endotracheally intubated a nasogastric or oralgastric tube is typically immediately placed to decompress the stomach helping to prevent aspiration as well as vent out air that may have been forced into the stomach during bag-valve mask ventilation. A air-distended stomach can prevent effective ventilation, particularly in pediatric patients. Remembering this pearl under pressure of a pediatric resuscitation may save a potentially salvageable pediatric patient during your career.
    Keywords: Radiology, Diagnostic X-Ray, Diagnosis, Neoplasms, cancer, metastatic cancer, Radiography, Roentgenography, Diagnostic X-Ray, X-Ray Radiology, Diagnostic, X-Ray, Diagnostic, Diagnostic X-Ray Radiology

  2. X-ray (chest), Metastatic Cancer, Adult Male

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    Description: 1.Multiple bilateral spherical masses (greater than 30 mm diameter) and nodules (less than 30 mm) characteristic of metastatic cancer. Many types of primary cancers metastasize to the lungs but the most common are breast, colon, prostate, and bladder cancer. 2. Fluid meniscus-shaped blunting of left costophrenic angle from pleural effusion. 3. Annotation #3 marks the radio-opaque strip built into an endotracheal tube. The tip of endotracheal tube surrounded by air-filled balloon. The ideal position for the endotracheal tube tip is in the mid trachea, 3-5 cm from the carina, or approximately the mid point between the clavicles and the carina (the division of the right and left mainstem bronchi - just superior to annotation C). The minimal safe distance from the carina is 2 cm because movement of the patient's head can lead to right main stem bronchus intubation. If the tip of the endotracheal tube is too high it can be dislodged by movement of the patient's head leading to extubation. Unrecognized displacement of the endotracheal tube in either direction rapidly becomes a very hazardous situation for the patient. Frequently the exact position of the carina can be difficult to ascertain, particularly on portable AP studies. Its location can be estimated by drawing a line that bisects the midpoint of the aorta at a 45-degree angle running inferiorly to the right (please see second x-ray). 4. Gastric tube with tip in stomach. Once a patient is endotracheally intubated a nasogastric or oralgastric tube is typically immediately placed to decompress the stomach helping to prevent aspiration as well as vent out air that may have been forced into the stomach during bag-valve mask ventilation. A air-distended stomach can prevent effective ventilation, particularly in pediatric patients. Remembering this pearl under pressure of a pediatric resuscitation may save a potentially salvageable pediatric patient during your career.
    Keywords: Radiography, metastatic cancer, Roentgenography, Radiology, Diagnostic X-Ray, Diagnostic X-Ray, X-Ray Radiology, Diagnostic, Diagnostic X-Ray Radiology, X-Ray, Diagnostic, Neoplasms, Diagnosis, cancer

  3. X-ray (chest), PA, Thymoma Invasive, Adult Male

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    Description: 1. Mediastinal mass with compression of trachea. Note that the mass silhouettes the superior aspect of the right heart border and superior vena cava suggesting it abuts or is anterior to these structures. Also note the roughly "sail-sign" like triangular shape with the inferior margin terminating at the inferior base of the hilum, a configuration similar to that seen when the thymus is visible on a pediatric radiograph. 2. Elevation of the right hemidiaphragm likely due to bronchogenic obstruction and associated volume loss given the increased opacity and plate-like atelectasis changes of the right lung parenchyma. Also could be due to injury to the right phrenic nerve. Note the marked overall lung volume loss and increased density of lung markings suggestive of bronchogenic obstruction. 3. Oblique fissure right lung. 4. Blunting of the right costophrenic angle consistent with a pleural effusion. In general it takes about 200-300 ml of fluid to cause blunting of the costophrenic angle. 5. Thickened, distorted horizontal fissure vs. plate-like atelectasis due to obstructed bronchus.
    Keywords: X-Ray Radiology, Diagnostic, Roentgenography, Diagnostic X-Ray Radiology, Diagnostic X-Ray, Radiology, Diagnostic X-Ray, X-Ray, Diagnostic, Diagnosis, Carcinoma, Thymic, Neoplasms, Neoplasms by Histologic Type, Radiography

  4. X-ray (chest), PA, Thymoma Invasive, Adult Male

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    Description: 1. Mediastinal mass with compression of trachea. Note that the mass silhouettes the superior aspect of the right heart border and superior vena cava suggesting it abuts or is anterior to these structures. Also note the roughly "sail-sign" like triangular shape with the inferior margin terminating at the inferior base of the hilum, a configuration similar to that seen when the thymus is visible on a pediatric radiograph. 2. Elevation of the right hemidiaphragm likely due to bronchogenic obstruction and associated volume loss given the increased opacity and plate-like atelectasis changes of the right lung parenchyma. Also could be due to injury to the right phrenic nerve. Note the marked overall lung volume loss and increased density of lung markings suggestive of bronchogenic obstruction. 3. Oblique fissure right lung. 4. Blunting of the right costophrenic angle consistent with a pleural effusion. In general it takes about 200-300 ml of fluid to cause blunting of the costophrenic angle. 5. Thickened, distorted horizontal fissure vs. plate-like atelectasis due to obstructed bronchus.
    Keywords: Radiography, Diagnostic X-Ray Radiology, Neoplasms by Histologic Type, Radiology, Diagnostic X-Ray, Roentgenography, Neoplasms, Diagnostic X-Ray, Carcinoma, Thymic, X-Ray, Diagnostic, X-Ray Radiology, Diagnostic, Diagnosis

  5. X-ray (chest), PA, Thymoma, Adult Male

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    Description: 1. Mediastinal mass. CT is required to differentiate this mass as a thymoma vs. sarcoidosis or carcinoma other than location. 2. Deviation of the trachea to the right of the vertebral processes from mass effect. 3. Silhouette of aorta showing common age-related ectasia or unfolding of the aorta. The fact that the border of the aorta can be sharply differentiated from the mediastinal mass argues strongly that the mass is not due to aortic aneurysm or dissection. 4. Age-related calcification of costal cartilage.
    Keywords: Neoplasms by Histologic Type, Carcinoma, Thymic, Radiology, Diagnostic X-Ray, Roentgenography, Diagnostic X-Ray, Diagnosis, X-Ray, Diagnostic, Radiography, Neoplasms, X-Ray Radiology, Diagnostic, Diagnostic X-Ray Radiology

  6. X-ray (chest), PA, Thymoma, Adult Male

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    Description: 1. Mediastinal mass. CT is required to differentiate this mass as a thymoma vs. sarcoidosis or carcinoma other than location. 2. Deviation of the trachea to the right of the vertebral processes from mass effect. 3. Silhouette of aorta showing common age-related ectasia or unfolding of the aorta. The fact that the border of the aorta can be sharply differentiated from the mediastinal mass argues strongly that the mass is not due to aortic aneurysm or dissection. 4. Age-related calcification of costal cartilage.
    Keywords: Diagnostic X-Ray, X-Ray Radiology, Diagnostic, Radiology, Diagnostic X-Ray, Roentgenography, Carcinoma, Thymic, Neoplasms, Radiography, Neoplasms by Histologic Type, Diagnosis, X-Ray, Diagnostic, Diagnostic X-Ray Radiology

  7. X-ray (chest), PA, Thymoma, Adult Male

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    Description: 1. Mediastinal mass. CT is required to differentiate this mass as a thymoma vs. sarcoidosis or carcinoma other than location. 2. Deviation of the trachea to the right of the vertebral processes from mass effect. 3. Silhouette of aorta showing common age-related “ectasia” or unfolding of the aorta. The fact that the border of the aorta can be sharply differentiated from the mediastinal mass argues strongly that the mass is not due to aortic aneurysm or dissection. 4. Age-related calcification of costal cartilage.
    Keywords: Diagnosis, Neoplasms, X-Ray Radiology, Diagnostic, X-Ray, Diagnostic, Carcinoma, Thymic, Diagnostic X-Ray Radiology, Diagnostic X-Ray, Roentgenography, Neoplasms by Histologic Type, Radiology, Diagnostic X-Ray, Radiography

  8. X-ray (chest), PA, Pneumonia RML Silhouette Sign, Answers, Adult Male

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    Description: 1. Right middle lobe airspace opacification. Opacification can be due to multiple causes: blood, infection, edema, infarction, infiltration, or consolidation are the main causes. 2. Obscured right heart border c/w silhouette sign. 3. Slight blunting of right costophrenic angle c/w small pleural effusion. ****parapneumonic effusion**** the old adage is never let the sun set (or rise depending on your shift) on a parapneumonic effusion 4. Silhouette of right hemidiaphragm as well as right heart border.
    Keywords: Diagnosis, Roentgenography, Pulmonary Inflammation, Pneumonia, Lobar, Diagnostic X-Ray, X-Ray, Diagnostic, Radiography, Radiology, Diagnostic X-Ray, Lobar Pneumonia, Diagnostic X-Ray Radiology, Pneumonitis, Experimental Lung Inflammation, X-Ray Radiology, Diagnostic, Lung Inflammation

  9. X-ray (chest), PA, Pneumonia RML Silhouette Sign, Numbered, Adult Male

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    Description: 1. Right middle lobe airspace opacification. Opacification can be due to multiple causes: blood, infection, edema, infarction, infiltration, or consolidation are the main causes. 2. Obscured right heart border c/w silhouette sign. 3. Slight blunting of right costophrenic angle c/w small pleural effusion. ****parapneumonic effusion**** the old adage is never let the sun set (or rise depending on your shift) on a parapneumonic effusion 4. Silhouette of right hemidiaphragm as well as right heart border.
    Keywords: Radiology, Diagnostic X-Ray, Pneumonia, Lobar, Radiography, Diagnostic X-Ray, Experimental Lung Inflammation, X-Ray Radiology, Diagnostic, Diagnostic X-Ray Radiology, Roentgenography, Pulmonary Inflammation, X-Ray, Diagnostic, Lobar Pneumonia, Pneumonitis, Lung Inflammation, Diagnosis

  10. X-ray (chest), PA, Thymoma Invasive, Adult Male

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    Description: 1. Mediastinal mass with compression of trachea. Note that the mass silhouettes the superior aspect of the right heart border and superior vena cava suggesting it abuts or is anterior to these structures. Also note the roughly “sail-sign” like triangular shape with the inferior margin terminating at the inferior base of the hilum, a configuration similar to that seen when the thymus is visible on a pediatric radiograph. 2. Elevation of the right hemidiaphragm likely due to bronchogenic obstruction and associated volume loss given the increased opacity and plate-like atelectasis changes of the right lung parenchyma. Also could be due to injury to the right phrenic nerve. Note the marked overall lung volume loss and increased density of lung markings suggestive of bronchogenic obstruction. 3. Oblique fissure right lung. 4. Blunting of the right costophrenic angle consistent with a pleural effusion. In general it takes about 200-300 ml of fluid to cause blunting of the costophrenic angle. 5. Thickened, distorted horizontal fissure vs. plate-like atelectasis due to obstructed bronchus.
    Keywords: Diagnostic X-Ray, X-Ray Radiology, Diagnostic, Roentgenography, Neoplasms, Diagnostic X-Ray Radiology, Neoplasms by Histologic Type, Radiography, Diagnosis, Carcinoma, Thymic, Radiology, Diagnostic X-Ray, X-Ray, Diagnostic