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X-ray (chest), PA, Aortic Dissection, Adult Male
show more Title: X-ray (chest), PA, Aortic Dissection, Adult Male Depositor: batchuser@i-human.com Creator: Anurag Agarwal, MD, Radiologist, NBE (radiograph)Lars Ensign, MD (annotations) Description: CXR PA - Adult male, aortic dissection 1. Tip of endotracheal tube. Ideally the tip of the endotracheal tube should be 3-5 cm above the carina. 2. Tip of central venous catheter in proper location at the junction of the SVC and the right atrium. Line placed in left subclavian vein. 3. Catheter placed into the right IJ vein that traverses the cardiac chambers most likely representing a Swan-Ganz hemodynamic monitoring catheter. 4. Wide mediastinum greater than 8 cm with indistinct AP window consistent with aortic dissection or aneurysm. Compare this to the normal mediastinum and sharp contour of the aorta on the right. Unfortunately, in clinical practice aortic dissection and aneurysm is usually much more subtle than on this study, particularly when you are seeing a patient that is still salvageable. The chest x-ray has a poor sensitivity and specificity for picking up this disastrous condition. If you think your patient may have this disease, do not be tricked into ruling it out based on a normal chest x-ray! 5. Deviation of the trachea to the right of the midline, likely due to mass effect from the aortic disease. Keywords: Computed X Ray Tomography, Tomography, X-Ray Computerized Axial, Aortic Dissection, Tomodensitometry, aorta, Computerized Tomography, X-Ray, Cine-CT, Electron Beam Computed Tomography, Tomography, X Ray Computed, CT X Ray, X-Ray Computer Assisted Tomography, X Ray Computerized Tomography, CAT Scan, X-Ray, Tomography, X-Ray Computer Assisted, X-Ray Computerized Axial Tomography, Diagnosis, Tomography, X-Ray Computerized, X-Ray Tomography, Computed, CAT Scan, X Ray, Tomography, Transmission Computed, X Ray Tomography, Computed, Computed Tomography, X-Ray, Electron Beam Tomography, CT Scan, X-Ray, Computerized Tomography, X Ray, Tomography, Xray Computed, aortic Date Uploaded: 02/27/2013 -
X-ray (chest), AP, Adult Male, Thoracic Bullet, Annotated
show more Title: X-ray (chest), AP, Adult Male, Thoracic Bullet, Annotated Depositor: batchuser@i-human.com Creator: Anurag Agarwal, MD, Radiologist, NBE (radiograph)Lars Ensign, MD (annotations) Description: CXR AP and Lat - Adult male, thoracic bullet 1. Foreign body, more radio opaque than bone, consistent with a metallic object such as a bullet. It is unclear if this object is located within the thoracic or the abdominal cavity. Addition of the lateral view shows the bullet lies either deep within the posterior chest cavity or in the paraspinous musculature. 2. Curved, meniscus-shaped blunting of the left costophrenic angle consistent with pleural effusion. If this study was obtained in the setting of acute trauma then this finding would most likely represent an acute hemothorax and indicate the placement of a chest tube during ED stabilization. Also a bedside ultrasound to check for pericardial effusion would be very useful and potentially lifesaving. Note there is no evidence of pneumothorax: lung markings can be seen all the way to the periphery of both lungs. Also, if there were a hemo-pneumothorax on the left the pleural fluid would layer with an air-fluid level, not be meniscus-shaped. Keywords: Diagnostic X-Ray, Radiography, Thoracic, Bullet, Roentgenography, Wounds and Injuries, Radiology, Diagnostic X-Ray, Diagnostic X-Ray Radiology, Foreign Bodies, X-Ray, Diagnostic, Diagnosis, X-Ray Radiology, Diagnostic Date Uploaded: 02/27/2013 -
X-ray (chest), PA, Aortic Dissection, Adult Male
show more Title: X-ray (chest), PA, Aortic Dissection, Adult Male Depositor: batchuser@i-human.com Creator: Anurag Agarwal, MD, Radiologist, NBE (radiograph)Lars Ensign, MD (annotations) Description: CXR PA - Adult male, aortic dissection 1. Tip of endotracheal tube. Ideally the tip of the endotracheal tube should be 3-5 cm above the carina. 2. Tip of central venous catheter in proper location at the junction of the SVC and the right atrium. Line placed in left subclavian vein. 3. Catheter placed into the right IJ vein that traverses the cardiac chambers most likely representing a Swan-Ganz hemodynamic monitoring catheter. 4. Wide mediastinum greater than 8 cm with indistinct AP window consistent with aortic dissection or aneurysm. Compare this to the normal mediastinum and sharp contour of the aorta on the right. Unfortunately, in clinical practice aortic dissection and aneurysm is usually much more subtle than on this study, particularly when you are seeing a patient that is still salvageable. The chest x-ray has a poor sensitivity and specificity for picking up this disastrous condition. If you think your patient may have this disease, do not be tricked into ruling it out based on a normal chest x-ray! 5. Deviation of the trachea to the right of the midline, likely due to mass effect from the aortic disease. Keywords: aorta, X Ray Tomography, Computed, Computed Tomography, X-Ray, Tomography, Transmission Computed, Computed X Ray Tomography, aortic, Electron Beam Computed Tomography, CAT Scan, X-Ray, CT X Ray, Electron Beam Tomography, Aortic Dissection, Diagnosis, Computerized Tomography, X Ray, Tomography, X-Ray Computerized Axial, X-Ray Tomography, Computed, Tomography, X-Ray Computer Assisted, Cine-CT, CT Scan, X-Ray, Tomodensitometry, Tomography, Xray Computed, Tomography, X Ray Computed, X-Ray Computer Assisted Tomography, Computerized Tomography, X-Ray, X Ray Computerized Tomography, CAT Scan, X Ray, Tomography, X-Ray Computerized, X-Ray Computerized Axial Tomography Date Uploaded: 02/27/2013 -
X-ray (chest), PA, With Annotations, Adult Male, Normal
show more Title: X-ray (chest), PA, With Annotations, Adult Male, Normal Depositor: batchuser@i-human.com Creator: Anurag Agarwal, MD, Radiologist, NBE Description: CXR PA - Adult male, Normal Annotated Keywords: X-Ray Radiology, Diagnostic, Radiography, Diagnostic X-Ray Radiology, X-Ray, Diagnostic, Diagnosis, Radiology, Diagnostic X-Ray, Chest, Thoraces, Roentgenography, Diagnostic X-Ray Date Uploaded: 02/27/2013 -
X-ray (chest), LAT, Adult Male, Thoracic Bullet
show more Title: X-ray (chest), LAT, Adult Male, Thoracic Bullet Depositor: batchuser@i-human.com Creator: Anurag Agarwal, MD, Radiologist, NBE (radiograph)Lars Ensign, MD (annotations) Description: CXR AP and Lat - Adult male, thoracic bullet 1. Foreign body, more radio opaque than bone, consistent with a metallic object such as a bullet. It is unclear if this object is located within the thoracic or the abdominal cavity. Addition of the lateral view shows the bullet lies either deep within the posterior chest cavity or in the paraspinous musculature. 2. Curved, meniscus-shaped blunting of the left costophrenic angle consistent with pleural effusion. If this study was obtained in the setting of acute trauma then this finding would most likely represent an acute hemothorax and indicate the placement of a chest tube during ED stabilization. Also a bedside ultrasound to check for pericardial effusion would be very useful and potentially lifesaving. Note there is no evidence of pneumothorax: lung markings can be seen all the way to the periphery of both lungs. Also, if there were a hemo-pneumothorax on the left the pleural fluid would layer with an air-fluid level, not be meniscus-shaped. Keywords: Roentgenography, Thoracic, Bullet, Wounds and Injuries, Radiography, X-Ray, Diagnostic, Radiology, Diagnostic X-Ray, X-Ray Radiology, Diagnostic, Diagnostic X-Ray Radiology, Diagnostic X-Ray, Diagnosis, Foreign Bodies Date Uploaded: 02/27/2013 -
X-ray (chest), LAT, Adult Male, Thoracic Bullet
show more Title: X-ray (chest), LAT, Adult Male, Thoracic Bullet Depositor: batchuser@i-human.com Creator: Anurag Agarwal, MD, Radiologist, NBE (radiograph)Lars Ensign, MD (annotations) Description: CXR AP and Lat - Adult male, thoracic bullet 1. Foreign body, more radio opaque than bone, consistent with a metallic object such as a bullet. It is unclear if this object is located within the thoracic or the abdominal cavity. Addition of the lateral view shows the bullet lies either deep within the posterior chest cavity or in the paraspinous musculature. 2. Curved, meniscus-shaped blunting of the left costophrenic angle consistent with pleural effusion. If this study was obtained in the setting of acute trauma then this finding would most likely represent an acute hemothorax and indicate the placement of a chest tube during ED stabilization. Also a bedside ultrasound to check for pericardial effusion would be very useful and potentially lifesaving. Note there is no evidence of pneumothorax: lung markings can be seen all the way to the periphery of both lungs. Also, if there were a hemo-pneumothorax on the left the pleural fluid would layer with an air-fluid level, not be meniscus-shaped. Keywords: Diagnostic X-Ray Radiology, Thoracic, Bullet, Foreign Bodies, Radiology, Diagnostic X-Ray, Roentgenography, Diagnostic X-Ray, Diagnosis, X-Ray, Diagnostic, Wounds and Injuries, X-Ray Radiology, Diagnostic, Radiography Date Uploaded: 02/27/2013 -
X-ray (chest), AP, Adult Male, Thoracic Bullet, Annotated Answers
show more Title: X-ray (chest), AP, Adult Male, Thoracic Bullet, Annotated Answers Depositor: batchuser@i-human.com Creator: Anurag Agarwal, MD, Radiologist, NBE (radiograph)Lars Ensign, MD (annotations) Description: CXR AP and Lat - Adult male, thoracic bullet 1. Foreign body, more radio opaque than bone, consistent with a metallic object such as a bullet. It is unclear if this object is located within the thoracic or the abdominal cavity. Addition of the lateral view shows the bullet lies either deep within the posterior chest cavity or in the paraspinous musculature. 2. Curved, meniscus-shaped blunting of the left costophrenic angle consistent with pleural effusion. If this study was obtained in the setting of acute trauma then this finding would most likely represent an acute hemothorax and indicate the placement of a chest tube during ED stabilization. Also a bedside ultrasound to check for pericardial effusion would be very useful and potentially lifesaving. Note there is no evidence of pneumothorax: lung markings can be seen all the way to the periphery of both lungs. Also, if there were a hemo-pneumothorax on the left the pleural fluid would layer with an air-fluid level, not be meniscus-shaped. Keywords: Diagnostic X-Ray Radiology, Bullet, Diagnostic X-Ray, Wounds and Injuries, Roentgenography, Radiology, Diagnostic X-Ray, Thoracic, X-Ray, Diagnostic, Diagnosis, Radiography, X-Ray Radiology, Diagnostic, Foreign Bodies Date Uploaded: 02/27/2013 -
X-ray (chest), PA, Calcified Mediastinal Nodes, Adult Male
show more Title: X-ray (chest), PA, Calcified Mediastinal Nodes, Adult Male Depositor: batchuser@i-human.com Creator: Anurag Agarwal, MD, Radiologist, NBE (radiograph)Lars Ensign, MD (annotations) Description: CXR PA - Adult male, Calcified Mediastinal nodes 1. Multiple symmetric calcified nodes. Note the nodes are even slightly more radio opaque than bone. 2. The rim or border of the nodes appears to be more calcified than the center. This is likely eggshell calcification. Eggshell calcification is usually due to: Silicosis, Coal-workers pneumoconiosis, or Sarcoidosis Keywords: Roentgenography, X-Ray, Diagnostic, Diagnosis, eggshell calcification, Besnier-Boeck-Schaumann Syndrome, Boeck Disease, X-Ray Radiology, Diagnostic, Schaumann's Syndrome, Besnier-Boeck Disease, Radiology, Diagnostic X-Ray, Boeck's Sarcoid, Lung Diseases, Interstitial, Radiography, Schaumann Syndrome, coal worker's pneumoconiosis, Boeck's Disease, Diagnostic X-Ray Radiology, Lymphoproliferative Disorders, Diagnostic X-Ray, Schaumann Disease Date Uploaded: 02/27/2013 -
X-ray (chest), PA, Calcified Mediastinal Nodes, Adult Male
show more Title: X-ray (chest), PA, Calcified Mediastinal Nodes, Adult Male Depositor: batchuser@i-human.com Creator: Anurag Agarwal, MD, Radiologist, NBE (radiograph)Lars Ensign, MD (annotations) Description: CXR PA - Adult male, Calcified Mediastinal nodes 1. Multiple symmetric calcified nodes. Note the nodes are even slightly more radio opaque than bone. 2. The rim or border of the nodes appears to be more calcified than the center. This is likely eggshell calcification. Eggshell calcification is usually due to: Silicosis, Coal-workers pneumoconiosis, or Sarcoidosis Keywords: Schaumann Syndrome, Besnier-Boeck-Schaumann Syndrome, Boeck's Sarcoid, Boeck Disease, Lymphoproliferative Disorders, Schaumann Disease, X-Ray Radiology, Diagnostic, Diagnosis, Diagnostic X-Ray Radiology, Diagnostic X-Ray, coal worker's pneumoconiosis, Lung Diseases, Interstitial, Radiography, Schaumann's Syndrome, Besnier-Boeck Disease, Radiology, Diagnostic X-Ray, Roentgenography, eggshell calcification, X-Ray, Diagnostic, Boeck's Disease Date Uploaded: 02/27/2013 -
X-ray (chest), PA, Calcified Mediastinal Nodes, Adult Male
show more Title: X-ray (chest), PA, Calcified Mediastinal Nodes, Adult Male Depositor: batchuser@i-human.com Creator: Anurag Agarwal, MD, Radiologist, NBE (radiograph)Lars Ensign, MD (annotations) Description: CXR PA - Adult male, Calcified Mediastinal nodes 1. Multiple symmetric calcified nodes. Note the nodes are even slightly more radio opaque than bone. 2. The rim or border of the nodes appears to be more calcified than the center. This is likely eggshell calcification. Eggshell calcification is usually due to: Silicosis, Coal-workers pneumoconiosis, or Sarcoidosis Keywords: Diagnosis, Roentgenography, Diagnostic X-Ray Radiology, Schaumann Disease, eggshell calcification, coal worker's pneumoconiosis, Schaumann's Syndrome, Radiology, Diagnostic X-Ray, Schaumann Syndrome, Diagnostic X-Ray, Boeck's Sarcoid, Besnier-Boeck-Schaumann Syndrome, Boeck Disease, X-Ray, Diagnostic, Besnier-Boeck Disease, X-Ray Radiology, Diagnostic, Lymphoproliferative Disorders, Radiography, Lung Diseases, Interstitial, Boeck's Disease Date Uploaded: 02/27/2013
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