Radiographs

So, I have been trying my hand at reading chest radiographs. Now I know most of us have become efficient at reading them from the ABC perspective that Dr. Nitz teaches, but this is a bit different. I can't remember if we looked at chest radiographs in Cardiopulmonary, but if we had we would be focusing on the characteristics of the lung fields instead of the bone.

I learned early in my internship that the lung (on radiograph) should extend down to the 6th anterior portion of the rib or the 8th posterior portion of the rib. It is normal for the right to be a few cm's higher than the left. But yesterday I learned how to identify a pleural effusion. The key is the very white substance in the lung base and the meniscal or crescent sign which looks almost like the waves (of the pool or ocean) you used to draw when you were 6 years old.

I found an article that has different pictures of plueral effusions. The purpose of the article was to determine how effective onlookers were at identifying plueral effusions in the supine position, but I used it more for the radiograph practice.

http://www.ajronline.org/cgi/reprint/142/1/59.pdf

Also, I found a great tutorial for reading chest radiographs. If you plan to go overseas for an internship or for work, I recommend this site.

http://www.med-ed.virginia.edu/courses/rad/cxr/

Always learning something new...