Pneumoperitoneum Plain film signs include: Erect CXR —free gas under diaphragm or liver. Can detect 10 ml of gas. Takes 10 minutes for all gas to rise. Supine AXR —most sensitive signs are often in the right upper quadrant. Gas outlines…
Gross cardiomegaly on CXR 1. Ischaemic heart disease —and other cardiomyopathies. 2. Pericardial effusion —globular (supine radiograph) or flask-shaped heart (erect radiograph), crisp cardiac outline (as the effusion masks ventricular wall motion). 3. Multivalve disease —particularly regurgitation. 4. Congenital heart…
Tracheal/bronchial narrowing, mass or occlusion Airway narrowing may occur at any site from below the level of the vocal cords down to the segmental/subsegmental airways. In the lumen 1. Mucous plug —e.g. asthma, cystic fibrosis, ABPA. Low density, usually contains…
Linear and curvilinear soft tissue calcification Common causes 1. Arterial —i.e. atherosclerosis. If seen in the hands or feet, this suggests underlying diabetes or hyperparathyroidism (secondary > primary). Calcification can also be seen in aneurysms (e.g. popliteal). 2. Cartilage —i.e.…
Monoarthritis Common 1. Septic arthritis —including tuberculosis. Marked juxtaarticular osteopenia with loss of definition of subchondral bone plate. 2. Trauma —evidence of fracture or lipohaemarthrosis. 3. Osteoarthritis (OA) —marginal osteophytes, subchondral sclerosis and/or cysts, joint space narrowing. Commonly involves weight-bearing…
Scoliosis Scoliosis is a lateral spinal curve on a PA radiograph with a Cobb angle >10 degrees. If <10 degrees then it should be described as spinal asymmetry. Idiopathic (80%) 1. Congenital —0–3 years, M>F. Left side convex. Usually regresses.…
Generalized increased bone density in an adult Most common 1. Metastases —prostate and breast most common. Heterogeneous; generally not diffuse. 2. Sickle cell disease —medullary sclerosis and bone infarcts. Growth arrest of long bones. H-shaped vertebrae. 3. Myelofibrosis —older patients.…