Radiologic Images

X-ray

Xray Region	Used for
Bones and teeth	Fractures and infections. In most cases, fractures and infections in bones and teeth show up clearly on X-rays. Arthritis. X-rays of your joints can reveal signs of arthritis. X-rays taken over the years can help your doctor determine if your arthritis is worsening. Dental decay. Dentists use X-rays to take pictures of the teeth and jaw and check for cavities. Osteoporosis. Special types of X-ray tests can measure bone density. Bone cancer. X-rays can reveal bone tumors.
Chest	Lung infections or conditions. Evidence of pneumonia, tuberculosis or lung cancer can show up on chest X-rays. Breast cancer. Mammography is a special type of X-ray test used to examine breast tissue. Enlarged heart. This sign of heart failure shows up clearly on X-rays. Blocked blood vessels. Changes in blood flow to the lungs and heart can be seen on chest X-rays.
Abdomen	Digestive tract problems. Barium, a contrast medium delivered in a drink or an enema, can help reveal problems in your digestive system. Swallowed items. If your child has swallowed something like a key or a coin, an X-ray can show the location of that object.

How to Read X-ray

Normal Chest X-ray

Mikael Häggström, CC0, via Wikimedia Commons

Mikael Häggström, CC0, via Wikimedia Commons

• A – Airway
  • Ensure trachea is visible and in midline
  • Trachea gets pushed away from abnormality, eg pleural effusion or tension pneumothorax
  • Trachea gets pulled towards abnormality, eg atelectasis
  • Trachea normally narrows at the vocal cords
  • View the carina, angle should be between 60 –100 degrees
  • Beware of things that may increase this angle, eg left atrial enlargement, lymph node enlargement and left upper lobe atelectasis
  • Follow out both main stem bronchi
  • Check for tubes, pacemaker, wires, lines foreign bodies etc
  • If an endotracheal tube is in place, check the positioning, the distal tip of the tube should be 3-4cm above the carina
  • Check for a widened mediastinum
  • Mass lesions (eg tumour, lymph nodes)
  • Inflammation (eg mediastinitis, granulomatous inflammation)
  • Trauma and dissection (eg haematoma, aneurysm of the major mediastinal vessels)
• B – Bones
  • Check for fractures, dislocation, subluxation, osteoblastic or osteolytic lesions in clavicles, ribs, thoracic
  • Spine and humerus including osteoarthritic changes
  • At this time also check the soft tissues for subcutaneous air, foreign bodies and surgical clips
  • Caution with nipple shadows, which may mimic intrapulmonary nodules
  • compare side to side, if on both sides the “nodules” in question are in the same position, then they are likely to be due to nipple shadows
• C – Cardiac
  • Check heart size and heart borders
  • Appropriate or blunted
  • Thin rim of air around the heart, think of pneumomediastinum
  • Check aorta
  • Widening, tortuosity, calcification
  • Check heart valves
  • Calcification, valve replacements
  • Check SVC, IVC, azygos vein
  • Widening, tortuosity
• D – Diaphragm
  • Right hemidiaphragm
  • Should be higher than the left
  • If much higher, think of effusion, lobar collapse, diaphragmatic paralysis
  • If you cannot see parts of the diaphragm, consider infiltrate or effusion
  • If film is taken in erect or upright position you may see free air under the diaphragm if intra-abdominal perforation is present
• E – Effusion
  • Effusions
  • Look for blunting of the costophrenic angle
  • Identify the major fissures, if you can see them more obvious than usual, then this could mean that fluid is tracking along the fissure
  • Check out the pleura
  • Thickening, loculations, calcifications and pneumothorax
• F – Fields (Lungfields)
  • Check for infiltrates
  • Identify the location of infiltrates by use of known radiological phenomena, eg loss of heart borders or of the contour of the diaphragm
  • Remember that right middle lobe abuts the heart, but the right lower lobe does not
  • The lingula abuts the left side of the heart
  • Identify the pattern of infiltration
  • Interstitial pattern (reticular) versus alveolar (patchy or nodular) pattern
  • Lobar collapse
  • Look for air bronchograms, tram tracking, nodules, Kerley B lines
  • Pay attention to the apices
  • Check for granulomas, tumour and pneumothorax
• G – Gastric Air Bubble
  • Check correct position
  • Beware of hiatus hernia
  • Look for fee air
  • Look for bowel loops between diaphragm and liver
• H – Hilum
  • Check the position and size bilaterally
  • Enlarged lymph nodes
  • Calcified nodules
  • Mass lesions
  • Pulmonary arteries, if greater than 1.5cm think about possible causes of enlargement

R Middle Lobar PNA

Mikael Häggström, M.D. , CC0, via Wikimedia Commons

R Influenza PNA patch consolidations

Mikael Häggström, M.D., CC0, via Wikimedia Commons

Tuberculosis

Unknown author, Public domain, via Wikimedia Commons

Ultrasound

Ultrasound Region	Used for
Abdominal Aorta US
Abdominal US	Diagnose gallbladder disease
Breast US	Examine a breast lump
Carotid US
Duplex US
Genital US	Detect genital and prostate problems
Liver Ultrasound
Obstetric US
Pelvic US	View the uterus and ovaries during pregnancy and monitor the developing baby's health
Renal Ultrasound
Thyroid US	Check your thyroid gland
Transabdominal US
Transrectal US
Transvaginal US
US	Guide a needle for biopsy or tumor treatment
US	Assess joint inflammation (synovitis)
US	Evaluate metabolic bone disease
Vascular US	Evaluate blood flow

Fetus heartbeat
Marcel Berteler / Public domain

CT

CT scan Region	Used for
CT Scan Abdomen	An abscess in the abdomen Inflamed colon Colon cancer Diverticulitis Appendicitis
CT Angiography	Detect signs of heart disease and atherosclerosis Examine pulmonary arteries to diagnose or rule out a pulmonary embolism Assess blood flow in the renal arteries Diagnose aneurysms Look for warning signs of a heart attack or stroke Assess heart health and blood flow after cardiovascular surgery
CT Scan Arthrography
CT Scan Bones
CT Scan Brain/ CT Scan Head	Locating skull fractures and brain damage in patients with head injuries Detecting a blood clot or bleeding within the brain shortly after a patient exhibits symptoms of a stroke Determining the extent of bone and soft tissue damage in patients with facial trauma, and planning surgical reconstruction Detecting and localizing bleeding in a patient with sudden severe headache who may have a ruptured or leaking aneurysm Detecting some brain tumors Diagnosing diseases of the temporal bone on the side of the skull, which may cause hearing problems Illuminating enlarged brain cavities (ventricles) in patients with hydrocephalus Determining whether inflammation or other changes are present in the paranasal sinuses Planning radiation therapy for cancer of the brain or other tissues Guiding the passage of a needle used to obtain a tissue sample (biopsy) from the brain Non-invasively assessing for aneurysms or arteriovenous malformations through a technique called CT angiography Detecting diseases or malformations of the skull Three-dimensional imaging of the skull and brain structures
CT Scan Chest (CT Scan Lung)	Old or new pneumonia Lung cancer Tumors Tuberculosis Emphysema Bronchiectasis Diffuse interstitial lung disease
CT Scan Neck
CT Scan Pelvis
CT Scan Renal Stones
CT Scan Sinus
CT Scan Spine	To detect or rule out spinal damage in patients who have been injured. The spine before and after surgery. To detect various types of tumors in the vertebral column, including those that have spread there from another area of the body. Some tumors that arise elsewhere are first identified by finding deposits of malignant cells (metastases) in the vertebrae; prostate cancer is an example. To detect narrowing of the spinal canal, vertebral fracture, infection, or degenerative disease such as arthritis, CT of the spine may provide important information when carried out by itself or in addition to magnetic resonance imaging (MRI). One of the most common causes of spinal pain that may be diagnosed by CT is a herniated intervertebral disk.

Mikael Häggström / CC0

MRI

MRI Region	Used For
Breast MRI
Cardiac MRI
Functional MRI (fMRI)	A functional MRI is a type of MRI. During an fMRI, the patient is asked to perform certain activities to help the neurosurgeons map the functional areas of the brain before surgery takes place.
Magnetic resonance angiography (MRA)	Magnetic resonance angiography (MRA) is a non-invasive diagnostic procedure that uses a combination of magnetic resonance technology (MRI) and intravenous (IV) contrast dye to visualize blood vessels. Contrast dye causes blood vessels to appear opaque on the MRI image, enabling the physician to visualize the blood vessels being evaluated. An MRA is often used to examine the heart and other soft tissues and to assess blood flow.
Magnetic resonance venography (MRV)	A diagnostic procedure that uses a combination of a large magnet, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. An MRV uses magnetic resonance technology and intravenous (IV) contrast dye to visualize the veins. Contrast dye causes the blood vessels to appear opaque on the X-ray image, allowing the physician to visualize the blood vessels being evaluated. MRV is useful in some cases because it can help detect causes of leg pain other than vein problems.