Download - Xray Comments
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1-Plain X-ray Chest & heart Postero-anterior view(PA) showing:
Multiple osteolytic lesions on ribs & humerous & clavicle & fracture on rt . humerous due to hyperparathyroidism (hypercalcemia).
2-Fracture posterior end of right 6th-7th ribs
Plain X-ray Chest &heart Postero-anterior view(PA) showing:
Fracture of the posterior parts of 6th and 7th rib on the right side.
D: fracture ribs.
3-Bilateral cervical ribs (biforked ribs )
Plain X-ray Chest Postero-anterior view(PA) showing:
The first rib is bilaterally attached to transverse process of 7th cervical vertebrae which are directed downwards.
D:bilateral cervical rib.
اليمين على األسفل فى الغوايش
4-Bilateral gas under diaphragm
Plain X-ray Chest & heart Postero-anterior view(PA) showing:
Bilateral elevation of both copula of the diaphragm.
D: gas under diaphragm for D.D perforated viscus-pneumoperitoneium- gas forming organism
5-Bilateral gas (air) under diaphragm
Plain X-ray Chest & heart Postero-anterior view(PA) showing: Bilateral gas (air) under diaphragm, With normal position of the diaphragm at 10th rib posteriorly, ( Without elevation of both copula of the diaphragm ) due to perforated viscus.
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6-Elevated Left copula of the diaphragm
Plain X-ray Chest & heart Postero-anterior view(PA) showing:
Unilateral elevation of the left copula of the diaphragm for D.D
-Diaph. Paralysis
-subphrenic abscess
-huge splenic mass
-huge gastric mass
7-Elevated Right copula of the diaphragm
Plain X-ray Chest & heart Postero-anterior view(PA) showing:
Unilateral elevation of the right copula of the diaphragm for D.D
-unilateral diaphragmatic paralysis
-subphrenic abcess
-huge hepatic mass
8-Massive left-sided pleural effusion
Plain X-ray Chest Postero-anterior view(PA) showing:
Massive unilateral homogenous opacity in the left side (lung) & obliterating costophrenic angle with shift of mediastinum (trachea)to opposite (rt.)side
9-Right-sided hydropneumothorax with collapsed lung
Plain X-ray Chest Postero-anterior view(PA) showing:
Localized homogenous opacity at the lower zone of rt. Lung , obliterating rt. Costophrenic angle with fluid level & collapsed lung tissue at the hilum below & jet black hypertranslucency above
D: Rt. sided hydropneumothorax
10-Left encysted (localized) pleural effusion
Plain X-ray Chest Postero-anterior view(PA) showing:
Localized homogenous wedge shaped opacity at lateral aspect of the lt. Lung obliterating lt. Costophrenic angle & rising to axilla.
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11-Right middle lobe (localized) pneumonia (consolidation)
Plain X-ray Chest Postero-anterior view(PA) showing:
Localized homogenous wedge shaped opacity at medial aspect of lower zone the rt. Lung & with central mediastinum
D.D it from localized ( collapse or effusion or infarction).
12-Pulomnary embolism on rt lungPlain X-ray Chest Postero-anterior view(PA) showing:
Localized homogenous wedge (triangular) shaped opacity at lateral aspect of middle zone of the rt. Lung with peripheral base & central apex
13-Plain X-ray Chest Postero-anterior view(PA) showing :
Localized homogenous coin shaped opacity at the medial aspectof the lower zones of the right lung.
D.D localized pneumonia, carcinoma, adenoma, abscess, F.B,cyst.
14-Resolving pneumonia or bronchopneumonia in left middle lobe(correct comment for slide no. 14 in powerpoint )Plain X-ray Chest & heartPostero-anterior view(PA) showing:
massive heterogenous opacity taking middle & lower zones (most)(periphery) of the lt. Lung with central trachea
15-Cannon ball metastasesPlain X-ray Chest Postero-anterior view(PA) showing:
Homogenous large coin shaped opacities on medial aspect of the lower zone of rt lungis about 5cm & 2 at lt lung the 1st at the upper zone is about 10 cm & the 2nd at middle , lower zones is about 5-7 cm
16-Plain X-ray Chest Postero-anterior view(PA) showing: Multiple homogenous small rounded pinpoint opacities on both lung fields.
D.D.
Miliary T.B.
Sarcoidosis, pneumoconiosis
17-Apical fibrocavitary lesion
Plain X-ray Chest Postero-anterior view(PA) showing:
Multiple nonhomogeneous opacities of fibrocavitary lesion of different sizes giving picture of fluffy-cotton appearance on both apices of the lungs
Diagnosis: TB pulmonary fibrosis.
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18-Bilateral Emphysema and Emphsematous bullae
Plain X-ray Chest Postero-anterior view(PA) showing:
-bilateral and diffuse Jet Black hypertranslucency of lung shadows.
_with horizontal ribs and wide intercostal spaces.
-and bilateral depression of both copula of diaphragm
-with 2 large emphysematous bullae on the right side
D:Bilateral emphysema with bullae, differentiate from deep respiration
19-Plain X-ray Chest & heart Postero-anterior view(PA) showing:
Jet black hyper translucency in Rt. Side e` collapsed lung in the hilum & trachea is shifted to the rt. side
Diagnosis-:
Rt. Side pneumothorax with lung collapse
20-Chronic lung abcessPlain X-ray Chest Postero-anterior view(PA) showing:
Localized translucency on medial aspect of lower zone of rt. Lung with very thick wall & fluid level
21-Chronic lung abcess
Plain X-ray Chest & heart Postero-anterior view(PA) showing:
Localized translucency on lateral aspect of lower zone of rt. Lung with thick wall & fluid level
22-Multiple chronic lung (cavities) abcesses
Plain X-ray Chest Postero-anterior view(PA) showing:
Localized translucency on lateral aspect of lower zone of rt. Lung with thick wall.
Diagnosis: TB cavity
23-Honey-comb appearance of Bronchiectasis
Plain X-ray Chest & heart Postero-anterior view(PA)showing:
multiple small rounded translucency (cavities) equal on both sides at basal zones of both lungs giving picture of Honey-comb appearance
24-Aortic aneurysm and bilateral emphysema
Plain X-ray Chest & heart Postero-anterior view(PA)showing:
Fusiform swelling of superior mediastinum ( aortic aneurysm) & ribbon shaped heart and bilateral emphysema
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25-Trifestoned(TB) hilar lymphadenopathy
Plain X-ray Chest & heart Postero-anterior view(PA) showing:
Multiple rounded small (tripple fused) trifestone opacities at hilum (medial aspect) of rt. Lung (called trifestones)
26-Artificial Pacemaker in right ventricle
Plain X-ray Chest & heart Postero-anterior view(PA) showing:
Metallic F.B. attached by wire to the right side of the heart
27-Plain X-ray Chest & heart Postero-anterior view(PA) showing:
Simple dextrocardia heart is on the right side
1-free costophrenic angles on both sides 3-Cardiophrenic angle on rt & lt side is acute 4-normal C/T ratio.
Abnormal site of the heart
1-the heart lies mainly to the rt side
2-the cardiac apex is on the rt side
3-lt border formed by rt atrium ,Rt. BORDER by pulm.artery, la ,lv
4-stomach is in normal site (gastric air bubbles on lt side)
28-Plain X-ray Chest & heart Postero-anterior view(PA) showing:
Situs inversus totalis
Heart is shifted to Rt. Side equal in both side&
Trachea is central&
Gastric air bubble in the rightDiagnosis-:
Situsinversus totalis(fundus air on right side) اليمين الناحية على بالمعدة الموجود الهواء على ركز
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�(Same comment as above) Plain X-ray Chest & heart Postero-anterior view(PA) showing:
�1-free costophrenic angles on both sides 3-Cardiophrenic angle on rt & lt side is acute 4-normal C/T ratio
�Abnormal site of the heart
�1-the heart lies mainly to the rt side but equal in both side
�2-the cardiac apex is on the rt side
�3-lt border formed by rt atrium , rt by pa, la ,lv
�4-stomach is in abnormal site (gastric air bubbles on rt side)while liver shadow is on lt side
�29-Plain X-ray Chest & heart Postero-anterior view(PA) showing:
�Pericardialeffusion 1-Flask shape.
�2-Increase C/T ratio equally on both sides with broad cardiac base. 3-Well defined border of shadow(stenciled) with symmetrical bulge on both borders but cardiac borders are ill-defined & same density of the contour. 4-No double contour.
�5-free costophrenic angles on both sides
�6)Cardiophrenic angle on lt & rtside is acute
�7-normal pulmonary vascular markings .#Diagnosis :-Massive pericardial effusion To be D.D.Multivulular lesion &Dilated
cardiomyopathy.
اليمين على األعلى فى خطين عالمة�
� 30-Left ventricular enlargement
�Plain X-ray Chest & heart Postero-anterior view(PA) showing:1 -Huge Increase C/T ratio at both Rt. & Lt. side e` no double contour.
2-Obtuse Lt. cardio -phrenic angle.( Lt. V ++). 3-broad shaped heart
3-Prominent aortic Knuckle
Diagnosis-:
Cardiomegally due to Lt. ventricular & Rt. atrial enlargement.
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31-Plain X-ray Chest & heart Postero-anterior view(PA) showing:1-free costophrenic angles on both sides 3-Cardiophrenic angle on lt side is acute
4-increased C/T ratio . 4-bulge of lt & rt borders of the heart & double contour ,not prominent PAdiagnosis: Cardiomegaly due to LAD, rt.VH
32 -Plain X-ray Chest & heart Postero-anterior view(PA) showing :1-Increase C\T ratio 2-obtuse c\ph angle 3-double contour
diagnosis: Cardiomegaly Lt. A &Lt. V enlargementاألعلى في اليمين في 2 عالمة في
33-Plain X-ray Chest & heart Postero-anterior view(PA) showing:1-increase cardiothoracic ratio,2- acute lt. cardiophrenic angle,3- double contour.
Diagnosis:
cardiomegally due to lt. ventricluar enlargement & LAD.
34-Plain X-ray Chest & heart Postero-anterior view(PA) showing :1-Increase cardiothorathic ratio
2-Cardiophrenic angle is acute3-No double contour
Diagnosis :- Rt. At. & Rt. Vt. ++.Pulmonary artery dilatation.
اليمين أعلى في 8 عالمة
35-Plain X-ray Chest & heart Postero-anterior view(PA) showing:
Homogenous opacity at lt. 2nd Space & normal sized heart diagnosis : ( Pulmonary artery dilatation due to p.hpn)
To be differentiated from Mass in posterior mediastinum, Pericardial cyst.
القلب في يمر أسود خط فيها
36-Plain X-ray Chest & heart Postero-anterior view(PA) showing:
Aneurismal dilatation of pulmonary artery on both sides take (Dumpbell) shape.
Most probably due to Bilharzial core pulmonal .
37-Plain X-ray Chest & heart Postero-anterior view(PA) showing:
Dumpell-shape Pulmonary artery dilatationAneurismal dilatation of pulmonary artery on both sides take (Dumpbell) shape, due to p.hpn.
Most probably Bilharzial core pulmonal.
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38-Multiple radio-opaque shadows in right hypochondrium
Plain X ray abdomen show-:
Multiple small opacities (radio-opaque stones) in Rt. Hypochondrium.
Kidney stone \ gall bladder stone ( need lateral view to differentiate gall stone anterior to vertebral column while renal stones on it. )
39-Intestinal obstruction
Plain x ray abdomen erect position show-:
Multiple air fluid level (more than >3) due to(intestinal obstruction )
40-Intestinal obstruction & perforated viscous
Plain x ray abdomen erect position show-:
Multiple air fluid level (more than >3) due to(intestinal obstruction )Bilateral gas under diaphragm due to ( perforated viscous )
41-Oral cholesystogram show-:
Multiple, small, rounded filling defect in gall bladder .
Diagnosis-: Calcular cholecystitis with radio translucent gall stones.
D.D: cancer gall bladder & acalcular cholecystitis artifact
فيها معدى خط في
42-T-tube cholangiogram with missed stone in common bile duct
T- tube cholangiogram show-:
Multiple radio translucent opacities (filling defects) stones in C.B.D & C.H.D.
with dilatation of biliary tree.
Diagnosis-:
Missed stone
43-Achalasia of lower esophageal sphincter
Barium Swallow Show-:
Short small smooth narrowing of lower part of the esophagus with smooth small dilatation Above ( funnel shaped).
Diagnosis-:
Acahlasia of the Cardia
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44-Barium swallow show-:
Short smooth narrowing with irregular filling defect with shouldering of the lower 1/3 of oesophagus, with rat tail appearance & mild abnormal irregular dilatation above.
Diagnosis-:
Cancer lower 1/3 esophagus
45-Barium swallow show -:
Large abnormal irregular filling defect in middle & lower oesophagus .
Diagnosis-:
Cancer mid & lower 2 thirds of oesophagus.
46-Esophageal varices
Barium swallow show-:
Multiple small rounded irregular filling defect in middle & lower Oesophagus giving picture of grape like.
47-Barium meal show-:
Gastric rougae pass through esophageal hiatus (diaphragm) into the chest. herniation of part of the stomach to or through the oesophogus.
Diagnosis -: Sliding hiatus hernia
48-Barium meal show-:
Huge dilatation of stomach giving picture of soap dish appearance & retograde passage of barium into oesophogus when patient is in tredlenberg’s position.
Diagnosis-:
Chronic pyloric (out let) stenosis (obstruction) & GERD.
49-Hour-glass stomach(cancer stomach) with persistent duodenal ulcer niche
Barium meal show-:
Hour glass constriction of stomach & multiple irregular filling defect s in the lower 1\2 of stomach & deformed duodenal cap .
Diagnosis-:
Infiltrating gastric carcinoma&
Persistent ulcer niche on 2nd part (D.U.) ( chronic cicatrizing duodenal ulcer) .
50-Barium meal show-:
leather bottle appearance due to cancer stomach taking all lumen leaving just narrow area above.
diagnosis : huge cancer stomach
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51-Barium meal show -:
normal C shape duodenal cap & out pouches in 3rd part of duodenum giving picture of ( mashroum shaped) doudenal diverticulum.
Diagnosis -:
duodenal diverticulum.
52-Barium meal show -:
Wide C shape deformity of duodenal cap & out pouches in 3rd part of duodenum ( flame-like doudenal diverticulum ).
Diagnosis -:
Cancer head of pancreas with duodenal diverticulum.
53-Trifolate duodenal cap
Barium meal show-: persistent Trifoliate deformity in duodenal cap
Diagnosis-:
Chronic ( cicatricial ) duodenal ulcer.
54-Ulcerative colitis complicated by cancer transverse colon
Barium enema show-:
Diffuse narrowing of the colon & Loss of haustration giving ribbon shaped appearance & smooth filling defect in rt. side of the transverse colon
Diagnosis-:
Ulcerative colitis complicated by cancer of transverse colon.
55-Colonic diverticulosis
Barium enema show-:
Multiple small out pouches in sigmoid colongiving saw tooth appearance.
Diagnosis-: Chronic diverticulosis coli.
56-Congenital megacolon
Barium enema show-:
Huge dilatation of the colon sparing rectum .
Diagnosis-:
Congenital mega colon (hirschsprung).
57-Barium enema show-:
Arrested barium enema in the middle of transverse colon stones, calcification.gas under diphragm, multiple fluid level
D.D. intusseption ,Cancer , obstruction, hard fecal mass.
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58-Acromegalic hand
Plain X ray on hand showing-:
Increase soft tissue shadow
Tufting of terminal phalanges, mushroom shaped.
59-Acromegalic skull
Plain X ray on skull showing-:1-Ballooning ( widening ) of sella turcica 2- erosion of dorsum sell .
3-Prognathism 4- pneumatization of air sinuses 5-thickened cortex, prominent occiput & mastoid.
Diagnosis: Acromegalic skull with (intrasellar) pituitary tumor .
60-Multiple osteolytic lesions in skull(Multiplte Myeloma)
Plain x ray on skull lateral view show-:
Multiple eqaul sized (small rounded filling defects) radiolucent osteolytic bone metastasis in the vault of skull mostly multiple myeloma
مغلق الفم
61-Osteosclerotic metastasis in occipital skull bone
Plain X ray on skull lateral view showing -:
Radio- opaque large shadow in occipital region (osteosclerotic bone metastasis )
D.D. cancer prostate &breast.
( تحت مكتوب 3رقم)
62-Cod-fish spine
Plain X ray abdomen (spine) lateral view Showing-: -Diffuse rarefaction of lumbar spine & code fish appearance ( biconcave vertebrae).
Diagnosis :- osteomalacia or Osteopenia for D.D. ( osteoporosis / osteomalacia )
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63-Cervical spondylosis.
Plain X ray, cervical spin Lateral view Show-:
Narrowing of disc (joint) space between C4 & C5. with osteophyte & sclerosis of adjacent vertebraeDiagnosis:- Spondylosis
D.D. T.B &Disc prolapsed
64-Cervical spondylosis.
Plain X ray, cervical spin Lateral view Show-:
Narrowing of disc (joint) space between C4 & C5. with osteophyte & sclerosis of adjacent vertebraeDiagnosis:- Spondylosis
D.D. T.B &Disc prolapsed
65-Cervical spondylosis.
Plain X ray, cervical spin Lateral view Show-:
Narrowing of disc (joint) space between C4 & C5 , C5 & C6 with osteophyte & sclerosis of adjacent vertebraeDiagnosis:- Spondylosis
D.D. T.B &Disc prolapsed
66-Cervical spondylosis.
Plain X ray, cervical spin Lateral view Show-:
Narrowing of disc (joint) space between C6 & C7. with osteophyte & sclerosis of adjacent vertebraeDiagnosis:- Spondylosis D.D. T.B &Disc prolapsed
67-Diffuse osteosclerosis of spine (Hypoparathyrodism)
Plain X ray abdomen (spine) show-:
Diffuse sclerosis of lumbar vertebraeD.D.
Hypoparathyroidism & Paget disease .
68-Plain x ray on Rt. Femur show: multiple cysts & healed pathological fracture
D.D. Ostietisfibrosacystica
Hyperparathyroidism
69-Hour-glass myelogram
Myelogram Show-:
Hour glass constriction in lumber region giving picture of saddle shaped blockDiagnosis
Extradural extramedullary compression of spinal cord.