2012 basics of chest radiology new edition dr h davies (contributing author)

This book would be an essential reading for every MedicalStudent, Intern, Foundation Training Doctor F1, F2s, Registrars inMedicine and Surgery, Accident and Emergency staff and allRadio

Dr David Wilson, MA, MB, BChir (Cantab), FRCR

Dr Hugh Davies, MBChB, MRCGP

Dr Mahesh Baj, MBBS, MD, FFRRCSI (Ireland), FRCR

* Common radiological signs such as Cervico-thoracic Sign,Golden S sign, Air Bronchogram, Hampton's hump, Hilum Overlaysign, Luftsichel sign, Silhouette sign have been explained with thehelp of illustrations and examples

This book would be an essential reading for every MedicalStudent, Intern, Foundation Training Doctor (F1, F2s), Registrars inMedicine and Surgery, Accident and Emergency staff and allRadiographers and Nurses who need to interpret x-rays of chest.

-A must read for candidates appearing for Assessments, Medicaland Board Exams

JM Books’ Medical Division is pleased to bring you this revisedand fully updated 4th Edition of our Best Selling Radiology eBook.Co-authors for 1st and 2nd Editions:

We suggest White Page Background setting for enhanced

reading experience On touch screen devices, you can Zoom andPan X-rays and illustrations by double tapping the image (please see further detail under the Suggested Kindle Settings) JMD Books

Introduction:

Imagine the scene you are on a busy ward round with yourmedical team and it seems to be going entirely to plan You haveremembered the thirteen causes of atrial fibrillation and no one hasasked you any impossible questions Just as you thought it was all

over, your Attending Physician (Consultant) puts a chest

radiograph on the viewing box You try to creep to the back of the

group but you can see the Consultant searching for you, and asksyou to ‘present this X-ray’ You wish you could remember yoursystem, or in fact, what any of the diseases you’ve learnt about looklike on a film You fumble your way through somehow, but latermake a resolution that this will never happen again

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Every medical student and house officer is familiar with thisfeeling Clearly, getting through ward rounds is not the onlyobjective here These skills are a cornerstone of good practice thatwill be used daily throughout our careers as doctors

The aim of this illustrated guide is to dispel that horror andprovide confidence in approaching chest radiographs This will bedone by tackling four main areas:

1 Developing a reliable and systematic approach to interpretingradiographs

2 Understanding the appearances of ‘normal’ on a film

3 Understanding how disease processes affect the appearances

of a film, creating ‘abnormalities’ that must be recognized

4 Relating the patterns of appearances with clinical conditions inorder to make a diagnosis

The high quality teaching films, practical illustrations and experttips will make learning chest radiology as easy as possible Some ofthe examples are shown below:

Air bronchogram is a classic sign of consolidation It is seen on a

chest film when bronchi are shown as darker branching tubularstructures passing through the opacified lung It is also one of thecommonest films shown in the exams

or cells and therefore, alveolar spaces appear opaque (white).Against the background of opacified (white) alveoli, the air containingbronchi then stand out as darker tubular structures

Normally, the air containing bronchi are outlined by air containing alveoli In consolidation, the air in the alveoli is replaced by fluid and the bronchi containing air appear as darker branching tubes.

This important radiological sign was first described on theconventional chest X-rays by late Dr Benjamin Felson Airbronchogram is also seen on CT scans (see example below) Thissign indicates patent bronchi If this appearance persists for morethan 6-8 weeks despite appropriate antibiotic therapy then aneoplasm should be excluded.

CT air bronchogram in a case of ARDS.

(Section continues… )

Note: Apparent nodule in the right lower zone is due to prominent nipple shadow.

The book also contains Practical Differential Diagnosis (D/D) Lists, Named Signs and Tips for common clinical scenarios.

‘Basics of Chest Radiology’ is a handy companion of allhealthcare professionals dealing with Chest X-rays The book hasgained a worldwide success and praise by trainees and tutors.

* A new section on mediastinal mass lesions along with severalnew examples of important conditions such as sarcoidosis, TB andlung malignancies.

* Updated section on the role of other modalities such as CT,MRI, U/S, PET scan and Echocardiogram in the imaging of chest

* Quiz Cases: This new section contains self-assessment casesfor membership, fellowship and board exams

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The book now contains over 140 teaching cases and illustrations selected by an experienced team.

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Learning Points and Summary: Key Reference Books:

Acknowledgments:

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no such claim These should be used to help you develop acomplete understanding of this subject All complex cases and otherpotentially life threatening conditions should be discussed with anexperienced member of your team such as Attending Staff or aConsultant.

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Antero posterior (view)

CCF

Congestive Heart Failure

COAD

Chronic Obstructive Airways Disease

CT

Computed Tomography/ CAT Scan

ED

Emergency Department

ER

Emergency Room

HRCT

High Resolution CT

MRI

Magnetic Resonance Imaging

PET

Positron Emission Tomography

US

Ultrasound

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Common spelling variations American / British English:

Radiology is a combination of pattern recognition and knowingthe list of causes, which can lead to such an appearance With thehelp of experienced tutors, we have brought you this concise textbook to help you understand the basics of chest imaging PreviousEditions of this book became a worldwide success The bookreached number one rank of radiology book on Amazon Kindle storewithin a few months of publication We received excellent feedback

rays and therefore, in this fully updated third edition we have addedmore than hundred new teaching cases and illustrations Importanttake-home messages have been highlighted throughout the textbook

by trainees Our readers also asked us to increase the number of X-

This book is dedicated to Professor Paul Goddard, famous Britishchest radiologist and author of hundreds of articles and severalbooks; a friend and guide This book is also dedicated to ProfessorDharam P Garg, an excellent tutor of basics of radiology and thelate Dr Benjamin Felson, Professor Emeritus and one of the mostfamous American chest radiologists and author of numerousradiology text books

I take this opportunity to thank Dr Hugh Davies and Dr DavidWilson, my Co-authors of the first and second editions of this book Iwelcome new contributors Dr Mahesh Baj, a celebrated Radiologist,

an author of several publications Dr Baj is on the Editorial Board ofseveral Journals and winner of many awards and honors includingthe ‘Hind Ratan Award’ received from the President of India Mythanks are due to Dr Anthony Edey and Dr J K Yadav for their input

and practical tips I am grateful to all our distinguished current andpast contributors and we all hope that you will enjoy this significantlyenhanced new Edition.

~ Benjamin Felson, MD

Famous Chest Radiologist, 1913-1988

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SECTION 1:

The Chest Radiograph:

X-rays were discovered in the 1895 by Wilhelm Conrad Röntgen.

They are short wave length electromagnetic radiation produced byaccelerating electrons across an evacuated tube onto a metal anodeusing a high voltage

The x-rays leave the source to pass through the patient's body,and expose the receptor In the past, this used to be a photographicplate containing an x-ray film, but with advances in technology, it hasbeen replaced largely by digital detection devices As the x-rayspass through the subject, different parts of the body absorb differentquantities of the radiation The detector converts this difference inthrough transmission into different shades of grey The amountabsorbed depends on the density and atomic number of the tissue Air absorbs very little and appears dark, whilst metal absorbsconsiderably more and shows as a white area on the resultingimage (Ref 1-4)