Makindo Medical Notes

Related Subjects: |Chest X Ray Interpretation |Chest X Ray Collection

Pericardial Effusion and Tamponade

🫀 Expected CXR findings:
• Enlarged, globular “water-bottle” cardiac silhouette.
• Clear lung fields (helps distinguish from heart failure).
• Rapid enlargement suggests tamponade rather than chronic effusion.
⚠️ CXR is insensitive for acute tamponade — echo is diagnostic.

Right Basal Pneumonia

🦠 Expected CXR findings:
• Focal consolidation in the right lower zone.
• Loss of right hemidiaphragm outline (silhouette sign).
• Possible air bronchograms.
• Mild pleural effusion may coexist.

Pulmonary Oedema

💧 Expected CXR findings:
• Bilateral perihilar “bat-wing” opacities.
• Upper lobe diversion (cephalisation).
• Kerley B lines (interstitial oedema).
• Cardiomegaly ± pleural effusions.

Pneumothorax

🫁 Expected CXR findings:
• Visible visceral pleural line.
• Absence of lung markings peripheral to this line.
• Increased radiolucency on affected side.
• Best seen on expiratory films.

Pneumothorax

🫁 Same core features — sharp pleural line with no distal lung markings.

Pneumothorax

🫁 Apical pneumothorax — subtle early finding: check lung apices carefully.

Tension Pneumothorax

🚨 Expected CXR findings:
• Large pneumothorax with complete lung collapse.
• Mediastinal shift away from affected side.
• Depressed hemidiaphragm.
• Hyperexpanded hemithorax.
⚠️ Clinical diagnosis — do NOT delay decompression for imaging.

Pneumothorax

🫁 Partial collapse — absence of lung markings remains key diagnostic clue.

Pneumothorax (tension physiology)

🚨 Severe pneumothorax with mediastinal displacement — treat as tension until proven otherwise.

Pneumothorax

🫁 Apical pleural line with peripheral hyperlucency — common exam stem.

Severe COPD

🚬 Expected CXR findings:
• Hyperinflated lungs with flattened diaphragms.
• Increased retrosternal air space.
• Narrow, vertical cardiac silhouette.
• Reduced peripheral vascular markings.

Left Pleural Effusion

🌊 Expected CXR findings:
• Homogeneous opacity at left lung base.
• Meniscus sign with blunting of costophrenic angle.
• Large effusions may cause mediastinal shift to the right.

Dilated Aorta (Marfan Syndrome)

🫀 Expected CXR findings:
• Widened mediastinum.
• Prominent aortic knuckle.
• Consider aortic root dilatation or dissection.
⚠️ CT angiography required if acute symptoms.

Cannonball Metastases

🎯 Expected CXR findings:
• Multiple, well-circumscribed round pulmonary nodules.
• Haematogenous spread.
• Classically from renal cell carcinoma, choriocarcinoma, sarcoma.