How to distinguish between small and large bowel
Small bowel = valvulae conniventes crossing all lumen in small bowel.
Small bowel obstruction on AXR
- Dilated greater than 3cm.
- No air in distal bowel and no air in rectum.
Explain Rigler’s sign and when would you see it?
What other Ix would also show cause?
- Gas outlining both sides of the bowel wall, presence of gas in bowel lumen and peritoneum.
- Seen in pneumoperitoneum so can be seen on CXR.
- Perforated bowel.
What is seen on x-rays of bones affected by myeloma
Lytic lesions seen as punched out lucencies
What does a caveatting lung lesion appear like on xray and name some causes of a caveatting lung lesion.
Fluid level by the cavity.
Carcinoma (bronchogenic, SCC), cystic bronchiectasis, autoimmune disease (granulomatosis with polyangiitis), pulmonary infarction, infections (TB, S.aureus, Klebsiella).
How can the location of a ?lung cancer on xray help point to its histology
Small cell = grow rapidly, met fast and usually located centrally.
Adenocarcinoma = no Hx of smoking, slow growing, met early, peripherally located.
SCC = can be located either central or peripherally, slowest growth rate, can invade chest wall!
- Signs of hyperinflation on a CXR.
- What can cause that?
- Other CXR signs in most common cause?
- Heart appears vertical and narrow. Downward push on diaphragm causes it to flatten and be low set (11th and 12 posterior rib), hyper-lucent/dark lung fields.
- COPD, cystic fibrosis, asthma,
- COPD = walls of blebs/bullous (thin walled air spaces in emphysema).
What is the Ghon focus?
The primary site of pulmonary tuberculosis infection, a calcified granuloma in the lower lobe associated with calcified hilar nodes.
