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


BasicsofChestRadiology




ABeginner’sGuidetoChestImaging
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RevisedandUpdatedFourthEdition
ContributingAuthors:

DrDavidWilson,MA,MB,BChir(Cantab),FRCR
DrHughDavies,MBChB,MRCGP
Dr.MaheshBaj,MBBS,MD,FFRRCSI(Ireland),FRCR
With
BMAAwardWinningAuthorandEditor:

DrSanjayGandhi,MBBS,MD,DNB,FRCR,FHEA


Aimofthe‘BasicsofChestRadiology’istoexplainfundamentals
ofchestimaginginaneasytounderstandmanner.











Highlightsofthisbook:
*Acomprehensivecoverageofnormalandabnormalchestx-ray
appearances
* Common radiological signs such as Cervico-thoracic Sign,
Golden S sign, Air Bronchogram, Hampton's hump, Hilum Overlay
sign, Luftsichel sign, Silhouette sign have been explained with the
helpofillustrationsandexamples
*Pearls,KeyLearningPoints,andTopTips
*Quizcasesforextrapractice
*Aquickreferencesourceintheclinicsandontheward
*Anexcellentoverviewofmostcommonlyaskedquestionsinthe
MBBSfinal,USMLE,andCollegemembership/fellowshipexams


This book would be an essential reading for every Medical
Student,Intern,FoundationTrainingDoctor(F1,F2s),Registrarsin
Medicine and Surgery, Accident and Emergency staff and all
RadiographersandNurseswhoneedtointerpretx-raysofchest.
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AmustreadforcandidatesappearingforAssessments,Medical
andBoardExams.


JM Books’ Medical Division is pleased to bring you this revised
andfullyupdated4thEditionofourBestSellingRadiologyeBook.
Co-authorsfor1stand2ndEditions:
DrHughDavies,MBChB,MRCGP
DrDavidWilson,MA,MB,BChir(Cantab),FRCR
NewContributingAuthorforthisEdition:
Dr.MaheshBaj,MBBS,MD,FFRRCSI,FRCR
WithContributionfrom:
Dr.JKYadav,MBBS,DTM&H(UK),MD
DrAnthonyJ.Edey,BMedSci,MBBS,MRCP,FRCR
Consultant Radiologist with specialist interests in thoracic and
cardiac CT imaging (Contributed cases of ‘Interstitial Lung Diseases’ and
‘MediastinalMasses’)









Note: You can use this book on up to four devices registered
underoneKindleaccount (subjecttoAmazon’sTerms&Conditions). Inorder
tobenefitfullyfromourhighqualitydigitalteachingfilms,wesuggest
that you should first use this book on a Good or High-resolution
screen of an iPad, or Kindle Fire HD. For revision on the ward or
‘Practice on the go’, later you can use this book on other devices
such as Android Tablet, Kindle Fire etc. The book can be used on
theLaptop,MacorPCalsousingKindleApp.
We suggest White Page Background setting for enhanced
reading experience. On touch screen devices, you can Zoom and
Pan X-rays and illustrations by double tapping the image (please see
furtherdetailundertheSuggestedKindleSettings).JMDBooks





KindlePreview:


Introduction:

Imaginethescene.....youareonabusywardroundwithyour
medical team and it seems to be going entirely to plan. You have
rememberedthethirteencausesofatrialfibrillationandnoonehas
asked you any impossible questions. Just as you thought it was all
over, your Attending Physician (Consultant) puts a chest
radiographontheviewingbox.Youtrytocreeptothebackofthe
group but you can see the Consultant searching for you, and asks
you to ‘present this X-ray’. You wish you could remember your
system,orinfact,whatanyofthediseasesyou’velearntaboutlook
like on a film. You fumble your way through somehow, but later
makearesolutionthatthiswillneverhappenagain.
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Every medical student and house officer is familiar with this
feeling. Clearly, getting through ward rounds is not the only
objective here. These skills are a cornerstone of good practice that
willbeuseddailythroughoutourcareersasdoctors.
The aim of this illustrated guide is to dispel that horror and
provide confidence in approaching chest radiographs. This will be
donebytacklingfourmainareas:
1.Developingareliableandsystematicapproachtointerpreting
radiographs.
2.Understandingtheappearancesof‘normal’onafilm.
3.Understandinghowdiseaseprocessesaffecttheappearances
ofafilm,creating‘abnormalities’thatmustberecognized.
4.Relatingthepatternsofappearanceswithclinicalconditionsin
ordertomakeadiagnosis.
The high quality teaching films, practical illustrations and expert
tipswillmakelearningchestradiologyaseasyaspossible.Someof
theexamplesareshownbelow:


KindlePreviewCase1:


Acloseupviewof‘airbronchogram’.


(Please remember that on touch screen devices you can Zoom and Pan X-rays by
doubletappingtheimage)


Airbronchogram is a classic sign of consolidation. It is seen on a
chest film when bronchi are shown as darker branching tubular
structures passing through the opacified lung. It is also one of the
commonestfilmsshownintheexams.




Explanation:
OnthechestX-ray,normallungfieldsareradiolucent(black)and
therefore, the air containing bronchi are not seen separately. In
casesofconsolidation,theairinthealveoliisreplacedbyeitherfluid
or cells and therefore, alveolar spaces appear opaque (white).
Againstthebackgroundofopacified(white)alveoli,theaircontaining
bronchithenstandoutasdarkertubularstructures.


Normally,theaircontainingbronchiareoutlinedbyaircontaining
alveoli.Inconsolidation,theairinthealveoliisreplacedbyfluidand
thebronchicontainingairappearasdarkerbranchingtubes.


This important radiological sign was first described on the
conventional chest X-rays by late Dr. Benjamin Felson. Air
bronchogram is also seen on CT scans (see example below). This
sign indicates patent bronchi. If this appearance persists for more
than 6-8 weeks despite appropriate antibiotic therapy then a
neoplasmshouldbeexcluded.



CTairbronchograminacaseofARDS.


Commoncausesofairbronchogram:












Consolidation
Pulmonaryedema
Hyalinemembranediseaseinchildren
Acuterespiratorydistresssyndrome(ARDS)
Sarcoidosis
Alveolarproteinosis
Passivecollapse/nonobstructiveatelectasis
Malignancies
Lymphoma

such

as

Severeinterstitialdisease
Pulmonaryinfarction

Bronchoalveolar

carcinoma

and


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KeyLearningPoints:







* Air bronchogram is a classic sign of consolidation. Clinicians
should be familiar with the common causes, which include benign
andmalignantdisorders.
* If this sign persists for more than 6-8 weeks then underlying
malignancyshouldbeexcluded.
*Itisalsooneofthecommonestradiologicalsignsshowninthe
Exam.
(Sectioncontinues…..)


PreviewCase2:


High Quality teaching films and practical illustrations are main
features of all our eBooks. For this text book, digital X-rays of
commonclinicalscenarioshavebeencarefullyselectedbyourteam
of tutors with more than 65 years of cumulative experience of
teachingradiologyatprestigiousUniversityHospitals.
Didyouspottherightpneumothoraxandacomminutedfracture
oftherightclavicle?
Other such exam cases have been covered in the section
‘ReviewAreas’.



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Note:Apparentnoduleintherightlowerzoneisduetoprominent
nippleshadow.






MagnifiedViewofSameCase:Prominentnippleshadow.
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~*~


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












Example:
ChronicLungOpacities:causesofchronic alveolar shadowing
(onfollowupfilm):Mnemonic:LASTS
Lymphoma
Alveolarproteinosis/Alveolarcellcarcinoma
Sarcoidosis
Tuberculosis
Silicosis
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~EndofPreview~


‘Basics of Chest Radiology’ is a handy companion of all
healthcare professionals dealing with Chest X-rays. The book has
gainedaworldwidesuccessandpraisebytraineesandtutors.






Customerfeedbackfromsecondedition:
‘Best under a fiver book I ever purchased. Very good quality xrays,butpleaseaddmorecases.’June,2012
AndonAmazonUSA:









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Inresponsetothefeedback;inthisnewFourtheditionwehave
added a lot more teaching and exam cases. Please see full list of
updatesbelow:


Whatisnewinthisupdatededition?


*Extraexamcases,illustrationsandalotmorepracticaltips.


*Toptipshighlightedseparatelythroughoutthisbook.
* Important chest pathologies and named Signs (e.g. Silhouette
sign, Air bronchogram, Golden S sign, Hampton's hump etc.)
explainedwithpracticaldiagramsandexamples.
* A new section on mediastinal mass lesions along with several
new examples of important conditions such as sarcoidosis, TB and
lungmalignancies.
* Updated section on the role of other modalities such as CT,
MRI,U/S,PETscanandEchocardiogramintheimagingofchest.
*QuizCases:Thisnewsectioncontainsself-assessmentcases
formembership,fellowshipandboardexams.









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Thebooknowcontainsover140teachingcasesandillustrations
selectedbyanexperiencedteam.
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Updated third edition offers even better value than ever. This
book is one of the most cost-effective and affordable methods to
practiceawidevarietyofclinicalscenariosatyourconvenience.

~*~


TableofContents:


DisclaimerandCopyrights©:
ListofAbbreviations:
PREFACE:
SECTION1:
TheChestRadiograph:
Basicprinciples:
Basicdensitiesonx-ray:
InterpretingtheChestRadiograph:
SystematicApproach:
Documentation:
Technicalfactors:
Extraobjects:
Areasofinterestandreviewareas:
Self-AssessmentAnatomyTest:
NormalAnatomy:
TheLateralView:
OtherImagingModalities:
CTscanofThorax:
InterpretingChestCT:
Self-AssessmentTestofCTAnatomy:
MRIofChest:
Ultrasound(US)Scan:
NuclearMedicine:
PETScan:
SECTION2:
Thelung:
1)LungVolume:
2)Lucency:
3)Opacity:
B)Collapse:
4)NodulesandMasses:
5)Lines:
ThePleura:
Extra-pulmonaryLesions:
Pleuralmasses:
TheHila:
TheHeart:
Mediastinum:
REVIEWAREAS:
Bonesandsofttissues:
Behindtheheart:
Belowthediaphragm:
FavoriteExamTopics:
PulmonaryTuberculosis:
DrugsAffectingLungs:
LungCancer:
RapidReviewofAIDS:
MiscellaneousTopics:


QUIZCASES:
LearningPointsandSummary:
KeyReferenceBooks:
Acknowledgments:







~*~



DisclaimerandCopyrights©:




(Backto:TableofContents)
ImportantNotice:
Please note that this book is intended for use of Medical
Professionalsonly. Although the authors and JMD Books Club (the
book publishing club) have made every possible effort to provide
accurateinformationatthetimeofpublication,however,errorsand
omissions are still a possibility due to human nature and/or new
developments.NeithertheauthorsnortheJMDBooksClubwarrants
thattheinformationcontainedhereinisineveryrespectcompleteor
error free and readers must confirm the information with other
sources. This is an introductory guide, written with the aim to help
candidatespreparefortheexam.Wedonotrecommendondeciding
yourclinicaldecisionsjustbasedonlyontheimagesordiscussionin
this book. The lists, causes and conditions described in this book
should be used as a starting point towards learning. The scope of
radiology is very wide and this book makes no claim to include all
conditions. This is not a reference medical textbook. A list of
reference books has been provided under Suggested Reading. No
singlebookcanguaranteesuccessinexams,andthisbookmakes
no such claim. These should be used to help you develop a
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TechnicalMatters:
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Copyrights©:
The contents of this publication entitled ‘Basics of Chest
Radiology’ are protected under international copyright© laws. This
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