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n CME : Your SA Journal of CPD - The abnormal chest X-ray - when to refer to a specialist : main article
- Chest X-rays are an important investigation in lung disease. However, history and physical examination are crucial steps in the evaluation of the patient and should be performed before reading chest X-rays.
- X-ray abnormalities need to be combined with clinical findings to make a diagnosis.
- If you are not sure, seek assistance from a specialist.
- Consolidation or air-space shadowing is caused by opacification of air-containing spaces of the lung.
- Collapse or atelectasis is due to partial or complete volume loss in a lung or lobe.
- Physical examination is required to determine if the mass is intrapulmonary or cutaneous.
- Intrapulmonary lesions are well defined and are projected over the lung on frontal and lateral projections. Extrapulmonary mass lesions are in contact with other soft-tissue structures.
- The summation of multiple, small, linear opacities on the chest X-ray may produce the appearance of multiple small nodules. Likewise the superimposition of multiple small nodules may produce a granular or ground-glass pattern.
- Hilar abnormalities may be vascular and non-vascular.
- Pleural effusions collect in the posterior costophrenic angle and as little as 100 - 200 ml may appear above the diaphragm.
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