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ASystematicApproach:BriefReminder

ASystematicApproach:BriefReminder
Ifyoudon'talreadyhaveyourownsystem,thentrythisapproachwhichwillhelppreventyoufrom
rushinginandmissingimportantfindings.Neverforgetthattheremaybemorethanoneabnormality.
Checkthename,patient'sgender,DOBanddate(NBradiographsusedinthistutorialhavehadthis
informationremoved)
LookforL(left)andR(right)markers
ChecktoseewhetherfilmisPA,APandwhetherthereisalateralview.
Checkfor
rotationi.e.themedialendsoftheclaviclesareanequaldistancefromthespinousprocesses

Above:Rotatedfilm,notehowtheverticallineformedbythespinousprocessesisnotequidistantfrom
themedialendsoftheclavicles.
2.adequatepenetration,youshouldbeabletomakeouttheoutlinesofthevertebralbodiesbehind
theheartborder

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ASystematicApproach:BriefReminder

3.adequateinspiration.Themidpointoftherighthemidiaphragmshouldberoughlylevelwiththetip
ofthesixthrib.

Afterabriefassessmentofthefilmqualityyouarenowreadytolookatthefilmforabnormalfindings.
Firstfocusonthemoststrikingfeature/abnormality.
Thenreviewthefollowingareas:
Pulmonaryvasculature
Hila(leftisusuallyhigherthanright)
Sharpnessofcostophrenicangles(shouldbewelldefined)
Apices
Peripherallungmargins
Cardiacsizeandoutline
Lookbehindtheheart!

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ASystematicApproach:BriefReminder

Bonystructures(vertebrae,ribs,shouldergirdle)
ThisTutorialfocusesonspottingthemoststrikingabnormality,butdon'tforgetthereviewareas!Ifyou
can'tfindanythingabnormal,workdownthelistabove,andifyouaresystematicenoughyouwillspotit.

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