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Basic Radiology

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Basic Chest Radiology Techniques and CXR Anatomy

Interpretation of Chest X-ray - checklist

Orientation (AP, PA, upright, supine, etc.)PenetrationRotation (Sternoclavicular Symmetry)Inspiration vs. Expiration (count ribs)Bone (fracture, symmetry, aggressive lesions)Lung fields (lesions, atelectasis, consolidation, pneumothorax)Hemidiaphragms (levels, free air)Pleural marginsCostophrenic angles (blunting, eg.)Cardiac silhouette (cardiomegaly, pericardium)Soft tissues (swelling, calcifications, sub-Q air)

Interpretation of Abdominal X-rays - checklist

Positioning (supine, erect, decubitus, X-table lateral)ExposureBowel gas patternExtraluminal air (free air)Abdominal organs (organomegaly)Soft tissue masses (distended bladder, enlarged uterus)Calcifications (renal stones, phleboliths, appendicoliths, gallstones, calcified fibroids)Bones

Imaging Exams for Common conditions

Neuroradiology
C+: w/Contrast
C-: w/o Contrast

Disease	Exam
Stroke	C- head CT
Seizure	C- head CT, then MRI if normal
Retropharyngeal	C+ neck CT
Cord compression	MRI spine survey

Thoracic Radiology

Disease	Exam
Cough	CXR
Aortic dissection	CTA C+ chest/abdomen/pelvis CT
Pulmonary embolism	V/Q, CTA C+ pulmonary angiogram

Abdominal Radiology

Disease	Exam
Pneumoperitoneum	Upright CXR
Cholecystitis	RUQ ultrasound
Appendicitis	C+ abdomen/pelvis CT, vs US if they are young and thin
Retroperitoneal bleed	C- abdomen/pelvis CT
Nephrolithiasis	C- abdomen/pelvis CT in prone position
Acute renal failure	Renal ultrasound
Abdominal pain	KUB or Obstructive Series, then C+ abdomen/pelvis CT with oral contrast

Pelvic Radiology

Disease	Exam
Ectopic pregnancy	Pelvic ultrasound
Ovarian torsion	Pelvic ultrasound

Pediatric Radiology

Disease	Exam
Pediatric intussusception	KUB, Barium enema
Pyloric Stenosis	Ultrasound

Vascular

Disease	Exam
Deep venous thrombosis	Ultrasound
Cold limb	Angiogram or CTA

Common Radiological Emergencies

Disease	Exam
CVA	C- CT
Appendicitis	C+ Abdomen/Pelvis, versus Ultrasound if they are young and thin
Aortic Dissection	CTA, transesophageal echo, MRA
Pulmonary embolism	CTA vs. Nuclear Medicine VQ scan

Contraindications to IV Contrast

Previous reaction to IV contrastRenal insufficiency (Acute dialysis is a contraindication to contrast but ongoing dialysis in patients with ESRD is not)Severe asthmaMultiple allergiesMonoclonal gammopathy

NOTE: Some patients with relative contraindications to IV contrast may require a CT with IV contrast and appropriate premedication may need to be considered AFTER discussion with radiology