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AP chest x-rays are harder to read than PA x-rays and are therefore generally reserved for situations where it is difficult for the patient to get an ordinary chest x-ray, such as when the patient is bedridden. In this situation, mobile X-ray equipment is used to obtain a lying down chest x-ray (known as a "supine film").
However, lesions may appear anywhere in the lungs. In HIV and other immunosuppressed persons, any abnormality may indicate TB or the chest X-ray may even appear entirely normal. [1] Old healed tuberculosis usually presents as pulmonary nodules in the hilar area or upper lobes, with or without fibrotic scars and volume loss. [1]
CT scan of the chest showing bilateral lymphadenopathy in the mediastinum due to sarcoidosis. Bilateral hilar lymphadenopathy is a bilateral enlargement of the lymph nodes of pulmonary hila. It is a radiographic term for the enlargement of mediastinal lymph nodes and is most commonly identified by a chest x-ray.
A chest X-ray will show fluid in the alveolar walls, Kerley B lines, increased vascular shadowing in a classical batwing peri-hilum pattern, upper lobe diversion (biased blood flow to the superior parts instead of inferior parts of the lung), and possibly pleural effusions. In contrast, patchy alveolar infiltrates are more typically associated ...
A) Normal chest radiograph; B) Q fever pneumonia affecting the right lower and middle lobes. Note the loss of the normal radiographic silhouette (contour) between the affected lung and its right heart border as well as between the affected lung and its right diaphragm border. This phenomenon is called the silhouette sign: Differential diagnosis
The root of the right lung lies behind the superior vena cava and part of the right atrium, and below the azygos vein.That of the left lung passes beneath the aortic arch and in front of the descending aorta; the phrenic nerve, pericardiacophrenic artery and vein, and the anterior pulmonary plexus, lie in front of each, and the vagus nerve and posterior pulmonary plexus lie behind.
This PA chest radiograph demonstrates an abnormal contour in the right hilar region, with visualization of the pulmonary vessels through the mass (the hilar overlay sign) indicating its posterior mediastinal location. On resection this was found to be a benign solitary fibrous tumor of the pleura.
In a study from 1980 that used chest X-rays to evaluate 65 cases of solitary lung cavities, 0% percent of cavities with walls 1 mm or less were malignant (that is, cancerous), versus 8% of cavities with walls 4 mm or less, 49% of cavities with walls 5 to 15 mm, and 95% of cavities with walls 15 mm or greater. [3]