Saturday, January 11, 2014

A bit of Radiology

Here here. A bit of lesson in Radiology.

First, let's look at Chest X-Ray (CXR) films. (I got these from Dr.Azian and Dr.Razali's tutorial but I cropped the patient's name and added some words so I guess it should be okay right hehe)

How do you describe CXR?
According to Dr.Azura, Dr.Fahmi's wife - we saw them going to CIMB bank and we thought that was cute them walking together their kids must be cute I pray so that they will live happily ever after forever okay let's get back to these films - these are the things you must remember if someone gives you a CXR film to interpret:

1. Describe the name of patient and date taken, what kind of XRay in what position
(eg: This is a Chest Xray of Mr.Ahmad, taken on 3/3/2013, Antero-Posterior view, in supine position)

2. Penetration and Exposure
(eg: It has good penetration and good exposure)

3. Obvious findings that you can see on the XRay - what, where (be specific!)

4. Systemic review: trachea, mediastinum, hilar, cardiac shadow, hemidiaphragm, costophrenic angle, lung field, bone, soft tissue

Now let's go to the first film:

Massive Left-sided Pleural Effusion

Left lung Pneumothorax

When you see a chest tube in XRay, that must mean something. Either you want to drain the air (pneumothorax), fluid (pleural effusion) or blood (haemothorax) inside the lung.

Now this is Kidney, Ureter, Bladder (KUB) XRay:
Those are bilateral staghorn calculi! Stones so BIG that they occupy renal pelvis!

Dr.Azian taught us on Contrast Studies. There are many contrast media such as Low Osmolality Contrast Media (LOCM), High Osmolality Contrast Media (HOCM), barium, gastrografin, water, gas, iodine etc. We usually use Omnipaque (a brand name) as LOCM. We dont use HOCM due to adverse side effects.

Barium Swallow is a standard contrast examination to visualise esophagus.
This patient had Esophageal Carcinoma because of the irregularity of middle third of esophageal wall. There is no evidence of obstruction as the barium flows through to the stomach. There is no proximal dilatation of distal part of esophagus. There is no stricture or leaking.

Barium Meal is to visualise stomach and duodenum mainly. In Barium Meal examination, the patient drinks barium, but in Barium Swallow, the patient swallows barium. You can tell by the name, right?

Barium Enema can be done by using Single Contrast (barium only) or Double Contrast (barium and gas).
How do you know this uses double-contrast? Because you can see the outline of the large bowel clearly.

This patient had Rectal Carcinoma and Diverticulum (outpouching of intestinal wall). Apple-core appearance is when the carcinoma is so severe that the intestinal wall is eroded on both sides, resembling apple core.

This is Hysterosalpingogram (HSG), a standard contrast examination to visualise uterus and Fallopian tubes.
She had Bicornuate Uterus!

My 5 sisters are at home now. This morning we went to the city together! My eldest sister was driving her way back home when we went out, so she's not in the picture:

From left: Me, Jehan, Adlin, Izzah and Syakirah

Cloudy.....with a chance of meatballs?
Yeahh in YOUR dreammmm

You have a good day!! And have a good weekenddd!! :D 

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