Dr. Strong, these videos have been difficult for me to start, cause every time I hear those lovely opening bars of the D major prelude I get a horrible urge to stop studying and start listening to Bach…
About 4:54 you described the pocket as the deepest posterior pocket and the x ray passing posteroanteriorly the direction of rays are wrong if its PA view
In general, if equally convenient, a PA and lateral is always preferable to a single, portable AP view. However, patients requiring chest X-rays are often acutely ill and when in the ED, it may not be clear that they are stable enough to be transported to radiology for non-portable films. And for patients on the hospital wards, it's usually easier to bring an X-ray technologist to them than it is to bring them to radiology. But for ambulatory outpatients, PA/lateral >>>>> AP.
Thank you for this, excellent video. Can I ask, sometimes CXRs are well penetrated and actually you can see the posterior sulcus quite well..is it not possible to see a small pleural effusion in the visible lung below the superior aspect of the diaphragm? So it doesn’t blunt the costophrenic angle but is still visible? Thanks
Hi I' d like to the thank for the videos Could you explain why are there two well defined lines orientated vertically on both lungs in patient with pneumopericardium (15:55) ?
Thank you for great video series :) Could you please explain, why there is so significant deviation of trahea in patient with pleura thickening due to the tuberculosis (on 12:10)?
Pleural fibrosis and scarring from any process will lead to an impairment in the ability to expand the affected side, since it decreases compliance of the chest wall/lung apparatus. This restriction will result in low lung volume on that side, which will pull the trachea and entire mediastinum towards it. The restriction might sometimes be balanced by a space occupying pleural effusion which works to push the airway and mediastinum away, but in this case, the restriction is clearly winning the tug-of-war
Sir i guess ribcages not to support i think to hold the heavier lungs in position eventhough alveoli present they are heavy they kept it in a tray in our anatomy hall
That pneumothorax with a deep sulcus sign looks like not only a pneumothorax but also the GI tract pushing on the lungs and heart, collapsing it further. I can clearly see the liver and intestines on the chest x ray. Normally those only show up on an abdominal x ray. I can only think of 1 condition that would push the liver and intestines towards the collapsed lung. That is pregnancy. So I do believe that the first x ray that isn't showing just a pneumothorax is that of a woman in the third trimester with a pneumothorax.
I think it has that appearance because of the combination of the fact that the radiology technologist included more of the abdomen in the view, and because it looks like a slightly lordotic film (i.e. one that is shot slightly angled from the feet). Impossible to know if that was done on purpose or not, but it does beautifully demonstrate the deep sulcus sign.
Hi, Thanks for the great videos they do make learning internal medicine things easier. I was just wondering about the animation you have on this video (CXR lesson 6) that seem to show an AP position of the patient but you refer to it as PA (e.g. minute 10:25), is this correct or is it just a animation issue? I just want to be clear since I feel that this is exactly the type of thing that a consultant would ask me about. Thanks again.
You're totally correct. The animation is obviously demonstrating an AP film, but the actual film is a PA one. I probably should have used a fully upright AP film instead in order to stay consistent.
Thank you, Sir, for great videos. Which book do you suggest for studying X-rays? Also, videos on Abdominal X-rays interpretation would be of great help.
I have not personally read it, but Felson's Principles of Chest Roentgenology is by far the most recommended book for learning chest X-rays. A video on abdominal X-rays is on my list of topics to cover, but unfortunately I can't offer an estimate of when I'll get to it.
8:45 it could be a mass in midlle of posterior mediastinum ?? because these opacities is very well delimited in parenchima of the lung whith sharply and very well definited rims
The three dimensional shape of asbestos-related pleural plaques are hard to visualize, but here's a description of them from Radiopeadia.org (radiopaedia.org/articles/pleural-plaque): "Pleural plaques exhibit the so called "incomplete border sign" on chest radiograph. The inner margin is often well defined because it is tangential to the x-ray beam and the adjacent lung is a good contrast medium. The tapering outer margin is indistinct as it isen face to the x-ray beam and the chest wall provide less tissue contrast. Calcified plaques is more obvious than non-calcified plaques to be identified. Locations most commonly encountered include posterolateral, mediastinal and diaphragmatic pleural. Appearance has been likened to that of a holly leaf, which thickened rolled and nodular edges."
Chilaiditi's sign,
Pneumopericardium
Pneumomediastinum.. awesomely explained 👍
Your videos are too good. Really love how you explain everything with practical examples.
Thank you Dr. Eric for the very clean organized medical lectures
Great series a very good review, and it's sad and shameful if someone tries to prejudice such a useful work.
Thank you Dr. Eric you very great to explain systemic ,more detatail very valuable
Gold standard explanation 🙏🙏
Thank you very much Dr Eric Strong. I cant thank you enough.
A great series of lectures. Truly interesting and beneficial. Thanks a lot.
Thank you for the great work you do publishing these videos
These are great! Thank you very much for taking the time and resources to produce these!
This is some next level work Professor
glad to hear you're doing better. thanks for the videos!
Dr. Strong, these videos have been difficult for me to start, cause every time I hear those lovely opening bars of the D major prelude I get a horrible urge to stop studying and start listening to Bach…
Greeting from Thailand. Admiring your good work.
❤️❤️ i needed this my whole life
Thanks sir, for real clinically important videoes
About 4:54 you described the pocket as the deepest posterior pocket and the x ray passing posteroanteriorly the direction of rays are wrong if its PA view
I was looking for part 7 Doc. Good videos.
Sorry, a few dozen computer viruses have slowed me down. I wish I had a budget to hire an IT guy! Part 7 (and 8-10) will hopefully be out soon.
Eric's Medical Lectures Thanks! They have been very informative. Keep the good work.
absolutely brilliant lectures. thank you very much.
Would the resulting x-ray of the diagram at 4:49 result in an AP view?
Fantastic lecture.
Thank you, doctor, for the nice explanation. I have a question. If the patient came complaining about the chest, always do PA and lateral?
In general, if equally convenient, a PA and lateral is always preferable to a single, portable AP view. However, patients requiring chest X-rays are often acutely ill and when in the ED, it may not be clear that they are stable enough to be transported to radiology for non-portable films. And for patients on the hospital wards, it's usually easier to bring an X-ray technologist to them than it is to bring them to radiology. But for ambulatory outpatients, PA/lateral >>>>> AP.
Thank you for this, excellent video. Can I ask, sometimes CXRs are well penetrated and actually you can see the posterior sulcus quite well..is it not possible to see a small pleural effusion in the visible lung below the superior aspect of the diaphragm? So it doesn’t blunt the costophrenic angle but is still visible? Thanks
awesomely done! Very informative
Great videos! Thanks for your time and effort!
thank you so muchyour video helps me a lot
Thanks so much for teaching so well!
Hi I' d like to the thank for the videos
Could you explain why are there two well defined lines orientated vertically on both lungs in patient with pneumopericardium (15:55) ?
seems to me like collapsed lungs, any radiologist opinion ?
yes, thank you very much sir! excellent teaching videos in general, really admirable work you are doing!
Thanks a lot doc!
Thank you for great video series :)
Could you please explain, why there is so significant deviation of trahea in patient with pleura thickening due to the tuberculosis (on 12:10)?
Pleural fibrosis and scarring from any process will lead to an impairment in the ability to expand the affected side, since it decreases compliance of the chest wall/lung apparatus. This restriction will result in low lung volume on that side, which will pull the trachea and entire mediastinum towards it. The restriction might sometimes be balanced by a space occupying pleural effusion which works to push the airway and mediastinum away, but in this case, the restriction is clearly winning the tug-of-war
Thanks foe explanation!
big-big thanks 4 great videos ....
Faltó hablar sobre la desviación del mediastino en el neumotorax.
thank you for all of your videos
GREAT WORK thank you so much
So should you expire when doing a chest ray to view the pneumothorax better?
Sir i guess ribcages not to support i think to hold the heavier lungs in position eventhough alveoli present they are heavy they kept it in a tray in our anatomy hall
can you explain why vomitting and ashma causes pneumomediastinum ?
Thank you.
Patient in first images has pleural effusion in the left lung as well.
That pneumothorax with a deep sulcus sign looks like not only a pneumothorax but also the GI tract pushing on the lungs and heart, collapsing it further. I can clearly see the liver and intestines on the chest x ray. Normally those only show up on an abdominal x ray. I can only think of 1 condition that would push the liver and intestines towards the collapsed lung. That is pregnancy. So I do believe that the first x ray that isn't showing just a pneumothorax is that of a woman in the third trimester with a pneumothorax.
I think it has that appearance because of the combination of the fact that the radiology technologist included more of the abdomen in the view, and because it looks like a slightly lordotic film (i.e. one that is shot slightly angled from the feet). Impossible to know if that was done on purpose or not, but it does beautifully demonstrate the deep sulcus sign.
Hi, Thanks for the great videos they do make learning internal medicine things easier. I was just wondering about the animation you have on this video (CXR lesson 6) that seem to show an AP position of the patient but you refer to it as PA (e.g. minute 10:25), is this correct or is it just a animation issue? I just want to be clear since I feel that this is exactly the type of thing that a consultant would ask me about.
Thanks again.
You're totally correct. The animation is obviously demonstrating an AP film, but the actual film is a PA one. I probably should have used a fully upright AP film instead in order to stay consistent.
Eric's Medical Lectures Thanks
Amazing!
Thank you, Sir, for great videos. Which book do you suggest for studying X-rays? Also, videos on Abdominal X-rays interpretation would be of great help.
I have not personally read it, but Felson's Principles of Chest Roentgenology is by far the most recommended book for learning chest X-rays. A video on abdominal X-rays is on my list of topics to cover, but unfortunately I can't offer an estimate of when I'll get to it.
Great job. Appreciated sir
8:45 it could be a mass in midlle of posterior mediastinum ?? because these opacities is very well delimited in parenchima of the lung whith sharply and very well definited rims
What is the shape of plaque you have mentioned?
The three dimensional shape of asbestos-related pleural plaques are hard to visualize, but here's a description of them from Radiopeadia.org (radiopaedia.org/articles/pleural-plaque):
"Pleural plaques exhibit the so called "incomplete border sign" on chest radiograph. The inner margin is often well defined because it is tangential to the x-ray beam and the adjacent lung is a good contrast medium. The tapering outer margin is indistinct as it isen face to the x-ray beam and the chest wall provide less tissue contrast. Calcified plaques is more obvious than non-calcified plaques to be identified. Locations most commonly encountered include posterolateral, mediastinal and diaphragmatic pleural. Appearance has been likened to that of a holly leaf, which thickened rolled and nodular edges."
excellent
Ty!
Big fat thanks 🌺
Very nice
brilliant sir
youre a beautiful person !
Thank youuu so much !!!
Thanx
pakistan loves you doc
eric strong i adore you
Tq sir
Thank youuuuuuuuu