CXR

• Rib #:

• Pneumothorax: erect chest in full expiration - absence of lung markings (vessels) between lung edge and chest wall

• Pneumonia: are both heart borders and hemidiaphragms well defined and clearly visible? L hemidiaphragm not well defined: LLL; L heart border: LUL; R hemidiaphragm (medial aspect): RLL; R heart border: RML;

• Heart failure: cardiomegaly (CT ratio>1/2), intersitial pulmonary odema (Kerley B lines; also seen in non-cardiac conditions e.g. pulmonary fibrosis), vascular redistribution (UL blood diversion/cephalization of vessels), pleural effusions

AXR

• Trauma:

• Acute abdomen: perforation (erect CXR: free air); obstruction: Small bowel mechanical obstruction: dilated small bowel (loops >30mm) no gas in large bowel, 'string of beads' sign on erect AXR); Incomplete small bowel obstruction/localised dynamic ileus*: dilated small bowel with gas in undistended colon. Mechanical large bowel obstruction/generalised adynamic ileus: dilated small bowel with gas in a distended colon.

*Ileus (ancient Greek for intestinal obstruction): disruption of the normal propulsive ability of the intestine due to lack of peristalsis or by mechanical obstruction

Thoracic / Lumbar spine

• Lateral: alignment, vertebral height (wedge fractures)

• AP: alignment (paraspinal hematoma), pedicles, transverse processes

Face

• Occipital-mental (OM): orbital margins, frontal sinuses, zygomatic arches (elephant trunk), maxillary mantra. McGrigor's 3 lines:

• OM 30: good for zygomatic arches, maxillary antra

• Tripod # (zygomatico-frontal suture, zygomatic arch, body of zygoma), blowout # (teardrop in roof of maxillary antrum; 2nd line). mandibular #

Shoulder

• AP +/- other views

• # humerus (neck/head), clavicle (middle 1/3), anterior dislocation, posterior dislocation, A/C subluxation/dislocation

Elbow

• AP/lateral

• Fat pad displacement, abnormal anterior humeral line, abnormal radiocapitellar line, CRITOL

Wrist & distal forearm

• PA, lateral. Scaphoid (navicular), lunate, triquetral, pisiform, hamate, capitate, trapezoid (lesser multangular), trapezium (greater multangular)

• # distal radius (Colle's, Smith's)