How to Interpret a Chest X-Ray (Lesson 3 - Assessing Technical Quality)

[@StrongMed]

Errata: @12:03, meant to say radiology technologist, not radiology technician. (Sorry, no offense intended!)

[@StrongMed]

@zeenat gazi As a very general rule, in US healthcare, technologists usually have more training than technicians (though in common parlance, the words are frequently used interchangeably).

[@giobasta6918]

R.I.P= rotation.inspiration.penetration.

[@lubondochilekwa]

NICE!

[@erickperez1302]

This is the most incredible lecture in Chest X rays I have ever had. Just Beautiful! Thanks SO much!

[@tegegnlegesse6829]

Sir,you teach me simply,clearly and easily remember able way. thank you very much. Tegegn from Ethiopia.

[@acazaam]

Tegegn legesse is amhari name or ormomian ?

[@menpagnaroat1269]

This is the most incredible lecture in Chest X rays I have ever had. Thanks so much! I will share the knowledge from your lectures to my colleagues here in Cambodia!

[@medicineandtravel]

I am loving your lectures on these!!! I am finally learning how to read CXRays!!!

[@penguiNET]

Hi Dr. Strong, big fan of your channel! Around 8:10, I believe there is an error. The laterality of the humeri are mislabeled, I think. Also, in the CXR inset, it looks to me that the patient's left side is rotated forward, so shouldn't the schematic on the left be opposite? If I understand your lesson, the schematic is demonstrating right forward rotation, so on CXR the spinous process should be closer to the patient's right clavicle on the left of the CXR screen (so confusing!). That is, I believe the schematic and the example CXR @8:10 are showing two separate things: schematic is right forward rotation, while CXR demonstrates left forward rotation?

[@jacquesjgsouza4376]

I agree with you Tom Shieh.

[@LilDroov]

Was confused about this too. However, think I figured it out- the schematic is also depicting left forward rotation. Imagine the schematic as us looking UP from a person's feet. The person is facing the X-ray film, so it is a PA. Their left side of the body is tilted towards the x-ray film, which is what they're facing, making the spinous processes point to the left and thus be closer to the left clavicle on imaging.

[@sararose7812]

same thing i ve noticed and i ve only inversed R and L all will be right

[@utkarshdubeyingoogleplus]

You are correct Tom, I noticed it too and was a bit confused and frustrated about the L/R

[@fasil2295]

Me ALSO CONFUSED

[@emadbalubaid]

Thank you so much . Great video.. Sir, can you please make videos about haemodialysis and peritoneal dialysis.

[@StrongMed]

Hemodialysis and peritoneal dialysis are on my list of topics to cover, but unfortunately, I'm so far behind on viewer suggestions that I can't offer an estimate as to when they'll get posted. Thanks for watching!

[@MACNTOSFAM]

To add to PA vs. AP projection, it is to reduce breast tissue dose. Thank you for a great compilation!

[@StrongMed]

+Cee Mac Thanks for pointing this out! The difference in radiation dose to the breast between AP and PA views is small, but non-zero. (i.e. the PA view results in less breast irradiation)

[@kashzful]

I'm a Radiodiagnosis resident and these videos are soo helpful!

[@tiffanytea1778]

I just want to say thank you so much. The way you break down X-ray interpretation, has been helping me for my boards! Thank you again!

[@DanaLouisseDignos]

hello! going from 8:12 the image you have on the left.. if the trachea is up front and the vertebral body is behind - shouldn't the R and L be reversed? since that is now the patients left side on the left side of the trachea?

[@naganathheble643]

Excellent video & lecture regarding chest radiography

[@MzHazze]

Glad I found your channel. Nice rads channel here

[@kotithella9733]

Happy new year. It's nice and very helpful.Thanks

[@dunyaaaaaaaaa]

or you could just say a radiographer. as they study 4 years for this degree!!!

[@icemanaxs]

Happy New Year!! Thank you for an informative and fun 2013, looking forward to 2014, can't wait to learn more from you.

[@sync3034]

Evaluation of appropriate exposure/penetration is also aided by EI (exposure index) value and the DQE (detective quantum efficiency) of the system. Unfortunately these are not standardized. But having said that I was taught that nothing replaces your eyes when evaluating proper exposure.

[@mateusfernandes7347]

You are an excellent teacher! Thank you very much!

[@lexielos4052]

love these lessons! thank you so much!

[@danielbrowniel]

I used to do mobile xray and I hated seeing these reports confusing rotation with deformities of the chest and spine, In these cases the concept of a "true AP" is ambiguous because there would be independent alignments of the manubrium/ trachea/ spinal direction.. where any radiographic correction would misalign another part.

[@victorgonzalez2927]

@ 14:10 you say that both are frequently referred to as underexposed, how can that be? The too bright image looks to be underexposed while the too much contrast looks overexposed.

[@azuhra9744]

What about technical quality (regarding how many ribs should be shown) in expiratory CXR?

[@HafizahHoshni]

Thank youuu so much! 11/11/2017 ✨

[@robertlambert5636]

AP Just incorporate AI to clean

[@gyaneward8737]

5:10 IS THE PIC ON THE RIGHT AN AP VIEW ? DONT THINK SO

[@StrongMed]

I'm not sure why you would doubt it was an AP view other than the quality is good, but it wouldn't matter if it was AP or PA for demonstrating the particular issue in question (i.e. that if the lung apices don't extend above the clavicles, the X-ray beams were probably not directed perpendicular to the plane of the patient's chest)

[@mikeb2407]

Thank you for this video! You were incredibly clear. Amazing

[@rajkumar01035]

Than you so much for sharing your knowledge .. these help me a lot of in my clinical practices

[@realzayasosho6362]

Sir Wat about differences in quality btn men n women ,breast position cannot affect technical quality of chest x ray

[@shivanisharma-zq4jl]

Great lectures.. Help me alot in clearing all doubts... Thnku so mch sir..

[@HannanZikrea]

Thank you so much for such amazing explanation!!

[@mustafamukaram7412]

Thank you, for this nice video explanation .

[@mhamadshawan3944]

U are the best thank uuuuuu❤

[@9872025414]

Awesome, Good thank u much . I appreciate ur explanation u have good knowledge regarding radiology. Dr Ram Singh India

[@lmiketenn]

Fantastic presentation...Thank you doctor...

[@ladyheart5147]

Thanks again for another great video. With inadequate inspiration why would the cardiac silhouette and mediastinum appear falsely enlarged? Thanks in advance hopefully I will be able to interpret my chest x-ray after watching these videos.

[@praj3111]

During inspiration , diaphragm pulls heart downwards therfore horizontal width is reduced in least inspiration effort

[@Harun_Ibrahim_]

Thanks Eric. My question is; why don't we take AP x-rays in ambulatory? You haven't answered that. Thanks

[@StrongMed]

I discuss it in the first 3 min of lesson 5 on the cardiac silhouette, since AP films cause the heart size to appear enlarged. kzbin.info/www/bejne/mIaTf6Btf6t9qrc

[@isaacheron1607]

Thanks very much sir. This was really helpful.

[@AmitLathoriya]

sir, will u please recommend me books for studying radiology

[@2003121300]

hi happy new year to you sir.Nice to see u again with video

[@mankiratsingh797]

Nice demostration ...sir what software have u used to make the demonstrations??

[@StrongMed]

Thanks! I use a combination of Audacity for recording and editing narration, PowerPoint and Photoshop for graphics (occasionally supplemented by Illustrator), Encore for those videos with original music arrangements, and Premiere Pro for animations and to stitch it altogether.

[@oliverallen5324]

A great series. Worth watching a couple of times.

[@ismailjimmy6944]

Sir please also make a video on CT chest

[@hishamrezk712]

Thanks for the videos .....any videos for general surgery

[@StrongMed]

I'm very sorry, but I generally focus on topics that are within my scope of clinical practice as a hospitalist.

[@dhruthia5783]

Tanx a lot...video is full helpful

[@sunilmoktan838]

Would u mind making videos on x ray abdomen plz???

[@StrongMed]

Thanks for the great suggestion! I've been meaning to cover abdominal X-rays for a long while, but never got around to it with some many other competing requests. Unfortunately, with the COVID-19 pandemic descending on the US right now, everything else is getting pushed back for a bit.

[@manabtiwari6269]

Thank you sir. These video series are really helpful.

[@gangotribanerjee3365]

Superb.Thanks a lot.

[@niamatullah4442]

Great job sir,,,,, appreciated really

[@Drsparjan]

There is so much technical language

[@acsauhaya]

Thank you for the great videos!

[@wildernesswarcry4882]

Very helpful. Thank you

[@mynameismarsss]

great video. This helps me a lot

[@DoctorAmritPandey]

Beautifully explained ❤

[@jodymbuilu]

informative Thank you Doc.

[@fredastaire6156]

this is such good information!

[@alnaturalle]

great video and instructions

[@conrad12able]

Very helpful, thank you.

[@abdulazeez.98]

Thanks for these great videos !

[@surajutmani367]

Excellent video sir!

[@strongmedicose7288]

Amazing

[@niranjangunjan4289]

thank u sir!

[@drjai1655]

great video

[@eb3tle]

Thanks Sir

[@doctoribra86]

thanks dr eric

[@nailahusnul7889]

Thank you

[@mathesondaniel]

bril

[@R0V3Rvids]

Good job

[@venkybly]

Tq

[@alex90811]

gut

[@canwetalklips_3570]

This one was a little confusing to me. I'll have to watch again. Thanks