Hi, Tough one Dr. Zaid ..

There is some Calcified Small Nodules at the Lower Right Zone near the Right Hilum ( large white arrows ), which could be an Old Calcified Tuberculosis ..

& at the Upper Right Lobe, if we concentrate on the 1st Rib, as there is a Missing Part before it attaches to the Sternum ( small white arrows ) ..
Really I do not know what it is; but this is my description of the abnormality ..


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Ahmed A. Al-Jubouri

In fact Dr.Ahmed you kept amazing me with your detailed answers
but there is one thing to add to what you said... It is left cervical rib

I want to ask you to wait for at least 3 replies or a whole day before answering coz when you answer, it would be final most of the time ... Give them a chance Dr.Ahmed

Sure coz it is dr. Adnan Al Juboury answers..loooooool

Dear Loay,
It was my own answer, & I don't need my father to help me in discover the abnormality of any CXR ..

1st, here in Sulaimania University & in the 5th year we took Radiology as subject alone ( about 45 lectures ), & I was the only writer for this subject lectures ..
2nd, we took about 3 weeks in Clinical Radiology & it was very good & nice sessions that we have learned alot from them ..
3rd, I am really interristed in Radiology ..

& by the way, my father is abroad right now ..

peace

----------------------
Ahmed A. Al-Jubouri

Hi ..
What about this CXR ?


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Ahmed A. Al-Jubouri

First I gotta say 3ASHAT EEDKUM 3ALA HATHA EL TOPIC
It's wonderful!

Now, for this x-ray
I am between Lymphoma and Marfan's Syndrome.

I'm with Marfan's Syndrome because:
-Widening of mediastinum
-Small cardiac shadow

and with Lymphoma because:
-Widening of mediastinum
-Plethora of both lungs

I'd go with Lymphoma

I'm afraid that i don't have definite diagnosis
but i like to share with you and discuss (hope you don't mind)

i can see that the aortic knukle is prominant . im not quite happy about the cardiac shadow either cause it appears abnormal to me

on the other hand there is abnormal haziness in both lung fields mainly in the hilar region and it fans out to involove the middle zone of both lungs.

i think it is an abnormality which is causing left side heart failure which resulted in pulmonary edema.


enlighten us


Farah Baha

Thanx for your replies ..
The correct answer is as follow :

Both lungs are Hyper-Inflated coz we can see more than 7-8 ribs, & the Diaphragm is pushed downward ( wide white arrows ), & also there is some areas in the lungs have no air-bronchogram ( i.e : pulmonary vessels ) ( thin white arrows ) ..

So, the Dx goes with Hyper-Inflated Lungs with Mutiple Emphysematous Bullae ..

I hope this will enlight U about this CXR ..
Salam ..


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Ahmed A. Al-Jubouri

thanks for the explanation Ahmed, i didn't know what's wrong with this one, i was waiting for u to tell the answer

keep up the good work

Too far I was!

Yella waiting for more... 3ashat eedkum

I really had no clue about it

Now what about this one?

HMMM MAY BE INTERSTETIAL LUNG DISEACE.
I AM NOT SURE

ALI

Hi

Miliary TB or Fibrosing Alveolitis.....I'm not sure

waiting for the correct answer

Hi ..
I think this CXR mostly goes with " Post-Primary Tuberculosis " ..
& I say this coz, the apices of the lungs are more affected ( black circles ) & it is more in the left side & if we concentrate on the trachea it is pulled to the left side ( black arrows ) due to fibrosis caused by pulmonary tuberculosis ..

& also there is some broncheactatic changes mostly on the left side ring shape (white & black arrows ) ..

& surely, both of the lungs are hyperinflated due to emphysematous changes because we can see more than 7-8 ribs & the diaphragm is pushed downward ..

I hope this is enough ..

Salam ..

Quite true Ahmed A. and Ahmed K. you were almost right