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DIAGNOSTIC RADIOGRAPHY · NTA LEVEL 4 · SEMESTER TWO Normal Chest X Ray CRT04211 · Image Pattern Recognition START READING NOTES Study Normal Chest X Ray using the sections below. Use the topic navigation to continue through Image Pattern Recognition. NORMAL CHEST X RAY NORMAL CHEST X RAY…… Visible structures on chest x ray which should be assessed for abnormalities are:- Aortic notch Ribs Breast shadow Scapular Soft tissue Trachea Hilum Lung field Diaphragm Heart Normal mediastinum…. Trachea Centered along the spine but slightly right at the level of aortic notch. trachea Normal mediastinum…. the heart borders should be clearly visible, the right border should be seen to the right of the spine. cardio-thoracic ratio should not be greater than 50%. Normal lungs and lung markings Pulmonary vessels and fissures appear as lines markings or shadow across the lung fields Bronchi are normally only visible near the hilae bronchus should only be 1mm or less in thickness. In the erect film lower zone vessels are larger than those in the upper lobe. In the supine chest X-ray, upper lobe vessels are the same size as the lower lobe vessels. ← PREVIOUS TOPICVIEW ALL MODULE NOTESVIEW SEMESTER NOTESVIEW ALL LEVEL NOTESALL DIAGNOSTIC RADIOLOGY NOTES Need These Notes as PDF? Need a clean, well-formatted PDF copy for offline study, revision or printing? Request the complete notes directly through WhatsApp. GET WELL-FORMATTED PDF NOTES

DIAGNOSTIC RADIOGRAPHY · NTA LEVEL 4 · SEMESTER TWO Abnormal Chest X-ray CRT04211 · Image Pattern Recognition START READING NOTES Study Abnormal Chest X-ray using the sections below. Use the topic navigation to continue through Image Pattern Recognition. Contents of This Topic Congenital Disorders Abnormal Chest X-ray Acquired Disorders Traumatic Disorders Degenerative Disorders Aortic aneurysm (thoracic): Widened mediastinal silhouette, abnormal aortic contour(enlargement of aortic knob). Introduction to Abnormal findings in chest radiographs Congenital Disorders These are abnormalities present at birth due to genetic or developmental causes and can cause structural or functional defects. Abnormal Findings ; Congenital diaphragmatic hernia: Herniation of abdominal contents into the thoracic cavity which can be presented with Air-filled bowel loops in the thoracic cavity and mediastinal shift. Congenital heart disease (e.g., Tetralogy of Fallot): presents with boot-shaped heart and can cause increased or decreased pulmonary vascular markings. Congenital diaphragmatic hernia Tetralogy of Fallot(heart disease) Abnormal Chest X-ray Bronchopulmonary Sequestration: Non-functioning lung tissue with abnormal blood supply in chest x-ray present with Mass-like opacity with systemic arterial supply (may not be obvious on plain X-ray). Bronchogenic cysts: Well-defined, round mediastinal or intrapulmonary mass. Eventration of diaphragm: Smooth, elevated hemidiaphragm without signs of trauma or infection. Pulmonary Agenesis: Complete absence of lung tissue, leading to mediastinal shift. Bronchogenic cysts Eventration of diaphragm Pulmonary Agenesis Acquired Disorders These develop later in life (after birth) due to various factors such as infections, tumors, or systemic diseases. Abnormal Findings: Pneumonia: Infection leading to Localized consolidation, opacities and air bronchograms. Tuberculosis: Upper lobe opacities, cavitations, calcified granulomas, fibrosis. Pleural effusion: Accumulation of fluid in the pleural spaces in chest x-ray will present with Blunting of costophrenic angles, meniscus sign, homogeneous opacity. Cavitation: Calcified granulomas: Fibrosis: Pneumonia Tuberculosis Pleural effusion Abnormal Chest X-ray Pulmonary edema (e.g., in CHF): Fluid accumulation in the lung causing Bilateral perihilar infiltrates ("bat-wing" appearance), Kerley B lines, cardiomegaly. Interstitial lung disease: Presents with Reticulonodular patterns, and honeycombing. Sarcoidosis: Bilateral hilar lymphadenopathy, interstitial infiltrates. Lung cancer: Mass lesion with irregular borders and possible hilar enlargement, and possible collapse or consolidation Pulmonary edema Interstitial lung disease Sarcoidosis Traumatic Disorders Result from direct physical injury to the chest wall or internal thoracic structures. Abnormal Findings: Rib fractures: Discontinuity in rib cortex, soft tissue swelling. Note rib fracture can potentially leading to pneumothorax. Pneumothorax: Abnormal air in the pleural space causing lung collapse presents with Visible pleural line with absent lung markings peripheral to it. Rib fractures Pneumothorax Abnormal Chest X-ray Hemothorax: Blood accumulation in the pleural cavity in chest x-ray will present with Fluid level or opaque hemithorax (depending on volume). Pulmonary contusion: Also known as lung contusion Patchy opacities, often localized to site of trauma. Flail chest: Paradoxical chest wall motion (clinical), multiple adjacent rib fractures on X-ray. Diaphragmatic rupture: Elevated hemidiaphragm, bowel loops in thorax. Hemothorax Diaphragmatic rupture Degenerative Disorders These are chronic conditions, usually progressing with age or chronic stress on the lungs. Abnormal Findings: Chronic Obstructive Pulmonary Disease (COPD): Emphysema and chronic bronchitis leading to Hyperinflated lungs, flattened diaphragms, increased retrosternal airspace. Pulmonary fibrosis: Scarring of lung tissue causing Reticular or reticulonodular pattern, volume loss, honeycombing. Aortic aneurysm (thoracic): Widened mediastinal silhouette, abnormal aortic contour(enlargement of aortic knob). Degenerative spinal changes (visible on chest X-ray): Osteophytes, vertebral body sclerosis, kyphosis affecting lung expansion. Silicosis: Interstitial lung disease due to inhalation of silica dust ← PREVIOUS TOPICNEXT TOPIC →VIEW ALL MODULE NOTESVIEW SEMESTER NOTESVIEW ALL LEVEL NOTESALL DIAGNOSTIC RADIOLOGY NOTES Need These Notes as PDF? Need a clean, well-formatted PDF copy for offline study, revision or printing? Request the complete notes directly through WhatsApp. GET WELL-FORMATTED PDF NOTES

DIAGNOSTIC RADIOGRAPHY · NTA LEVEL 4 · SEMESTER TWO Dental And Breast Pattern CRT04211 · Image Pattern Recognition START READING NOTES Study Dental And Breast Pattern using the sections below. Use the topic navigation to continue through Image Pattern Recognition. Contents of This Topic Dental And Breast Pattern Learning objectives BREAST ANATOMICAL STRUCTURES Key Anatomical Structures: Areola: The circular area of pigmented skin surrounding the nipple. Muscle: Relations Arterial supply Venous drainage INDICATIONS FOR BREAST (MAMMOGRAPHY) RADIOGRAPHY Follow-up of previous breast surgery or biopsy Mammography (Breast X-Ray) Preparation Clothing Choice: Wear a two-piece outfit so you only need to remove your top during the exam. TOOTH TYPES Dental Anatomical Structures Enamel Gingiva (Gums) Cementum Dental radiography indications include Trauma to teeth or jaws Dental Radiography (Dental X-Ray) Preparation NORMAL DENTAL RADIOGRAPHIC FINDINGS Terminologies Tooth Structures Enamel: Highly mineralized outer layer; appears as the most radiopaque (white) outer layer, indicating a healthy tooth Periodontal Structures Maxillary Anatomical Landmarks Normal anatomical landmarks of the maxilla and surrounding structures. Mandibular Anatomical Landmarks Normal anatomical landmarks of the mandible and surrounding structures. Cancellous and Cortical Bone ABNORMAL DENTAL RADIOGRAPHIC FINDINGS Dental Caries (Tooth Decay) Radiographic findings of dental caries Occlusal Caries (Chewing Surface) In summary, Radiographic Detection of Dental Caries Dental Trauma Radiographic findings of dental trauma Alveolar Bone Fractures Summarized Radiographic Signs of dental trauma Clinical Correlation – Trauma Neoplasms Ameloblastomas Radiographic Findings of ameloblastoma Odontomas Radiographic findings of odontomas: Non-Odontogenic & Malignant Neoplasms Clinical Correlation – Neoplasms Oral Cancer Radiographic findings/features Dental Cysts Radiographic findings of a dental cyst Expansion and Thinning of Cortical Bone Salivary Duct Calcifications (Sialoliths) Radiographic Findings of Sialothis Clinical History of Sialothis: Differential – Soft Tissue Calcifications Clinical Correlation – Sialolithiasis NOTE: Periodontal Disease Category DENTAL AND BREAST RADIOGRAPHY Apply image pattern recognition steps in identifying abnormalities in dental radiographs Dental And Breast Pattern Radiographic imaging plays a vital role in the early detection, diagnosis, and monitoring of diseases affecting both the oral cavity and the breast. Dental radiographs are essential for identifying pathologies such as dental caries, periodontal disease, cysts, and jaw fractures, while breast radiographs (mammograms) are crucial for the detection of abnormalities like breast masses, calcifications, and early signs of breast cancer. Learning objectives Describe breast and dental anatomical structures Outline indications for breast and dental radiography Explain preparation procedures for breast and dental radiography Describe normal dental radiographic findings Describe abnormal dental radiographic findings (dental carries, trauma, neoplasm, salivary ducts calcifications) Correlate patient clinical history with findings of dental radiography BREAST ANATOMICAL STRUCTURES The breast is a glandular organ located on the anterior chest wall. The breast is an apocrine gland found in both males and females. However, in females, it has a specific function – the production of milk for neonatal nutrition and immune function. The breast has an inhomogeneous structure that is predominantly composed of adipose tissue and glandular tissue. In addition, there are also suspensory Cooper's ligaments and connective tissue such as collagen and elastin. An apocrine gland is a type of exocrine gland that releases its secretions by "decapitation," where part of the cell membrane pinches off along with the secreted product Dental And Breast Pattern The adult breast has nearly 14-18 lactiferous lobes. Each lobe is made up of several lobules, and each lobule is made up of several acini. Each acinus drains into a branching duct that converges into a single lactiferous duct in each lobe, which subsequently drains at the nipple-areola complex. The breast parenchyma comprises glandular structures, namely acini and ductal tissue. Meanwhile, the breast stroma consists of fat and fibrous tissue. Dental And Breast Pattern The glandular parenchyma is estrogen-dependent. During adolescence, the growing breast becomes increasingly glandular. During pregnancy and lactation, the number of acini increases. When lactation stops, the gland becomes even less glandular when compared to before pregnancy. Thus, the breast of a parous woman is less glandular when compared to a nulliparous woman of the same age. Breast parenchyma starts to atrophy in adulthood and accelerated in menopause with an increasing amount of fat. Key Anatomical Structures: Lobes: Each breast contains 14-20 lobes, arranged like the petals of a daisy. These lobes are the major milk-producing glands. Lobules: Smaller sacs within the lobes, these are where milk is produced. Ducts: Tubes that carry milk from the lobules to the nipple. Nipple: The central projection of the breast, containing muscle fibres that allow it to become erect. The nipple is the small, raised part at the centre of the breast. It has 10–20 tiny openings for milk ducts, allowing milk to exit during breastfeeding. It contains smooth muscle, which makes it erect when stimulated. Areola: The circular area of pigmented skin surrounding the nipple. or The areola is the circular, darker skin surrounding the nipple. It contains small glands (Montgomery’s glands) that keep the area moist and protected. The areola helps guide the baby to the nipple during breastfeeding. Ligaments: Connective tissue bands that support the breast and attach it to the chest wall. Fatty and Connective Tissue: Surrounds and fills the spaces between the lobes and ducts, providing structure and volume to the breast. Blood Vessels: Supply the breast with oxygen and nutrients, as well as remove waste products. Adipose Tissue Fat that surrounds and cushions the breast. Connective Tissue Provides structure and support to the glandular tissue Nerve Supply The nipple is richly supplied with nerves, making it sensitive to touch. Muscle: There are no muscles within the breast tissue itself, but muscles like the pectoralis major and pectoralis minor lie underneath the breast. Lymphatic Drainage: Lymph vessels from the breast tissue drain into lymph nodes, primarily in the axillary (armpit) region, but also in the parasternal (along the breastbone) and supraclavicular (above the collarbone) areas. The lymphatic drainage is significant for clinical reasons, particularly in cancer metastasis. Lymph fluid drains into axillary nodes (75%), parasternal nodes (20%), and posterior intercostal nodes (5%). This drainage system plays a critical role in immune response and cancer spread. Nerve Supply:

DIAGNOSTIC RADIOGRAPHY · NTA LEVEL 4 · SEMESTER TWO Documenting Radiological Reports CRT04211 · Image Pattern Recognition START READING NOTES Study Documenting Radiological Reports using the sections below. Use the topic navigation to continue through Image Pattern Recognition. Contents of This Topic Introduction Report Components Clinical History / Indication Imaging Technique Description of Findings Conclusion / Impression Suggestions (Recommendations) Name, Signature & Date Summary Sample Skeleton of a Chest X‑Ray Report: Impression: Communicate Findings Documenting Radiological Reports Apply image pattern recognition steps in documenting radiological image Introduction Applying Image‑Pattern Recognition in Radiology Reporting Objective: Enhance speed, consistency, and clarity by structuring reports around standard components: clinical history, technique, findings, conclusions, recommendations, and sign-off, while leveraging AI-powered pattern recognition for image interpretation. Report Components Clinical History / Indication Techniques used Description of findings Conclusion / Impression Suggestions / Recommendations Name , Signature & Date Clinical History / Indication A concise summary of why the exam was performed, symptoms, medical background, suspected diagnosis. Patient demographics: age, sex, hospital ID Chief complaint / symptoms: e.g., "Shortness of breath for 3 days" Relevant medical background: e.g., "History of COPD, recent fever, elevated WBC count" Image pattern recognition is used to flag anatomy regions or pathology based on history (e.g., lung zones in dyspnea) Missing history should be noted. Imaging Technique Modality and views performed (e.g., PA & lateral chest X‑ray) Technical parameters and equipment used Contrast type/dose if relevant Quality remarks (e.g., limited inspiration, motion artifact) Comparison Mention review of prior relevant studies, with dates If none exist, note absence of prior imaging Description of Findings Systematic, structured description using recognized imaging patterns (e.g., ground-glass opacities, consolidation). Pattern‑based observations: Normal structures: bronchi, vessels Abnormal findings: For example, “Patchy ground‑glass opacities in bilateral lower lobes” “Tree‑in‑bud nodularity in right middle lobe” Negative observations: e.g., "no pleural effusion or lymphadenopathy Use of standard descriptors: size, distribution, location, density Pattern‐ recognition helps identify and classify lung findings (e.g., consolidation vs. interstitial) Findings (Description of Findings) Systematic, organ‑based breakdown (e.g., bones, lungs, mediastinum) Use precise language—dimensions, densities, margins Describe both abnormalities and relevant negatives Identify any incidental findings Reference previous exams for comparison Conclusion / Impression Concise synthesis interpreting image patterns with reference to history, providing diagnoses or differential. Summarize key findings: Example: “Findings of bilateral peripheral GGOs are highly suggestive of viral pneumonia (e.g., COVID‑19); consider differential of organizing pneumonia.”(differential dx) Most critical section, directs clinical action and decision-making Pattern matches guide diagnostic confidence and differential. Impression / Conclusion Brief summary of the most significant findings Provide a definitive diagnosis or ranked differential Directly address the clinical question Include incidental findings of importance Suggestions (Recommendations) Advice for next steps, follow-up imaging, clinical correlation, further testing. Further imaging: e.g. “Recommend high‑resolution CT in 4–6 weeks for follow‑up.” Clinical correlation: “Correlate with COVID‑19 PCR and inflammatory markers.” Management advice: “Consider antibiotics if bacterial infection cannot be excluded.” Suggest targeted follow‑up driven by pattern severity and distribution. Improves patient care and minimizes unnecessary procedures Suggestions / Recommendations Advise further imaging, referral, or follow-up timing if needed Ensure recommendations align with clinical benefit and avoid unnecessary testing Name, Signature & Date Essential details: Name and credentials: Miss, Gloria Nathaniel, BScMIR (Radiology scientist) Signature: Typed or digital signature Date of report/interpretation: June 23, 2025 Contact info (if applicable): “For questions, call Radiology Dept at XXX‑XXXX.” Ensures legal integrity, accountability, and follow-up availability. Summary Structured reports ensure clarity and consistency. Pattern recognition assists with discovery and description. Radiologist/radiology scientist judgment remains essential for final interpretation and management guidance. Balanced synergy enables efficient, accurate, and clinically valuable reporting. Sample Skeleton of a Chest X‑Ray Report: Patient: Jane Doe • DOB: 01-Jan-1970 • ID: 123456 Date/Time: 22-Jun-2025, 10:15 • Facility: Mwanza Regional Hospital Clinical History: 55 y/o female with acute chest pain and shortness of breath; possible pneumonia vs. pulmonary edema. Technique: PA and lateral chest X‑rays obtained; no contrast. Comparison: No prior imaging available. Findings: Bones/Soft Tissue: No rib fractures. Clavicles symmetrical. Lungs & Pleura: Patchy consolidation in the right lower lobe with air bronchograms; no pleural effusion or pneumothorax. Mediastinum/Heart: Heart size within normal limits; mediastinal contours normal. Impression: Right lower lobe consolidation suggestive of pneumonia. No evidence of pleural effusion, pneumothorax, or bone injury. Recommendations: Recommend clinical correlation and a follow-up chest X‑ray in 4–6 weeks if symptoms persist. Reported by: Dr. John Smith, Consultant Signature/Date: 22‑Jun‑2025, 11:00 Is anything missing Communicate Findings In the “Communicate Findings (hard copy, RIS/DICOM/PACS)” section of an image pattern recognition report, ensure that each described lesion or pattern is clearly linked to specific image(s) ideally annotated within PACS for visual confirmation Use a structured reporting format—such as DICOM Structured Reports (SR) or RIS-integrated templates to encode descriptions with standardized terminology and coded elements which supports semantic interoperability and efficient downstream use. Whether distributing via hard copy or electronically through RIS/PACS, maintain consistency, clarity, and metadata integrity (patient info, modality, technique) This approach ensures findings are unequivocally communicated and actionable, enhancing clinician trust, workflow efficiency, and facilitating downstream tasks like follow-up, data mining, and quantitative analysis Documenting Radiological Reports QN:”A 60‑year‑old patient presents with progressive dyspnea. The upright posteroanterior chest X‑ray above demonstrates right-sided blunting of the costophrenic angle with a concave meniscus and homogenous opacity in the lower lung zone. The left lung field is clear. Documenting Radiological Reports Using the image provided, compose a structured chest X‑ray report focused on suspected pleural effusion. Your report should include the following sections: Clinical History & Indication. Technique & Quality – Comment on image projection (PA upright), adequacy of inspiration, exposure, and positioning. Findings – Describe radiographic sign(s) of pleural effusion estimated volume, location, and any mass effect or shift. Comparison – State if previous imaging is available and, if missing, note that explicitly. Impression Recommendations THANK YOU ← PREVIOUS TOPICNEXT TOPIC →VIEW ALL MODULE NOTESVIEW SEMESTER NOTESVIEW ALL LEVEL NOTESALL DIAGNOSTIC RADIOLOGY NOTES Need These Notes as PDF? Need a clean, well-formatted PDF copy for offline study, revision or printing? Request the complete notes directly through WhatsApp.