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Understanding chest x-ray from Gunshots to Goombas Joshua Broder, MD Emergency Medicine Duke University Medical Center Financial Disclosures None Objectives Review chest x-ray (and CT) findings of important emergency conditions Review diagnostic limitations of imaging Pearls and pitfalls of chest imaging Topics Normal Infections Masses PE Aortic dissection CHF Trauma X-ray history… Wilhelm Conrad Roentgen Discovers x-ray 1895 X-ray history… X-ray history… Roentgen’s wife’s hand 1895 Medical radiation history… Radiation International Commission on Radiological Protection (ICRP) Tricho Hair Removal System -1920s Herzig R Removing Roots: "North American Hiro shima Maidens" and the X Ray Technology and Culture, Vol 40, No 4, October 1999, pp 723-745 Rosen IB, Walfish PG Sequelae of radiation facial epilation (North American Hiroshima maiden s yndrome) Surgery 1989 Dec;106(6):946-50 PMID: 2588120 Rib fractures CASE 35 Smoke inhalatio n, chronic changes CASE 36 CASE 36 Subcutaneo us emphysema Subcutaneo us emphysema Subcutaneous emphysema Subcutaneous emphysema CASE 37 SVC syndrome CASE 37 TB Summary Review plain film and CT findings of important emergency conditions Review diagnostic limitations of imaging Pearls and Pitfalls of Chest Imaging Questions? ... Masses PE Aortic dissection CHF Trauma X- ray history… Wilhelm Conrad Roentgen Discovers x- ray 189 5 X- ray history… X- ray history… Roentgen’s wife’s hand 189 5 Medical radiation history… Radiation... Disclosures None Objectives Review chest x- ray (and CT) findings of important emergency conditions Review diagnostic limitations of imaging Pearls and pitfalls of chest imaging Topics ... the X Ray Technology and Culture, Vol 40, No 4, October 1999, pp 723-745 Rosen IB, Walfish PG Sequelae of radiation facial epilation (North American Hiroshima maiden s yndrome) Surgery 1 989