Learning objectives
To propose a radiological diagnostic approach from chestradiograph through the epidemiology of the mediastinum landmarks.
To explain differential diagnosis for mediastinal masses according its prevalence by age and mediastinal localization.
To review the most frequent findings of mediastinal disease on plain chest radiograph.
Background
Chest X-ray is a test that is frequently requested.
To identify mediastinal disorders is a priority in the semiotic approach.
Mediastinal silhouettes disturbance allow tosuspect a disease when an altered morphology and composition is presented.
Each of the detected alterations are correlated with characteristics of mediastinal spaces lesions.
When one considers the semiotics of mediastinal lesions,
their location in the anterior ,
medium or posterior compartment and the 3 most common diseases,
the possibility of an etiologic diagnosis increases(1).
To identify mediastinal lesions is essential...
Findings and procedure details
IDENTIFY MEDIASTINAL MASSES
The first step in addressing mediastinal masses is suspect their mediastinal origin.
Radiographic features of a lesion of mediastinal origin are: The intimate effect of the mass with mediastinal structures,
smooth and sharp margins and obtuse angles between the mass and lung (1) (6)
Signs of the intimate effect of mediastinal structures are the change in the anatomy and movement of mediastinal structures adjacent to the injury,
displacement of the trachea,
main brochus or displacement of the heart.
Compartments and mediastinal anatomy...
Conclusion
Anatomical references are useful in identifying mediastinal lesions,
however,
to date,
these references do not achieve enough sensitivity to point to the location of a disease within the mediastinal compartments.
An epidemiologic approach increases the accuracy of the diagnosis.
There are much more sensitive signs of mediastinal disease like mediastinal widening,
presence of lymphadenopathy or pleural effusion.
Personal information
Salinas,Emmanuel,
MD .
Hospital Santa Fé De Bogotá,
El Bosque University,
Bogotá.Colombia; email:
[email protected]
Cifuentes,
Karen,
MD .
Hospital Santa Fé De Bogotá,
El Bosque University,
Bogotá.Colombia; email:
[email protected]
Sossa,
Didier,
MD .
Hospital Santa Fé De Bogotá,
El Bosque University,
Bogotá.Colombia; email:
[email protected]
Pinzon,Bibiana,
MD .
Hospital Santa Fé De Bogotá,
El Bosque University,
Bogotá.Colombia; email:
[email protected]
References
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Gibbs JM,
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Oldham SAA.
Lines and Stripes: Where Did They Go? —From Conventional Radiography to CT.
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Digital chest imaging: radiography versus selenium storage phosphor imaging.
Comparison of visualization of specific anatomic regions of the...