Wk 1, Case 3 - Review

EXAM: Portable AP chest radiograph (X-ray)

INDICATION: Newborn female with respiratory distress.

TECHNIQUE: Single frontal AP chest radiograph obtained using portable technique.

FINDINGS:

There are diffuse, bilateral granular opacities without focal consolidation. The cardiac silhouette is unremarkable. A suction catheter courses down the midline and terminates over the upper abdomen. The distal tip of an umbilical venous catheter extends nearly to the level of the lower caval-atrial junction. There is no pneumothorax or effusion.

IMPRESSIONS:
1. Diffuse, bilateral pulmonary opacities likely secondary to retained secretions versus the effects of prematurity. No focal pneumonia.
2. Satisfactory positioning of the support lines and tubes.

EXAM: Portable AP chest radiograph (X-ray)

INDICATION: 1-month-old female with respiratory distress.

TECHNIQUE: Single frontal AP chest radiograph obtained using portable technique.

FINDINGS:

The diffuse bilateral opacities are coarsened in appearance when compared with newborn imaging. There is no focal pneumonia. The cardiac silhouette is stable and unremarkable. There is no pneumothorax or large effusion. There are linear lucencies seen on the left.

A suction catheter courses down the midline and terminates over the gastric lucency in the left upper quadrant. A lower extremity PICC terminates in the IVC, nearly to the level of the lower caval atrial junction. An endotracheal tube terminates in the thoracic trachea, above the carina.

IMPRESSIONS:

1. Increased and coarsened appearance of the bilateral opacities seen on prior imaging, likely expected evolution of premature lung disease with superimposed atelectasis.
2. Left lucencies suggestive of pulmonary interstitial emphysema, likely secondary to barotrauma.
3. Satisfactory positioning of the support lines and tubes.

EXAM: Portable AP chest radiograph (X-ray)

INDICATION: 4-month-old female with respiratory distress.

TECHNIQUE: Single frontal AP chest radiograph obtained using portable technique.

FINDINGS:

The lungs are hyperexpanded. There are coarse bilateral pulmonary opacities with patchy, basilar areas of more focal opacity.

The endotracheal tube tip terminates in the thoracic trachea, above the level of the carina. A right-sided PICC extends to the mediastinum with the tip likely located high in the SVC. The cardiac silhouette is stable and unremarkable. There is no pneumothorax or large effusion.

IMPRESSIONS:

1. Hyperexpanded lungs, with redemonstrated opacities of chronic lung disease of prematurity, with patchy superimposed basilar atelectasis.
2. Suboptimal positioning of the right PICC, with tip located high in the SVC.
3. Otherwise, satisfactory positioning of the support lines and tubes.