I am not ashamed to admit that my memory is imperfect. Because the practice of chest radiography encompasses the entire breadth of medical knowledge it is very difficult to consider all the possibilities for the different patterns of chest radiography. That's why I make liberal use of mnemonics (which I call "pneumonics";). Here are a couple which you should find useful.
Interstitial Lung Disease (top)
As a resident, I memorized a list based on tunafish. Unfortunately, this was difficult to remember because it had nothing to do with interstitial lung disease. As you know there are several hundred diseases that cause interstitial lung disease. With such a plenitude of choices, one would think that a resident at a teaching conference could at least remember a few but, unfortunately, this is not the case. There must be a Murphy's law-with more choices available-fewer can be remembered. The look on a first year resident's face as they struggle with a differential for interstitial lung disease was the inspiration for this pneumonic. Notice, as with any good pneumonic, either the most important or more common diseases appear at the top of the list. Even though the list is not very long, it encompasses 80-90% of interstitial lung disease seen in clinical practice.
- Sarcoid
- Histiocytosis X
- Idiopathic Pulmonary Fibrosis
- Tumor (Lymphangitic)
- Failure
- Asbestosis (and other dusts)
- Collagen Vascular Disease
- Environmental dusts (organic - farmer's lung, inorganic - silica, coal)
- Drug
ABC's of Trauma (top)
The chest radiograph is an economical and sensitive screening examination for the major injuries in the patient who has sustained blunt chest trauma. Just as the physician uses the ABC's to stabilize the critical ill patient (Airway, Breathing, Circulation), the radiologic ABC's prompt the radiologist to consider all of the critical injuries that may be sustained with blunt trauma. THE most critical injury is considered first.
- Aortic Transection
- Bronchial fracture
- Cord injury (Thoracic spine)
- Diaphragmatic rupture
- Esophageal tear
- Flail chest
- Gas (subtle pneumothorax)
- Heart (Cardiac injury)
- Iatrogenic (Misplaced monitoring & support catheters)
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- PEARL: Causes of Unilateral Lung Disease (top)
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- Pneumonia
- Edema
- Aspiration
- Radiation
- Lymphangtic Tumor
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- FAT PAD: Cardiophrenic angle mass (top)
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- Fat
- Pericardial cyst
- Adenopathy/Aneurysm
- Diaphragmatic Hernia
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- BIG HIPS: Honeycomb Lung (top)
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- Bleomycin
- Idiopathic
- Granulomas
- Histiocytosis X
- Interstitial pneumonia
- Pneumoconiosis
- Sarcoid
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- Late Night Sex: Interstitial lung disease & Hyperinflation (top)
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- Lymphangiomyomatosis
- Neurofibromatosis
- Sarcoid
- Emphysema
- X, histiocytosis
- Balls: Nodules with Air Bronchograms (courtesy G. Pearson) (top)
- BAC
- Amyloid
- Lymphoma
- Lipoid pneumonia
- Sarcoid
- Balls: Chronic Airspace Disease (top)
- Bronchoalveolar carcinoma
- BOOP
- Aspiration
- Alveolar proteinosis
- Lipoid pneumonia
- Loeffler's (chronic eosinophilic pneumonia)
- Lymphoma
- Pseudolymphoma
- Sarcoid (alveolar)
Set Carp: Apical Lung Disease (courtesy of Paul Stark) (top)
- Sarcoid
- EG, Eosinophilic pneumonia
- Tuberculosis
- Cystic Fibrosis
- Ankylosing spondylitis
- Radiation therapy
- PCP (cystic)
- Pneumoconiosis
Bad Rash: Basilar Lung Disease (courtesy of Paul Stark) (top)
- Bronchiectasis, BOOP
- Aspiration
- Drugs
- Rheumatoid
- Asbestosis
- Scleroderma
- Hamman-Rich
YES CT: Germ Cell Tumors (courtesy of Paul Stark) (top)
- Yolk Sac Tumors
- Embryonal cell carcinoma
- Seminoma
- Choriocarcinoma
- Teratoma
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Systemic Pulmonary Artery Shunts (courtesy of Paul Stark) (top)
- Good Glenn ( SVC to RPA )
- Flow Fontan ( RA to RV )
- Really Rastelli ( RV to RPA )
- Would Waterston-Cooley ( RPA to AA )
- Be Blalock-Taussig ( RPA to subclavian )
- Perfect Potts ( LPA to DA )
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Contrast Enhancing Mediastinal Mass
- Capt/Capt
- Castleman
- Aneurysm
- Paraganglioma
- Thryoid
- Carcinoid
- Aneurysm (so important needs to be mentioned twice)
- Parathyroid
- Tuberculosis
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- O Captian! My Captian
- O Captain! my Captian! our fearful trip is done;
- The ship has weather'd every rack, the prize we sought is won;
- The port is near; the bells I hear; the people all exulting,
- While follow eyes the steady keel, the vessel grim and daring, Walt Whitman
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Multiple thin-walled cavities
- Pitch
- Pneumatocele + bullae
- Infections (Tb, cocci)
- Tumors (Squamous cell)
- Cysts (bronchogenic, trauma)
- Hydrocarbon ingestion
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Solitary Lung Mass
- CASH PLEASE (if you miss it!)
- Cancer
- Abscess
- Solitary met
- Hamartoma
- Psuedotumor
- Lymphoma
- Echinococcus
- Actinomycosis
- Sequestration
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Calcifying Metastases
- BOTTOM
- Breast
- Osteogenic carcinoma
- Thyroid (papillary)
- Ovarian
- Mucinous adenocarcinoma
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Multiple Pleural Masses
- MALLETS
- Mesothelioma
- Adenocarcinoma
- Lymphoma
- Leukemia
- Empyema
- Thymoma
- Splenosis
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Cavity
- Cancer
- Autoimmune (Wegeners, RA)
- Vascular (septic emboli)
- Infectious (Tb, Abscess)
- Trauma
- Young (bronchogenic cyst, laryngotracheal papillomatosis)
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