PREFACE
Despite the continuing development and increasing sophistication of computed tomography (CT) and magnetic resonance imaging (MRI), the chest x-ray (CXR) is still the most frequently requested radiology investigation in a general hospital. Swiftly, inexpensively, and with a high degree of accuracy the CXR enables the physician to detect or rule out numerous disorders, diseases and abnormalities. It will also help to exclude several serious therapeutic complications. A normal CXR will time and again provide valuable clinical reassurance. The CXR remains the most appropriate examination in many circumstances — it is a bedrock imaging test.
Yet there is an important caveat. Accurate CXR interpretation requires a sound understanding of basic principles. The increasing reliance on CT and MRI has caused these essential competencies to become neglected. They are in danger of being lost altogether. The aim of this book is to assist in reversing this trend, by providing a convenient and informative white coat pocket guide to complement the numerous excellent bench reference volumes.
The structure of this book derives from the Radiology Red Dot teaching course “The CXR: A Survival Course” (www.radiology-courses.com), and from the regular questions and concerns of its participants. Part A concentrates on the core knowledge — describing normal and abnormal thoracic anatomy, CXR appearances occuring with several common conditions, and also CXR findings in the intensive care and neonatal intensive care units. Part B focuses on specific clinical problems — including those CXR appearances about which our students most frequently seek guidance.
The English author C.C. Colton identified three difficulties in authorship: to write anything worth publishing, to find honest people to publish it, and to get sensible people to read it. In attending to these we added our own fourth requirement…to find an outstanding medical illustrator. Explanatory drawings were always crucial to achieving our main goal — to describe and explain how assessment of the CXR depends upon an informed and organised analytical approach. Happily, we found that exceptional illustrator, Philip Wilson.
Finally, a couple of quick notes about our use of language. We use the word “physician” to include all medical doctors (rather than just those covered by the parochial British usage of the word). Our choice of pronoun (he or she) occurs randomly and arbitrarily throughout the book.
Whether you are a senior doctor, a doctor in training, or a medical student learning the fundamental and important aspects of our craft, we hope that you will have as much enjoyment reading and using this book as we had creating it.