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grepmeded's profile
GrepMed
GrepMed
GrepMed
@grepmeded

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GrepMed

@grepmeded

Image Based Medical Reference: Sharing crowd-sourced checklists, algorithms, decision aids, #PhysicalExam #POCUS, and more - by @GeraldMDMD + @k00bideh

Sacramento, CA
grepmed.com
Joined March 2018

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    1. Jacobi Internal Medicine Chiefs‏ @jmcchiefs 11 Jul 2019
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      Last Tuesday we had an amazing lecture on basic CXR interpretation by our own Dr Shim. Although going through the entire interpretation of CXR is way too long for a tweetorial, here are a couple useful tips we got... 1/n #JacobiIM #NoonConference #TipsForNewDocspic.twitter.com/0J8v6g6Fk4

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    2. Jacobi Internal Medicine Chiefs‏ @jmcchiefs 11 Jul 2019
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      First things first!. Check quality of the film, this include penetration, type of study, rotation, etc. You can rotation this by assessing the clavicle (most anterior aspect) and the spinous process (most posterior aspect). 2/n #JacobiIM #TipsForNewDocspic.twitter.com/BIEXXy8qdd

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    3. Jacobi Internal Medicine Chiefs‏ @jmcchiefs 11 Jul 2019
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      Always try to have a systematic order. Going right to the abnormality might make you miss more subtle changes. There are several ways to do it, but a good one proposed by Dr Shim is: 3/n #JacobiIM #TipsForNewDocspic.twitter.com/JqFn4j8SDK

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    4. Jacobi Internal Medicine Chiefs‏ @jmcchiefs 11 Jul 2019
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      Ok, once you check quality, we can start looking at some other aspects. In order to have appropriate inspiration, we should see at least 6 ribs anteriorly intersecting with the mid-clavicular line. Notice the nice dome shape of the diaphragm. 4/n #JacobiIM #TipsForNewDocspic.twitter.com/DnFxlewBnq

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    5. Jacobi Internal Medicine Chiefs‏ @jmcchiefs 11 Jul 2019
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      Now lets look at hyperinflation. You will see more ribs anteriorly, and more importantly, you will notice flattening of the diaphragm. This is evidence by a distance <1.5cm between the dome diaphragm and an imaginary line between the medial and lateral insertion point. 5/npic.twitter.com/cqMj8nCePM

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    6. Jacobi Internal Medicine Chiefs‏ @jmcchiefs 11 Jul 2019
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      In the lateral film, you will see evidence of diaphragm flattening as well, and increased in the retro-sternal space. If this space is >1.5 cm, it is also suggestive of hyperinflation. 6/n #JacobiIM #TipsForNewDocspic.twitter.com/maoWl1G6Ms

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    7. Jacobi Internal Medicine Chiefs‏ @jmcchiefs 11 Jul 2019
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      Lets talk about the 𝗙𝗲𝗹𝘀𝗼𝗻'𝘀 or 𝗦𝗶𝗹𝗵𝗼𝘂𝘁𝘁𝗲 𝗦𝗶𝗴𝗻. It consist of a loss of 𝗱𝗲𝗳𝗶𝗻𝗶𝘁𝗶𝗼𝗻 between 2 structures with equal densities are same plane. We can use it to identify if a density (alveolar opacity/consolidation) is at the same plane or not. 7/npic.twitter.com/QRQoTX7kcy

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      GrepMed‏ @grepmeded 14 Jul 2019
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      Replying to @jmcchiefs

      would encourage everyone to read Felsons classic CXR book where he details the silhouette sign and much more. The best, most high yield book in medicine IMO.

      11:46 AM - 14 Jul 2019
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