Doctor Ammad

The comparison of PA vs AP chest X-ray

🧠 One-line memory

PA = standing, true heart size.
AP = supine, heart looks bigger & diaphragm higher.


🫁 Chest X-ray Views

📸 PA View (Postero-Anterior)
• Patient is standing / erect
• Scapulae outside lung fields
• Clavicles over lung fields
• Ribs seen from posterior ends
• Hands placed on hips
• Heart size looks normal (minimal magnification)
• Cardiothoracic ratio is accurate
• Diaphragm is low
• Gastric air–fluid level is visible
• Taken in deep inspiration
• Lungs fully expanded
• Lung markings normal (lower zones more visible)
• Lung volume looks normal

📸 AP View (Antero-Posterior)
• Patient is lying supine
• Scapulae overlie lungs
• Clavicles project above lung apices
• Ribs seen from anterior ends
• Hands by the sides
• Heart appears enlarged (magnified)
• Cardiothoracic ratio is falsely increased
• Diaphragm is high
• No gastric air–fluid level (only gas)
• Often taken in mid-inspiration or expiration
• Lung expansion is reduced
• Lung markings look crowded, upper zones prominent
• Lung volume appears reduced
ammad

Placenta previa is a pregnancy complication where the placenta covers part or all of the cervix (uterus opening), typically causing painless, bright red vaginal bleeding after 20 weeks. Risk factors include prior C-sections, uterine surgery, multiple pregnancies, older age, and smoking. It's managed with monitoring, rest, and often requires a C-section for delivery to prevent severe maternal bleeding, though it can sometimes resolve as the uterus grows.

ammad

https://whatsapp.com/channel/0029Vb6kTaH1dAvyEP9dt13z

Septic Arthritis Vs Reactive Arthritis

🦠 Septic Arthritis

Mnemonic: “SEPSIS”

☑ S – Sudden onset severe joint pain
☑ E – Extremely painful passive movement
☑ P – Purulent synovial fluid (WBC > 50,000)
☑ S – Systemic signs: high fever, chills
☑ I – Infectious organism present (Staph aureus most common)
☑ S – Single joint (knee, hip)

Key Points
• Usually monoarticular
• Patient looks toxic
• Joint is hot, red, swollen
• Emergency! Can destroy joint in hours

Management
✔ Immediate joint aspiration
✔ IV antibiotics
✔ Surgical drainage if needed

⸻

🔄 Reactive Arthritis

Mnemonic: “CAN’T SEE”

☑ C – Conjunctivitis
☑ A – Asymmetric arthritis (knees, ankles)
☑ N – No organism in joint fluid
☑ T – Triggered after infection (GI or GU)
☑ S – Sexually transmitted / diarrhea history
☑ E – Enthesitis (heel pain)
☑ E – Extra-articular signs (mouth ulcers, rash)

Key Points
• Occurs 1–4 weeks after infection
• Joint fluid is sterile
• Often young adults
• Classic triad:
Arthritis + Conjunctivitis + Urethritis

Management
✔ NSAIDs
✔ Treat original infection
✔ Steroids if severe