Radiographic Pattern Pneumonics

Interstitial lung disease
ABC's blunt chest trauma
Unilateral lung disease
Cardiophrenic angle mass
Honeycomb lung
Interstitial lung disease & hyperinflation
Nodules with air bronchograms
Chronic airspace consolidation
Apical Lung Disease
Basilar Lung Disease
Germ Cell Tumors
Systemic Pulmonary Artery Shunts
Contrast Enhancing Mediastinal Mass
Multiple thin-walled cavities
Solitary Lung Mass
Calcifying Metastases
Multiple Pleural Masses
Cavity

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)
Drugs

 

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)

 
PEARL: Causes of Unilateral Lung Disease (top)

Pneumonia
Edema
Aspiration
Radiation
Lymphangtic Tumor

 

FAT PAD: Cardiophrenic angle mass (top)

Fat
Pericardial cyst
Adenopathy/Aneurysm
Diaphragmatic Hernia

 
BIG HIPS: Honeycomb Lung (top)

Bleomycin
Idiopathic
Granulomas
Histiocytosis X
Interstitial pneumonia
Pneumoconiosis
Sarcoid

 
Late Night Sex: Interstitial lung disease & Hyperinflation (top)

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

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 )

Contrast Enhancing Mediastinal Mass (top)

Capt/Capt
Castleman
Aneurysm
Paraganglioma
Thryoid
Carcinoid
Aneurysm (so important needs to be mentioned twice)
Parathyroid
Tuberculosis
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

Multiple thin-walled cavities (top)

Pitch
Pneumatocele + bullae
Infections (Tb, cocci)
Tumors (Squamous cell)
Cysts (bronchogenic, trauma)
Hydrocarbon ingestion

Solitary Lung Mass (top)

CASH PLEASE (if you miss it!)
Cancer
Abscess
Solitary met
Hamartoma
Psuedotumor
Lymphoma
Echinococcus
Actinomycosis
Sequestration

Calcifying Metastases (top)

BOTTOM
Breast
Osteogenic carcinoma
Thyroid (papillary)
Ovarian
Mucinous adenocarcinoma

Multiple Pleural Masses (top)

MALLETS
Mesothelioma
Adenocarcinoma
Lymphoma
Leukemia
Empyema
Thymoma
Splenosis

Cavity (top)

Cancer
Autoimmune (Wegeners, RA)
Vascular (septic emboli)
Infectious (Tb, Abscess)
Trauma
Young (bronchogenic cyst, laryngotracheal papillomatosis)