Chest X-ray
A chest radiograph should be examined in a systematic way:
- check the name and date on the film
- make an estimate of age and sex of patient if this information is not provided
- check the projection which should be posterior-anterior - PA
- the whole of the chest should be visible on the film, check for rotation and that there has been satisfactory penetration
- check chest expansion and the diaphragm - the right hemidiaphragm is 2 cm higher than the left
- check for normal lung markings - the horizontal fissure is visible in 60% of normal chest X-rays; it runs from the centre of the right hilum, laterally and horizontally, to meet the sixth rib in the mid-axilla.
The following are described in more detail in subsequent nodes:
- check the mediastinum
- assess the cardiothoracic ratio (only on the PA film)
- look at the pulmonary vessels
- lung fields
- bones
- soft tissues
Reference
- Kelly B. The chest radiograph. Ulster Med J. 2012 Sep;81(3):143–148.
Related pages
- What to look for in the apparently normal radiograph
- Cardiothoracic ratio
- Survey of lung fields, bones and soft tissues
- Survey of the mediastinum
- Survey of the heart
- Some chest x-ray abnormalities
- Some chest X-ray appearances of particular conditions
- Guidance for urgent referral for a chest X-ray
- Chest xray in community acquired pneumonia (CAP)
- X-ray (exposure to ionising radiation)
- Lung cancer (NICE guidance for urgent referral for suspected cancer)
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