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What to look for in the apparently normal radiograph

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

If the chest radiograph appears normal then the following should be checked for:

  • a mastectomy
  • a small apical pneumothorax
  • a fluid level below the heart, due to a hiatus hernia
  • collapse of the right middle lobe and loss of clarity of the right heart border
  • absence of the outline of the left diaphragm behind the heart (sail sign) as a result of left lower lobe collapse
  • deviation of the trachea
  • paratracheal lymphadenopathy
  • air beneath the diaphragm
  • dextrocardia with the film reversed
  • always check the apices, hila, behind the heart and the costophrenic angles

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