3) Chest X-Ray – ABCDE Approach A – Airways/Mediastinum: the Right (R) or Left (L) marker should correspond to proper anatomic orientation, e.g. Left hemidiaphragm visible to the spine and vertebrae visible behind the heartĪlterations in standardized positioning, or x-ray exposure, will alter the ‘typical’ appearance of the image and may lead to inaccurate assessment, or misdiagnosis.Įnsure laterality is correct i.e. The medial aspect of each clavicle should be equidistant from the vertebral spinous processesĥ – 6 anterior ribs, 9 – 10 ribs posteriorly in the mid-clavicular line, the lung apices, both costophrenic angles and the lateral rib edges are all visible Lateral: Figure 5.5 Positioning for a Lateral Chest x-ray 2) Assess Image Quality: Posterior-Anterior (PA): Figure 5.4 Positioning for a Posterior-Anterior Chest x-ray Table 5.1 Terminology pertinent to chest x-ray 1) Chest x-ray Image Acquisition Positioning: Process by which air in the lungs is replaced by products of disease rendering the lung more solid Whiter area on the image due to absorption of the x-rays prior to reaching the detector Terminology Pertinent to the Chest x-ray: Termĭarker area on the image as relatively more of the administered x-rays reaching the detector Remember, abnormalities on imaging are simply aberrations of anatomy.įor example, a numerical strategy can be deployed: Figure 5.3A PA Chest Radiograph Figure 5.3B Lateral Chest Radiograph 1 Repetitive viewing of images will help establish a baseline of normality and normal variation that will represent an internal yard stick for the detection of variation from normal.ĭetection of abnormality will allow you to diagnose clinical conditions that may require medical attention. With time, and repetition, the process will become subconscious. Consistency and thoroughness are good general strategies. There is no correct way to analyze the images. An approach to reviewing a chest x-ray will create a foundation that will facilitate the detection of abnormalities.
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