Chest X-ray Interpretation

What is a chest X-ray?

A chest X-ray is  exposing the chest briefly to radiation to produce an image of the chest and the organs in the chest. An X-ray film is positioned against the body opposite the camera,and there is two view anterior-posterior and lateral view. which sends out a small dose of a radiation beam. As the radiation penetrates the chest wall, it is absorbed in varying amounts by different body tissues depending on the tissue's composition of air, water, blood, bone, or muscle. Bones, for example, absorb much of the X-ray radiation while lung tissue (which is filled with mostly air) absorbs very little, allowing most of the X-ray beam to pass through the lung.
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Systematic Review:

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General

1. See XRay Interpretation
2. Compare findings from side to side

Alignment

1. Note if patient is lordotic or kyphotic
2. Note patient rotation
   1. Spinous processes midway between clavicle heads

Specific points of exam

1. Lines and Tubes
2. Bones
3. Soft tissues
4. Pleural spaces
5. Mediastinum
6. Cardiovascular structures
7. Lung parenchyma
8. Infradiaphragmatic areas

Standard Checks

1. Hilum is higher on the left
2. Hemidiaphragm is lower on the left
   1. May be variable in older patients
3. Right hemidiaphragm sharply outlined
4. Left hemidiaphragm sharply outlined lateral to apex
5. Localize any lesion on both lateral and AP
6. Endotracheal Tube should be above carina
   1. Usually overlies 5-6th vertebrae
7. Trace intravenous lines along entire course
8. Trace Nasogastric Tubes along entire course

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Posted in: Medical,Radiology