Medical Imaging Approach to Chest X-Rays

Diaphragm

1. Evaluate for Diaphragm
On the lateral film the costophrenic (CP) angle of each hemidiaphragm (HD) should be sharp.
Right Image: Close up of CP angle of each HD. (RD = right HD and LD = left HD)

Review Densities

Different Views

Posterior-Anterior Lateral Anterior-Posterior Lordotic Lateral Decubitus

Technical Factors

Patient ID Side Markers Rotation Penetration Degree of Inspiration

Bones & Soft Tissues

Identify PA Bone Anatomy Review Bone Anatomy Review Fractures Lesions Decreased Bone Density

Pleura & Diaphragm

Parietal & Visceral Pleura Costophrenic Sulcus Diaphragm Diaphragm - Elevation Diaphragm - Depression Diaphragm - Free Air Evaluate for Appearance Effusion - Meniscus Effusion - Blunted Angles/Thickening Effusion - Fluid Pooling Effusion Mediastinal Shift Pneumothorax - Lung/Air Contrast Pneumothorax - Sulcus Sign Pneumothorax - Mediastinal Shift

Identify Structures #1 Identify Structures #2 Identify Structures #3 Identify Structures #4 Heart Size Pericardial Effusion Right Atrial Enlargement Left Atrium Enlargement Right Ventricle Enlargement Left Ventricle Enlargement Calcifications

Sillhouette Sign (Localizing Path)

Upper Airway/Trachea #1 Upper Airway/Trachea #2 Upper Airway/Trachea #3 Right Upper Lobe - Anatomy Right Middle Lobe - Anatomy Right Lower Lobe - Anatomy Left Upper Lobe - Anatomy Left Lower Lobe - Anatomy Right Upper Lobe - Evaluate Right Middle Lobe - Evaluate Right Lower Lobe - Evaluate Lingula - Evaluate Left Lower Lobe - Evaluate

Lung Parenchyma

Consolidation - Air Bronchogram Consolidation - Airspace Nodules Interstitial Disease Interstitial Disease - Reticular Pattern Interstitial Disease - Nodular Pattern Interstitial Disease - Recticulonodular Pattern Interstitial Disease - Kerly B Lines Pulmonary Edema - Peribronchial Cuffing Pulmonary Edema - Indistinct Pulmonary Vasculature Pulmonary Edema - Kerly B Lines Pulmonary Edema - Reticulonodular Pattern Pulmonary Nodules Atelectasis

Mediastinal Mass

Mediastinal Mass - Anterior Mediastinal Mass - Middle Mediastinal Mass - Superior Mediastinal Mass - Posterior

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