Xrays

Chest xray

Black area is lucency

White area is opacity

Before reading xray, confirm these 4

  1. Confirm patient name?

  2. When taken?

  3. Why requested to xray?

  4. What view it is?

  • AP or PA

How to differentiate

*for cardiomegaly PA is better(no magnification)

  • Erect or Supine

Quality of xray

  1. Rotation/centering

  • distance between the clavicle and spinous process L and R are equal

  1. Exposure

  • lower thoracic vertabrae is barely visible (not hyperexpose or hypoexposed)

  1. Inspiration

  • How to know?

Q- where does origin of rib comes from

Criteria(above the diaphragm)

- visible 5-6 anterior end of ribs

- visible 8-10 posterior end of ribs

Normal Chest Xray interpretation

Inside out Method

  1. Trachea

  • slightly tilted to Right because of aortic arch

  1. Hilum

  • Right Hilum is lower or equal than left hilum

concave shape

3.Heart size

  • CTR <0.5 = normal

PA view > 0.55 abnormal

AP view = False cardiomegaly (<0.6 is normal)

  1. Mediastinum marking

Right

  • SVC, RA, IVC

Left

  • Aortic knuckle, pulmonary Artery trunk, LA appendage, LV

  1. Diaphragm

  • Left dome is lower than right dome because heart is resting on left dome

  1. Costophrenic and cardiophrenic angle

  2. chest walls compare both side

  3. Compare lungs, any pathology?

  4. Bones- rib, scapula, sternum, clavicle