Thoracic cage deformities (scoliosis, etc.)Įvaluate the size and shape of the cardiac silhouette.Right mainstem is more straightly aligned with tracheaīones (and soft tissues) Scan all bony structures.Under-penetration will make structures more radioopaque, which may lead to “over-calling” certain findings Over-penetration will make structures more radiolucent which could lessen significance of opacities. 10 or more ribs typically suggests hyperinflation as in COPD, asthma, bronchiectasis.Įxposure quality of the film. Less than 7 suggests poor effort by the patient and/or low lung volumes as in restrictive lung disease, atelectasis, etc. Clavicular heads should be equidistant from vertebral spinous processes.Īssessment of inspiratory effort and lung volumes. Abnormal angles will distort the image by creating an oblique view. Ideally CXR beam should be transmitted perpendicular to the chest. Utilize a Systematic Approach RIP – ABCDE – LUNGS Assessing Technical Quality The beam penetrates from anterior to posterior chest. X-ray beam originates from 2-4 feet in front of the patient. Patient is usually in bed and leaning with back against the x-ray plate. The beam penetrates from posterior to anterior chest X-ray beam originates from 5-6 feet behind the patient. Patient is usually standing with anterior chest against the x-ray plate. Know which structures should be present or absent.Type of CXR will have an impact on what is considered “normal”.Develop confidence with the normal appearance.Correlate basic CXR findings with clinical evaluation in order to reach a diagnosis.Utilize a systematic and reliable approach in CXR evaluation.Develop an understanding of the normal CXR appearance.Having a systematic and repetitive approach is the key.īy the end of this lecture, the learner will be able to: Clinical decisions are too often made based on reports from non-clinicians. Few providers (including MDs) are comfortable interpreting their own films. Chest X Ray is probably the most common imaging test.
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