Chest x-ray interpretation

ABC Method

• Airways - ex. FB, trachea deviation
• Bones and soft tissue - ex. Rib fractures, clavicle fracture
• Cardiac - ex. Cardiomegaly
• Diaphragm - ex. Free air
• Effusions - ex. Pleural effusion
• Fields and Fissures - ex. Congestion, consolidations
• Great vessels - ex. Apical cap
• Hila and mediastinum - Widened mediastinum
• Impression

DRSABCDE Method

• Details
  • Info of patient
  • PA/AP, Lateral
• RIPE - Image quality
  • Rotation
  • Inspiration
  • Picture
  • Exposure
• Soft tissues and bones
• Airway & mediastinum
• Breathing
  • Lung fields
• Circulation
  • Heart position and size
• Diaphragm
• Extras
  • Lines, tubes, catheters

Examples

• 

  ARDS

• 

  Pneumoperitoneum

• 

  Prominent wedge-shape area of airspace consolidation in the right lung, characteristic of bacterial pneumonia

• 

  Esophageal foreign body (penny in 12 mo male)

• 

  Right sided pneumothorax

• 

  Pulmonary edema with small pleural effusions on both sides.

• 

  Left sided tension pneumothorax with mediastinal shift

• 

  Lung abscess

• 

  Hyperinflated lungs consistent with asthma/COPD

• 

  Endotracheal tube and nasogastric tube in correct position.

Special Findings

Elevated Hemidiaphram

Elevated hemidiaphragm algorithm

See Also

• X-ray interpretation (main)