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Chest X-ray

Authoring team

A chest radiograph should be examined in a systematic way:

  • check the name on the film
  • make an estimate of age and sex of patient if this information is not provided
  • check the projection which should be posterior-anterior - PA
  • the whole of the chest should be visible on the film, check for rotation and that there has been satsifactory penetration
  • check chest expansion and the diaphragm - the right hemidiaphragm is 2 cm higher than the left
  • check for normal lung markings - the horizontal fissure is visible in 60% of normal chest X-rays; it runs from the centre of the right hilum, laterally and horizontally, to meet the sixth rib in the mid-axilla.

The following are described in more detail in subsequent nodes:

  • check the mediastinum
  • assess the cardiothoracic ratio (only on the PA film)
  • look at the pulmonary vessels
  • lung fields
  • bones
  • soft tissues

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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