Chest X-ray

Systematic approach

Tutorial conclusion

This tutorial has discussed the need for a systematic approach to ensure no important structures are ignored. The patient and image data is always checked, and image quality assessed. There is no single order for viewing the anatomical structures visible on a chest X-ray, but the chest X-ray anatomy tutorial is presented in an order that you may find useful while developing your own system.

Anatomical structures to check

  • Trachea and bronchi
  • Hilar structures
  • Lung zones
  • Pleura
  • Lung lobes and fissures
  • Costophrenic angles
  • Diaphragm
  • Heart
  • Mediastinum
  • Soft tissues
  • Bones

If you see an abnormality, try to locate it and describe it as fully as you can before continuing to examine the rest of the image systematically. Finish by double checking the review areas.

Try and answer any specific questions raised by the clinical features.

Checklist for a systematic approach

  • Patient identity
  • Image data
  • Image quality
  • The obvious abnormality - description/location
  • Systematic check of anatomy
  • Review areas
  • Consider the clinical question

©Radiology Masterclass 2007 -