Chest X-ray Anatomy
Tutorial Introduction

Key points

  • Visible anatomical structures in the chest should be assessed on every chest X-ray
  • Each of these anatomical structures should be viewed using a systematic approach
  • There are also important structures that are obscured or become visible only when abnormal

Related tutorials

This tutorial describes the important anatomical structures visible on a chest X-ray. These structures are discussed in a specific order to help you develop your own systematic approach to viewing chest X-rays.

By the end of the tutorial you will be familiar with all the important visible structures of the chest, which should be checked whenever you look at a chest X-ray. The tutorial also discusses anatomical structures that are not easily seen, but become visible when abnormal due to disease. You will learn more about these structures and diseases in the tutorial on chest X-ray abnormalities.

Before you start, have a look at the normal chest X-ray below.

Normal chest X-ray anatomy

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Normal chest X-ray anatomy

  • How many anatomical structures can you name on this X-ray?
  • Can you think of any important structures in the chest that are difficult to see on the X-ray?

Visible structures

  • 1 - Trachea
  • 2 - Hilum (hila)
  • 3 - Lungs
  • 4 - Diaphragm
  • 5 - Heart
  • 6 - Aortic knuckle
  • 7 - Ribs
  • 8 - Scapulae
  • 9 - Breasts
  • 10 - Bowel gas

Important obscured/invisible structures

  • Sternum
  • Oesophagus
  • Spine
  • Pleura
  • Fissures
  • Aorta

Chest X-ray anatomy

Many structures of the chest are readily visible on a chest X-ray. Other important structures, such as the pleura, only become visible when abnormal, and some are not visible at all, such as the phrenic nerve.

Your course assessment certificate

A certificated course completion assessment is available which is based on the material in this tutorial and the related sections.

All the certificated online course completion assessments provided by Radiology Masterclass award CPD/CME credits in accordance with the CPD Scheme of the Royal College of Radiologists, London, UK.

Page author: Salisbury NHS Foundation Trust UK (Read bio)

Last reviewed: February 2020