Chest X-ray Systematic Approach
Patient and image data

Key points

  • Check the patient's identity
  • Note the image date and time
  • Note the image projection
  • The image annotations are often useful

Patent ID and date

The identity of the patient should be checked before interpreting any X-ray. The date of the investigation should also be noted and even the time is relevant if the patient has had more than one X-ray on the same day.

Image projection

Check if a posterior-anterior (PA) or anterior-posterior (AP) projection was used, and note if the patient was standing, sitting or supine? Was the mobile X-ray machine used?

Image annotations

Useful information is often annotated on the image. If the projection is not marked, it is likely to be a standard PA view. If there is one, check the side marker is correct.

Image annotations

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Image annotations

  • This is a mobile chest X-ray taken with the patient supine, at 11.25am in the resuscitation room of the Emergency Department. The patient's name, ID number and date of birth are annotated.
  • Note the side marker is correct.