Chest X-ray Systematic Approach
Tutorial conclusion

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

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 universally accepted correct order for viewing the anatomical structures visible on a chest X-ray. 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

  • 1. Trachea and bronchi
  • 2. Hilar structures
  • 3. Lung zones
  • 4. Pleura
  • 5. Lung lobes and fissures
  • 6. Costophrenic angles
  • 7. Diaphragm
  • 8. Heart
  • 9. Mediastinum
  • 10. Soft tissues
  • 11. 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.

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: July 2018