How to read X ray chest

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1 : Findings 13. The Lung Fields! To help you determine abnormalities and their location. compare lung sizes evaluate pulmonary vascular pattern compare upper to lower lobe, right to left, normal tapering to periphery pulmonary parenchyma pleural surfaces fissures - major and minor - if seen compare hemidiaphragms follow pleura around rib cage
2 : How To Read CXR Dr. Saqib Rasheed PGR Pulmonology Sheikh Zayed Hospital Rahim Yar Khan
3 : The 13-Steps 1: Name 2: Date 3: Position markers 4: What type of view's 5: Initial survey 6: Penetration 7: Inspiration 8: Rotation 9: Angulation 10: Soft tissues / bony structures 11: Mediastinum 12: Diaphragms 13: Lung Fields Quality Control Findings } } Pre-read }
4 : Pre-Reading 1. Check the name 2. Read the date 3. Position markers 4. Which view’s do you have? PA / AP, lateral, decubitus, AP lordotic
5 : 5. Initial survey General Body Size, Shape, and Symmetry Sex Age (cartilage/aortic arch /ascending aorta/Pulmonary trunk) Infant/ child/ young adult/ elderly person Foreign objects tubes, IV lines, ECG leads, surgical drains, prosthesis non-medical objects, bullets, shrapnel, glass, etc
6 : Quality Control 6. Penetration Can see ribs through the heart Barely see the spine through the heart Can see pulmonary vessels nearly to the edges of the lungs
7 : Overpenetrated Film Lung fields darker than normal—may obscure subtle pathologies See spine well beyond the diaphragms Inadequate lung detail
8 : Underpenetrated Film Hemidiaphragms are obscured Pulmonary markings more prominent than they actually are
9 : Quality Control 7. Inspiration Should be able to count 9-10 posterior ribs Heart shadow should not be hidden by the diaphragm 1 2 3 4 5 6 7 8 9 10
11 : Quality Control 8. Rotation Medial ends of bilateral clavicles are equidistant from the midline or vertebral bodies
12 :
13 : If spinous process appears closer to the right clavicle (red arrow), the patient is rotated toward their own left side If spinous process appears closer to the left clavicle (red arrow), the patient is rotated toward their own right side


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