Technique of interpretation of plain radiograph of chest

CHECK LIST FOR PA FILM

Study the request form,

• Patient’s age sex, clinical information.
• Check serial number of radiograph against number on request form.

Technical aspects     

• Correct position of patient
• Area of interest - lung apices,lower neck, diaphragm, lateral chest walls. 
• Exposure factors.   

Central shadow,

• Heart - Size, margins, position.
• Trachea – position, calibre, impressions on it.
• Carina (cartilaginous ridge within the trachea).
• Aortic knuckle and margins of aorta.
• Mediastinal borders.
• Mediastinal masses.

 Lungs,

• Normal opacities – nipple shadows, breast shadows, companion lines.
• Abnormal opacities and lucencies, cavities, calcifications, fibrosis.
• Blood vessels, bronchi 

Diaphragm,

Level, contour, partial or complete obscuration, lateral costophrenic angles and cardiophrenic angles.

Hila,

          Positions, size, calcifications.

Pleura,

         Fissures, pneumothorax, pleural effusions.

‘Hidden areas’,

Lung apices, behind the heart, below the diaphragm, four corners of the film.

 

CHECK LIST FOR LATERAL FILM

Following important observations should be made, in addition to the routine employed for PA radiograph.
 

Normal lucent areas,

         Retrosternal and retrocardiac areas.

Vertebral translucency,

         Normally vertebrae become progressively translucent cranio-caudally.

Diaphragm,

         Posterior costophrenic angles.

Fissures,

         Oblique fissures.