CXR
Confirm details
Assess image quality (RIPE)
Interpretation (ABCDE)
C (Cardiac)
D (Diaphragm)
B (Breathing)
E (Everything else)
A (Airway)
Date/time
Any previous imaging
Name/DOB
Inspiration
Projection
Rotation
Exposure
Clavicle
Spinous processes
The lung apices
Costophrenic anglews
5-6 anterior ribs
Lateral rib edges
AP vs PA film
No label; the scapulae is not projected within the chest ➡ PA
Left hemidiaphragm visible to the spine and vertebrae visible behind heart
Carina and Bronchi
HIlar structures
Trachea
Lungs
Pleura
Heart borders
Heart size
Bones
Soft tissues
Mediastinal contours
Tubes/Valves/Pacemakers
Pushing: e.g large pleural effusion, tension pneumothorax
Pulling: e.g. consolidation with lobar collapse
Hilar enlargemengt ?
BIlateral/Symmetrical ~ Sarcoidosis
Unilateral/Asymmetrical ~ underlying malignancy
Pleural thickening ~ mesothelioma
Pneumothorax. hydrothorax, haemothorax, hydropneumothorax
Tension pneumothorax
Shortness of breath, tracheal deviation
CTR < 0.5
Cardiomegaly
Cardiomyopathy
Pulmonart hypertension
Valvular diseases
Pericardial effusion
Loss of definition of the left heart border is associated with lingular consolidation
Loss of definition of the right heart border is associated with right middle lobe consolidation
Costophrenic blunting
Pseudopneumoperitoneum - Chilaiditi syndrome
Fluid, consolidation
Lung hyperinflaion (COPD)
Aortic knuckle
Aorto-pulmonary window