How to Interpret a Chest X-Ray




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Summary: <br> A-B-C-D-E-F-G<br> <br> <br> <br> Two Types of X-Rays<br> <br> <br> <br> * Anterior-Posterior (“AP”)* Classic “portable” xray* The beam shoots from in front of the patient (anterior)* TO* The plate sitting behind the patient (posterior)* Posterior-Anterior (“PA”)* Requires trip to radiology* Results in a better picture* The beam shoots from behind the patient (posterior)* TO* The plate sitting in front of the patient (anterior)<br> <br> <br> <br> Three Indicators of a High Quality Chest X-Ray<br> <br> <br> <br> * Well inflated lungs* Visualize spine through cardiac silhouette* Medial aspect of both clavicles lined up* Evaluates for rotation<br> <br> <br> <br> Chest X-Ray Interpretation Mnemonic<br> <br> <br> <br> * A-B-C-D-E-F-G* A = Airway* Trachea midline (rule out tension pneumothorax)* B = Bones* Rib/Clavicle/Shoulder fractures* C = Cardiac silhouette* Should be no bigger than 50% of distance from chest wall to chest wall* Larger than this may represent cardiomyopathy* D = Diaphragm* Costophrenic angles should be sharp* Blunted in pleural effusion* E = Equipment* Central lines* Endotracheal tubes* Chest tubes* F = Lung Fields* The most important step* Look at lung markings/tissue to evaluate for…* Pneumothorax* Consolidation* Nodules* Pulmonary Edema* G = Great vessels* Look for mediastinal widening (&gt; 8cm)* Can be a sign of aortic injury* Looks falsely widened on AP/portable chest x-ray<br> <br> <br> <br> Additional Reading<br> <br> <br> <br> * How to Read a Chest X-Ray <a href="https://medgeeks.co/articles/how-to-read-a-chest-x-ray">(Medgeeks)</a>* Learn to Read a Chest X-Ray in 5 Minutes <a href="https://www.youtube.com/watch?v=uo7ho8ZW2YY">(YouTube)</a><br>