CXR REVIEW

Quick Review
• STEP 1
• You must determine if it is technically a good CXR:
• R- Rotation (Trachea midline; spinous process half way evenly
between clavicle heads)
• I – Inspiration (5-6 anterior ribs or 9 posterior ribs, lung apices, lateral
ribs edges and costophrenic angles should be seen)
• P – Projection (PA, AP, Lateral)
• E – Exposure (Too white=under exposed; too dark over exposed in
general but you should be able to see vertebra through the heart)
Review Continued
• Step 2
• Order or Sequence to evaluate the CXR (ABCD’s):
• A (Airway) – Look at the trachea is it central or deviated, remember
certain conditions pull or push the trachea in one direction or the other.
Also will appear deviated if you have rotation of the body during
imaging
• B (Bones) – ribs, clavicles, and scapula for fractures or metastatic
lesions
• C (Cardiac Silhouette) – Cardiac shadow < 50% of width of thorax
• D (Diaphragm) – Well defined edges, costophrenic and cardiophrenic
angles sharp-look for sub-diaphragmatic air
Review Continued
Step 2

• E (Edge of Heart –Should be clearly seen

• F (Fields of Lungs) – Note lung markings, vasculature, masses,
consolidation, pneumothorax, etc
• G (Gastric Bubble)
• H (Hilar area)-pulmonary vessels, no lymph nodes, or masses
• I (Instruments, wires, devices) – make note of any
CXR 1
normal
CXR 2
O
CXR 3

border
cardiac
is obscured

RML

infiltrates
 CXR 4

-u
meniscus ④
sign pleural effusion
CXR 5
CXR 5
CXR 6
CXR 7
CXR 8
CXR 9
CXR 10
CXR 11
CXR 12
CXR13
order detailed

rib ✗R

oblique view
-
CXR 14 Abd pain
ulcer stomach

)
Fluid
small (
vs
→

- large bowel
↳ Fecal material