Reading chest xray

reading Chest Xray








Following are the points to see  in Chest Xray:

1. check for rt  and LT side
2. Looks whether is well centralized or not,...check for medial end of Clavicle ...both should be at equi level from spine..i f not then it difficult to comment about cardiomegaly, medistinal deviation..     whichever end is more close to spine-----mediastinum is deviated on that side...           6th ant rib level or 9th post rib level        
3. look for exposure....if u see four spinal process then its well exposed...if over exposed then it looks translucent( like emphysema)
4. Looks for cardio and costophrenic angle...all should be  acute...if nt then its abnormal....also look for Diaphragmatic contour...if flattened ---then probably some lung disease....Both diaohragm are at
5. divide the lungs field into 3 section....Upper: above the anterior end of 2nd rib.....middle: between 2nd anf 4th rib...lower: below 4th rib...compare both lung field...
6. check Apical area ...esp behind the Clavicle for TB lesion then check lower lung filed for all 4 angle,,
7. check trachea...and trace it upto carina...should be patent
8. Cardiac: Let side border is made  by Aortic knob, pulm conus, lt atrium and Lt ventricle while rt side border is made by  SVC and rt atrium
9. Vascular markings: Lower lobe vessels are more prominent compare to Upper lobe coz of Gravity...If not then Cardiac problem.. rt side vessels look more prominent than lt side...

few other points...

• how to say number of thoracic vertebra using chest xray??:--- check anterior end of 1st rib which is connected to 1st thoracic vertebera...
• if engorged upper lobe vessels: probably it's puml veins...due to CCF
• Kerly A line: prominent vascular markings in upper lobe
• Kerly B lines: in Lower lobe of lungs on peripheral side ----which suggest fluid between septa...
• Carinal Ange is around 90...any angle above 90 is abnormal probably coz of Lt atrial enlargement----( lt atrium lies just below carina)
• batt wing's appearance:  Enlargement of hilar vessels....in Acute pulm edema..