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Chest X-Ray Review: ABCDE Guide

This document provides guidance on using the ABCDE method for reviewing chest x-rays. It involves assessing: the Airways for tracheal and bronchial abnormalities; Breathing by examining lung volumes and densities; Circulation of the heart and vessels; Disability through checking for bone fractures; and Exposure of other structures like the diaphragm or soft tissues. For each category, key features are outlined to evaluate such as tracheal position, lung expansion, cardiac size, and bone integrity. The ABCDE method acts as a systematic approach for medical students and doctors to interpret chest x-rays.

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Yaasin R N
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232 views3 pages

Chest X-Ray Review: ABCDE Guide

This document provides guidance on using the ABCDE method for reviewing chest x-rays. It involves assessing: the Airways for tracheal and bronchial abnormalities; Breathing by examining lung volumes and densities; Circulation of the heart and vessels; Disability through checking for bone fractures; and Exposure of other structures like the diaphragm or soft tissues. For each category, key features are outlined to evaluate such as tracheal position, lung expansion, cardiac size, and bone integrity. The ABCDE method acts as a systematic approach for medical students and doctors to interpret chest x-rays.

Uploaded by

Yaasin R N
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Basic Radiology ABCDE

This is a basic article for medical students and other non-radiologists


Chest x-ray review is a key competency for medical students, junior doctors and other
allied health professionals. Using A, B, C, D, E is a helpful and systematic method for chest
x-ray review:

 A: airways

 B: breathing (the lungs and pleural spaces)

 C: circulation (cardiomediastinal contour)

 D: disability (bones - especially fractures)

 E: everything else, e.g. pneumoperitoneum


Reference article
This is a summary article; we do not have a more in-depth reference article.
Summary
Airways
Start at the top in the midline and review the airways.

 start at the top and trace down the trachea to carina


o is it straight and midline?

 trace down both main bronchi


o is the carina wide (more than 100 degrees)?

o is there bronchial narrowing or dilatation?

chest x-ray assessment of the airways


Breathing
Look for lung and pleural pathology.

 both lungs should be well expanded and similar in volume


o can you count 10 posterior ribs bilaterally?

o is one lung larger than the other?

 compare the apical, upper, middle and lower zones in turn


o are they symmetrical?

o are there areas of increased density?


 trace the lateral margins of the lung to the costophrenic angles
o are the costophrenic angles crisp?

 trace the hemidiaphrams to the midline


o can you see the whole of the hemidiaphragm?

 trace the cardiac borders


o can you clearly see the left and right heart border?

chest x-ray assessment of lungs and pleural spaces


Circulation
Look at the heart and vessels (systemic and pulmonary).

 check the cardiac position

 assess cardiac size

 check the position and size of the aortic arch

 check the width of the upper mediastinum

 look at the hilar vessels


o can you see them clearly on both sides?

chest x-ray assessment of the cardiomediastinum


Disability
Check for any bony pathology (fracture or metastasis).

 trace along each posterior (horizontal) rib on one side of the chest
o is there a fracture or abnormal area?

 repeat with the other side of the chest

 now trace lateral and anterior ribs on the first side

 repeat on the other side

 now, check the clavicles and shoulders


o can you trace around the cortex of the bones?

 finally the check the vertebral bodies


o are they all rectangular and of a similar height?

o can you see 2 pedicles per vertebral body?

o are there disc spaces?


chest x-ray assessment of the bony thorax
Exposure
Everything else including the upper abdomen and soft tissues.

 is there free gas under the diaphragms?

 is there a hiatus hernia?

 is there an absent breast shadow?

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