Prepared By
The Anesthesia Team
Al-shifa Medical Complex - Gaza
Palestine
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1-Confirm details
• Begin chest X-ray interpretation by checking the
following details:
Patient details: name, date of birth and unique
identification number.
Date and time the film was taken
Previous imaging: useful for comparison.
2-Assess Image Quality
• a mnemonic you may find useful is ‘RIPE’.
Rotation
• The medial aspect of each clavicle should be equidistant
from the spinous processes.
• The spinous processes should also be vertically aligned.
Inspiration
• The 5-6 anterior ribs, lung apices, both costophrenic
angles and the lateral rib edges should be visible.
Projection
• Note if the film is AP or PA: if there is no label, then
assume it’s a PA film.
Exposure
• The left hemi-diaphragm should be visible to the spine,
and the vertebrae should be visible behind the heart.
3-ABCDEFG approach
“Reading” the Chest X-ray
Air: Central airways ,main stem bronchi.
Bones: Ribs, clavicles, spine, shoulders,scapulae
Cardiac: Heart, blood vessels and mediastinum
Diaphragm and pleura costo-pherenic angle
Everything else: soft tissues of the neck, chest wall…
Fields (Lung fields) infiltrates ,pattern,mass ……
Gastric Gastric Tubes &gases……..
A-Airway
A-Airway
B-Bones
C-Cardiac
The cardiac silhouette refers to the outline of the heart as
seen on a chest X-ray.
C-Cardiac
• normaly cardiothoracic ratio of less than 0.5)
C-Cardiac
C-Cardiac
D-Diaphragm
Pneumoperitoneum = sub-pherenic air = perforated viscous
D-Diaphragm
congenital left diaphragmatic hernia ,with a
displacement of the cardiac silhouette to the right.
E – Effusion
Rt. Pleural effusion =obliteration of Rt. Costo-phrenic angles
E – Effusion
Lt.Pleural effusion with tracheal deviation
F – Fields (Lung fields)
F – Fields (Lung fields)
F – Fields (Lung fields)
F – Fields (Lung fields)
Rt. Lobar consolidation = pneumonia
F – Fields (Lung fields)
lung mass affecting the right middle lube lung.( toumor)
F – Fields (Lung fields)
Pulmonary Hydatid Cyst
G – Gastric
Gastric Tubes
G – Gastric
Gastric gas
Other Devices
Devices ETT
