Basics of Chest Radiograph
(CXR)
Dr. Mohamed Abdelmonim Khogali
Learning Objectives
Learning Objectives
• Learn CXR techniques.
• Learn normal lung anatomy as appear in CXR.
• Learn how to interpret CXR.
• Lear how to interpret important lung
pathological lesions in CXR.
Introduction
Anna Bertha Ludwig
How to read CXR
D Details
(Name, Age , Date , Sex, Medical History)
R RIPE image
(Rotation, Inspiration, Picture, Exposure (Penetration)
S Soft Tissue & Bone
A Airway
B Breathing
C Circulation
D Diaphragm
E Extra
(CVP, Catheters, NG-tube…)
D Details
(Patient name , Age , Date , Sex)
Patient Details
Patient Details
• The following points are important before
assessment of CXR:
1. Patient identification details.
2. Relevant patient medical history.
3. Relevant clinical findings.
D Details
(Name, Age , Date , Sex, Medical History)
R RIPE image
(Rotation, Inspiration, Picture, Exposure (Penetration)
CXR Imaging Techniques
CXR Imaging Techniques
Rotation
Picture
Mode Exposure
(Penetration)
Inspiration
Rotation
Normal CXR
Rotation
Inspiration
Inspiratory VS Expiratory CXR
Counting Ribs
Picture Mode
Posterior & Lateral View
Posterior Anterior View (PA-CXR)
Anterior Posterior View
Lateral Decubitus View
Lateral Decubitus CXR
Exposure (Penetration)
Penetration
Over-penetrated Under-penetrated
D Details
R RIPE image
S Soft Tissue & Bone
Soft Tissues & Bones
Cannonball Metastasis
Rib Fracture
D Details
R RIPE image
S Soft Tissue & Bone
A Airway
Airway
D Details
R RIPE image
S Soft Tissue & Bone
A Airway
B Breathing
Breathing
Cavity Lesion
• A cavity has been defined in the radiology as a
gas-filled space within a zone of pulmonary
consolidation or within a mass or nodule.
Miliary Tuberculosis
Interstitial Lung Disease
Circulation
Cardiac Silhouette
Heart Failure in CXR
Heart Failure - ABCDE
A Alveolar oedema (Bat’s Wing)
B Kerley B lines (Interstitial oedema)
C Cardiomegaly
D Dilated prominent upper lobe vessels
E Pleural Effusion
Hyper-inflated Chest
1. More than 10 ribs in PA CXR.
2. Flattened diaphragm.
3. Increased lung translucency- Black lung sign
(parenchymal loss).
4. Long narrow cardiac shadow.
5. Decreased peripheral Broncho vascular markings.
6. Bulla especially in air apices.
7. Prominence of the hilar vessels in pulmonary
hypertension.
Diaphragm
Pneumoperitoneum
Extra
