What is the radiation dosage of a chest x-ray?
0.02mSV
Second lowest dosage
What is the normal projection of chest x-rays?
- PA unless really poorly
- Allows us to see lung bases and heart is not enlarged as x-rays hit this last
What anatomy should be included in a chest-xray for it to be adequate?
How can we tell there is no rotation on towards the detector on a chest x-ray?
Spinous processes and the clavicles line up
How much lung volume should you see on an inspiration phase chest x-ray?
- If don’t take full breath in may think some area is consolidation when it’s not
- Incomplete inspiration on big heart
- Exagerrated expansion on obstructive airways diseases
What should the lung bases look like on a chest x-ray?
- Should be dome shaped
- If flattened and can see 8 or 9 ribs could be emphysema or if asymmetrical flattening tension pneumothorax
How can you tell there has been adequate penetration on a chest x-ray?
- Vertebrae just visible through the heart
- Complete left hemidiaphragm visible
What are some artefacts that can appear on a chest x-ray?
- Clothes
- Hair
- Surgical lines
- Pace makers
Identify the following anatomical structures
What should you see on a chest x-ray when assessing the trachea?
Left hilar point should always be higher than right, if altered then pathology
What are the different lung zones on a chest x-ray?
What fissure can you see on a chest x ray?
Horizontal in the right lung running towards right hilum
How should we see the diaphragm on an xray?
Running all the way up to the vertebral bodies
What borders of the heart should you see on a chest x ray?
Atrial enlargement carina splays
What contours should you see at the mediastinum, e.g aortic knuckle?
Aortic window and LPA disappear with enlarged lymph node
How can you overcome seeing nipple markings on a chest x ray?
Stick paperclips on nipples so don’t mistake nipples for a mass
What might be the pathology if the 1st rib is not visible on chest x ray?
Pancoast tumour as it erodes the first rib
How do you systematically review a chest x-ray?
