This document provides an overview of normal x-ray interpretation. It discusses technical aspects like orientation, inspiration, penetration and rotation that should be considered for all x-rays. It describes what should be looked at in an x-ray like the bony framework, soft tissues, lungs, heart and abdomen. The stages of evaluating an abnormality are outlined as identification, localization, identification of pathological process and etiology. Practice and repetition are emphasized for improving x-ray interpretation skills.

1. GOOD MORNING..!!

2. NORMAL X-RAY
INTERPRETATION
BY
GEETHIKHA B

3. Recognition
of abnormal
first requires
knowledge of
normal.

4. Different tissues in body absorb X-rays
at different extents:

7. DATA BASE
7
Date
Position
markers
Type of film
Patient’s
position
Technical
quality

8. TECHNICAL ASPECTS
Orientation
Inspiration
Penetration
Rotation
Angulation
Factors to be considered on all x-rays include:

9. ORIENTATION
• PA- the x-rays penetrate through the back of the
patient on to the film
• AP-the x-rays penetrate through the front of the
patient on to the film

12. INSPIRATION /EXPIRATION

14. PENETRATION

15. ROTATION

20. LOOK INTO
• Bony Framework
• Soft Tissues
• Lung Fields and Hila
• Diaphragm and Pleural
Spaces
• Mediastinum and
Heart
• Abdomen and Neck

23. Bony Fragments
• Ribs
• Spine
• Shoulder
girdle
• Clavicles

24. Soft Tissues
• Breast shadows
• Supraclavicular areas
• Axillae
• Tissues along side of
breasts

25. Mediastinum and Heart
• Heart size on PA
• Right side
• Inferior vena cava
• Right atrium
• Superior vena cava

27. Mediastinum and Heart
• Left side
• Left ventricle
• Pulmonary artery
• Aortic knuckle

29. Diaphragm and Pleural Surfaces
• Diaphragm
• Dome-shaped
• Costophrenic angles
• Normal pleura is not
visible
• Interlobar fissures

31. Lung Fields and Hila
Hilum
• Pulmonary vessels
Lungs
• Linear and fine
nodular shadows of
pulmonary vessels

34. Abdomen and Neck
• Abdomen
• Gastric bubble
• Neck

36. Stages of Evaluating an
Abnormality
1. Identification of abnormal shadows
2. Localization of lesion
3. Identification of pathological process
4. Identification of etiology
5. Confirmation of clinical suspension
• Complex problems
• Introduction of contrast medium
• CT chest
• MRI scan

37. And finally..!!
• Practice and repetition.
• Plain XR is the starting point, findings on the
XR will direct you towards further imaging.
• Some diseases have certain XR patterns, but
this is not written in stone!
• Always keep the patient clinical presenting
features in mind when coming up with your
differential diagnosis.