This document provides information about chest x-rays, including how to read a chest x-ray film, the common uses of chest x-rays, and the benefits and risks. It explains that a chest x-ray makes images of the heart, lungs, and bones in the chest to help diagnose conditions like pneumonia, heart problems, and lung cancer. It also outlines the basic components radiologists examine on a chest x-ray like the heart size and shape, lungs, diaphragm, and bones. While x-rays provide fast, low-cost exams, there is a small risk of cancer from radiation exposure.

1. ‫الرحيم‬ ‫الرحمن‬ ‫هللا‬ ‫بسم‬
‫علما‬ ‫زدني‬ ‫رب‬ ‫قل‬ ‫و‬
‫العظيم‬ ‫هللا‬ ‫صدق‬

2. Reading
Chest X-ray
Films

3. How to read chest X-ray film?

4. What is a Chest X-ray (Chest Radiography)?
 The chest x-ray is the most commonly
performed diagnostic x-ray examination.
 A chest x-ray makes images of the heart,
lungs, airways, blood vessels and the bones of
the spine and chest.
 An x-ray (radiograph) is a noninvasive medical
test that helps physicians diagnose and treat
medical conditions.
 Imaging with x-rays involves exposing a part
of the body to a small dose of ionizing
radiation to produce pictures of the inside of
the body.
 X-rays are the oldest and most frequently used
form of medical imaging.

5. Chest X-ray imaging, A-P & Lat. Positioning

6. What are some common uses of the procedure?
A chest x-ray is typically the first imaging test used
to help diagnose symptoms such as:
 shortness of breath.
 a bad or persistent cough.
 chest pain or injury.
 fever.
Physicians use the examination to help diagnose or
monitor treatment for conditions such as:
 pneumonia.
 heart failure and other heart problems.
 emphysema.
 lung cancer.
 line and tube placement.
 other medical conditions.

7. A = Airway
are the trachea and mainstem bronchi
patent; is the trachea midline
B = Bones
are the clavicles, ribs, and sternum present
and are there fractures?
C = Cardiac silhouette
is the diameter of the heart ½
< thoracic
diameter (enlarged)?
D = Diaphragm
are the costophrenic and costocardiac
margins sharp ?is one hemidiaphragm
enlarged over another?.
is free air present beneath the diaphragm?

8. E = Effusion/empty space
is either present
F = Fields (lungs)
are there infiltrates, increased interstitial
markings, masses, air bronchograms,
increased vascularity, or silhouette signs?
G = Gastric bubble
is it present and on the correct (left) side
H = Hilar region
is there increased hilar lymphadenopathy?
I = Inspiration
did the patient inspire well enough for 10
ribs to be counted, or was the patient
rotated

9. Effect of positioning & respiration

10. Normal chest landmarks

11. What are the benefits vs. risks?
Benefits
 No radiation remains in a patient's body
after an x-ray examination.
 X-rays usually have no side effects in the
diagnostic range.
 X-ray equipment is relatively inexpensive
and widely available in emergency rooms,
physician offices, ambulatory care centers,
nursing homes and other locations, making
it convenient for both patients and
physicians.
 Because x-ray imaging is fast and easy, it is
particularly useful in emergency, diagnosis
and treatment.

12. Risks
 There is always a slight chance of cancer
from excessive exposure to radiation.
However, the benefit of an accurate
diagnosis far outweighs the risk.
 The chest x-ray is one of the lowest
radiation exposure medical examinations
performed today. The effective radiation
dose from this procedure is about 0.1 mSv,
which is about the same as the average
person receives from background radiation
in 10 days.
 Women should always inform their
physician or x-ray technologist if there is
any possibility that they are pregnant.

13. Lung nodule & cervical rib

14. Missing breast & dextrocardia

15. Prosthetic aortic & mitral valves

16. Pleural effusion & collapse

17. Pneumonectomy & air fluid level

18. Consolidation & Pneumonia

19. Aspestos plaques & mesothelioma

20. Bronchogenic carcinoma & lung abscess

21. Bronchiectasis & fibrosis

22. COPD & Pneumothorax

23. Enlarged hilum, uni & bilateral

24. Left ventricular aneurysm & pericardial
effusion

25. Thoracic aortic aneurysm & metastatic
deposits

26. Pancoast tumor

27. Chest wall mass (lipoma)

28. Pleural effusion in lat. Decubitus &
pneumothorax

29. Fracture vertebra & scoliosis

30. Surgical emphysema & cavity

31. Bronchogenic carcinoma

32. Eventrated diaphragm & bilateral pleural
effusion

33. Tuberculoma & Miliary T.B.

34. Canon ball chest & mediastinal lymph nodes