The document discusses the approach to interpreting radiographs. It provides details on how x-rays work and how radiographs are obtained. It recommends following a systematic approach by first evaluating technical aspects like patient identification and image quality, then checking anatomical structures. Common structures seen on chest x-rays are listed. Normal anatomy appearances are described. Brief clinical scenarios are presented as examples of when chest x-rays may be used.
2. X-Ray
• Form of electromagnetic
radiation.
• First discovered in 1895 by
Wilhelm Röntgen who
recognized its medical
properties.
• A radiograph is obtained by
passing X ray beams
through the patient who is
in front of a detector.
Bones and other structures
cast a shadow allowing
their visualisation
3. Quick guide
• Patient identity
• Inspiration – 5- 7 anterior ribs for chest x ray
• Rotation –thoracic spinous processes/clavicles
• Projection
• Penetrance
• Field of view
• Overall quality
• The obvious abnormality?
• Systematic check of anatomical structures
• Consider the clinical question
4. Anatomical structures on the chest X-
ray
• Trachea and bronchi
• Hilar structures
• Heart and mediastinum
• Lung fields
• Pleura
• Lung lobes and fissures
• Costophrenic angles
• Diaphragm
• Soft tissues
• Bones
5. Normal anatomy
• Dark – gas
• White –
bone/calcification
• Grey – soft tissues
• Dark grey - fat
16. Summary
• A systematic approach
is vital
• Start with technical
aspects and then
anatomy
• Remember bone, soft
tissue and artefacts
• Consider clinical
context
• Investigations are an
adjunct to clinical
assessment.
