All medical students, throughout their years of study, have been told about the importance of correctly interpreting a chest X-ray. Chest x-rays are required in virtually any specialty. That is why it is vitally important to have basic reading concepts that will allow us to easily interpret any radiograph. Here are some guidelines for a correct interpretation.
Type of projection we have
To begin with the reading of the chest X-ray, it will be necessary to determine if it is posteroanterior, anteroposterior, lateral, decubitus, etc. You will have to keep the data of symmetry, shape, size, sex of the patient, age, etc.
More accurate reading of the chest X-ray by apparatus
After this, you will begin a much more precise reading by apparatus, going on to assess the extrapulmonary structures:
- Soft tissues: skin folds, breasts, etc.
- Skeleton: joint space, calcifications, shoulder girdles, number of ribs, assess vertebrae.
- Mediastinum: observe possible widening, masses, presence of catheters.
- Diagram: keep in mind that the right is a little higher than the left.
- Pleura: It is a fine line that delimits the chest wall from the lung content.
Consider the lungs
The lungs have a density that is given by the vessels and the presence of air. You have to take a look at the airways. First you have to look at the apical area; then it will be necessary to assess the hilar area and finally identify the different lobes and fissures.
The chest X-ray should also assess the cardiac silhouette and blood vessels.
The X-ray will be performed in a standing position and forced inspiration, since in decubitus and expiration, the cardiac silhouette may appear enlarged. You must look at the size of the heart and its chambers separately, thus ruling out a possible cardiomegaly.