The normal lateral chest x-ray view is obtained with the left chest against the cassette. Position: PA, AP, or lateral view? The standard chest X-Rays consists of a PA and lateral chest X-Ray.Inspiration: On good inspiration, the diaphragm should be seen at the level of the 8th – 10th posterior rib or 5th – 6th anterior rib.įigure 2 – The chest x-ray shows adequate inspiration.If there is a rotation, mediastinum may look abnormal.įigure-1: The clavicular heads and spinous process alignment. The x-ray shows minimal rotation. The distance between the thoracic spinal process and clavicular heads should be equal (Figure-1). Rotation: The clavicles should appear symmetrical and be seen as equal length.The image quality is one of the most important things in image interpretation.Īssessing The Image Quality, “ RIPE” mnemonic is used Rotation, Inspiration, Position, Exposure(Penetration). Emergency physicians interpret many portable (bedside) anteroposterior chest x-rays with poor quality, without lateral views to make the diagnosis. Unfortunately, the majority of the patients may not fit the ideal situation because of their acute problems. Meanwhile, the X-ray tube should be 180 cm away. The ideal timing can be defined as the end of inspiration, and the patient should hold his breath at that time. This chapter will summarize the basics of chest x-ray interpretation and give some pathologic examples. Therefore, knowing the basics and pathologies in the ED setting is very important. Emergency physicians are particularly exposed to various chest x-rays during a regular shift. Chest X-ray interpretation is one of the fundamental skills of every doctor.
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