Chest X-Rays

Last Updated on February 4, 2023

Introduction

• 12 ribs
• Anterior ribs are more diagonally downwards; Posterior ribs are more horizontal

Some common indications of doing chest X-rays

• TRO lung pathology e.g. pneumonia, TB, pleural effusion, pneumothorax
• Post intubation
• Post central venous catheter insertion at neck / chest, e.g. internal jugular catheter, subclavian catheter

Common CXR views/projection

Some common abnormalities

• Subcutaneous emphysema of chest wall
• Rib fracture (trauma cases)
• Cardiomegaly
• Blunted costophrenic angle ≈ pleural effusion / haemothorax
• Patches of consolidation
• Air under diaphragm

Important Signs from Chest X-Rays

Hyperinflated lungs

Features:
• Flattened hemidiaphragm
• > 6 anterior ribs or >10 posterior ribs in the mid-clavicular line at the lung diaphragm level
• Hyperlucent lungs (less bronchovascular markings per cm²)

Differential diagnosis
• COPD
• Acute bronchiolitis (children)

Related Posts

1. common X-rays view/projection [open]

Reference / Further Reading

1. https://glassboxmedicine.com/2019/02/10/radiology-normal-chest-x-rays/
2. Anatomy for radiology: Chest
3. Hyperinflated lungs, Radiopaedia
4. Pleural tap