Described below is one approach to the assessment of airways, lungs and pleura on chest x-ray. Start by assessing the tracheal air column, followed by the lungs and finally the pleural spaces.
On this page:
Tracheobronchial tree
-
assess position, should be central and deviation can be due to
positive mass effect, e.g. mediastinal mass, pleural effusion, tenion pneumothorax
negative mass effect, e.g. atelectasis, volume loss
Lungs
-
assess lung volume
increased: emphysema
decreased: atelectasis, pulmonary fibrosis
assess each lung zone individually as well as comparing to the contralateral side
-
assess for pulmonary nodule/mass, airspace opacity and/or reticular opacity
pulmonary nodules can be mimicked by nipple shadows
-
assess pulmonary vasculature
enlarged: congestive heart failure, pulmonary hypertension
decreased: Westermark sign
Pleura
-
lung edge sign of pneumothorax
if hydropneumothorax an air-fluid level will be present
-
abnormal pleural opacification, e.g.
pleural effusion: meniscus sign
pleural plaque (can be calcified)
See also
Systematic chest radiograph assessment:
airways, lungs and pleura
Unable to process the form. Check for errors and try again.