1. Describing a chest x-ray
2. Cardiothoracic ratio (CTR)
3. Tips

Describing a chest x-ray

• Patient details [nameagesexdateplace]
• Film details [contrast typelevelplane]

Then checklist ABCDEFGHI:

• Aorta
• Bubble [gastric]
• Cardiac shadow/ CTR
• Diaphragm: inflationangles
• Esophagus (foreign body)/ Effusion
• Fields/ Fractures [rib]
• Gas (pneumothorax)
• Hila and bronchi
• Iatrogenic (subclavian linepacemaker)

Alternatively:

• Airway: tracheabronchihilafieldseffusion
• Bubble [gastric]
• CTR
• Diaphragm: inflationcostophrenic angles
• Esophagus (foreign body)
• Fractures [rib]
• Gas (pneumothorax)
• Heart: shadowaorta
• Iatrogenic (subclavian linepacemaker)

Cardiothoracic ratio (CTR)

• Measurement: widest part of heart divided by widest part of chest as measured inside theribs.
• Normal value: <50%except in:
  • Neonatesinfants.
  • Skeletal problems: scoliosisetc.
  • Athletes.

Tips

• Usual CXR is taken in PA direction during inspiration.
• Echocardiogram better for finding effusionas CXR needs 250mL accumulation beforevisible.

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