Adult chest radiograph pathology checklist

The adult chest radiograph pathology checklist is just a pathology checklist of things not to miss when reviewing a chest radiograph, especially in the exam setting.

  • standard review areas
    • apices
    • retrocardiac area
    • hilar regions
    • below the diaphragm
    • right descending pulmonary artery (like a little finger)

Easily missed pathology

Run through the areas of the chest radiograph in order and think of pathology that you need to actively check for.  It's not going to just out an hit you in the face.

Pulmonary
  • lobar collapse - check hilar position
  • silhouete sign
Pleural
  • pneumothorax - especially small apical ones
Mediastinal
  • thyroid mass
  • paratracheal lymph nodes - espesically right paratracheal
  • density in the azygous region
  • coarctation - check rib notching
  • right-sided aortic arch
  • hilar lymphadenopathy
  • pneumomediastinum
  • paraspinal mass
  • mediastinal mass
Chest wall
  • ribs
    • metastases - sclerotic or lucent
    • destruction from local process
    • fracture
  • free intraperitoneal gas
Other
  • humeral head
    • humeral head AVN - Sickle cell disease
    • fracture
  • clavicular fracture
  • vertebra
    • pedicle destruction
    • vertebral collapse/fracture
    • paravertebral mass
    • H-vertebra
  • spleen
    • splenic calcification
    • asplenia
      • gas in the splenic flexure immediately below the diaphragm
      • sickle-cell disease
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Article information

rID: 16956
System: Chest
Synonyms or Alternate Spellings:

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