Apical zone

Last revised by Dr Daniel J Bell on 02 Aug 2021

The apical zone (a.k.a. lung apex) is one of the four chest radiograph zones and an important location for missed diagnoses when reporting a frontal chest radiograph and makes up one of the "review areas". It is sometimes thought of as a subdivision of the upper zone

Radiographic features

Plain radiograph
  • portion of the lungs that lie above the inferior margin of the clavicles on a frontal chest radiograph (see Figure 1) 2
CT
  • using the zonal terminology for the location of findings on CT is generally discouraged, as a more precise lobar +/- segmental site, can usually be provided

Related pathology

The apices and upper zones are preferentially affected by pathology that is related to inhalation. The upper portion of the lungs have a positive ventilation mismatch when compared to the bases, where there is preferential perfusion. Common conditions involving the apical zone include:

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Cases and figures

  • Figure 1: apical zone highlighted
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  • Case 1: normal chest x-ray
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