Assessment of cardiomediastinal contours on chest x-ray (approach)

Described below is one approach to systematic assessment and associated pathology of the cardiomediastinal contours on chest x-ray.

  • size: widened mediastinum can be seen in aortic dissection, traumatic aortic injuries
  • abnormal contour, e.g. lymphadenopathy, anterior mediastinal mass
  • abnormal gas pattern, e.g. pneumomediastinum, hiatus hernia

Heart (cardiac silhouette)

  • assess position (frontal view): normally one-third right of midline and two-thirds left of midline
  • assess borders and both frontal and lateral for silhouette sign and abnormal appearance
  • pericardial fat pad (frontal view): normally in the cardiophrenic angle(s)
  • assess overall size
Share article

Article information

rID: 62198
System: Chest
Section: Approach
Synonyms or Alternate Spellings:

Support Radiopaedia and see fewer ads

Updating… Please wait.

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.