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.

Mediastinum
  • 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
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Article information

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

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