Assessment of lungs, pleura and airways on chest x-ray (approach)
Described below is one approach to the assessment of airways, lungs and pleura on chest x-ray. Start by assessing the tracheal air column, followed by the lungs and finally the pleural spaces.
- assess position, should be central and deviation can be due to
- positive mass effect, e.g. mediastinal mass, pleural effusion, tenion pneumothorax
- negative mass effect, e.g. atelectasis, volume loss
- assess lung volume
- assess each lung zone individually as well as comparing to the contralateral side
- assess for pulmonary nodule/mass, airspace opacity and/or reticular opacity
- pulmonary nodules can be mimicked by nipple shadows
- assess pulmonary vasculature
- lung edge sign of pneumothorax
- if hydropneumothorax an air-fluid level will be present
- abnormal pleural opacification, e.g.