Chest x-ray review: diaphragm

Last revised by Liz Silverstone on 23 Sep 2024

Chest x-ray review is a key competency for medical students, junior doctors and other allied health professionals. Using A, B, C, D, E, F is a helpful and systematic method for chest x-ray review where D refers to diaphragm and infradiaphragmatic structures.

Summary

  • right diaphragm usually up to 2 cms higher

  • check for hiatus hernia

  • check for free gas beneath the diaphragm

  • check for splenomegaly

  • check for gall stones and renal calculi

Imaging differential diagnosis

  • Rib fracture
  • Clavicle fracture
  • Rib metastasis
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