Chest x-ray review is a key competency for medical students, junior doctors and other allied health professionals. Using A, B, C, D, E is a helpful and systematic method for chest x-ray review where E refers to "everything else".
Summary
-
introduction
- look at things that do not fit into the A-D categories and review areas
- apices
- behind the heart
- below the diaphragm
- soft tissues abnormalities (e.g. absent breast shadow)
- look at things that do not fit into the A-D categories and review areas
-
procedure
- apices
- many people forget to look above the clavicles
- look again at the lung above the clavicles
- behind the heart
- altered density in the retrocardiac region can be difficult
- check for basal consolidation or a mass in this region
- fluid-level of hiatus hernia
- below the diaphragm
- diaphragmatic contour is the dome of the diaphragm
- the lungs extend posteriorly below the diaphragm
- look out for mass lesions below the diaphragm
- soft-tissue abnormalities
- gas in the soft-tissues (surgical emphysema)
- look for both breast shadows in female patients
- apices
-
checklist
- apical lung tumor
- left lower lobe collapse
- hiatus hernia
- breast shadows