Review areas on chest radiograph
Last revised by Rohit Sharma on 18 Feb 2024
Citation, DOI, disclosures and article data
Citation:
Manickam A, Sharma R, Hacking C, et al. Review areas on chest radiograph. Reference article, Radiopaedia.org (Accessed on 19 Apr 2024) https://doi.org/10.53347/rID-62204
Permalink:
rID:
62204
Article created:
5 Aug 2018,
Appukutty Manickam
Disclosures:
At the time the article was created Appukutty Manickam had no recorded disclosures.
View Appukutty Manickam's current disclosures
Last revised:
18 Feb 2024,
Rohit Sharma ◉
Disclosures:
At the time the article was last revised Rohit Sharma had no financial relationships to ineligible companies to disclose.
View Rohit Sharma's current disclosures
Revisions:
11 times, by
6 contributors -
see full revision history and disclosures
Systems:
Sections:
Synonyms:
- Review areas on a chest x-ray
- Review areas on a CXR
- Review areas on chest x-rays
- Chest radiograph review area
- Chest radiograph review areas
- CXR review area
- CXR review areas
- Chest x-ray review areas
- Chest x-ray review area
Review areas on a chest radiograph are common areas for missed findings, and special attention should be paid to them:
lung apices: masses (e.g. Pancoast tumor), pneumothorax
behind the heart: consolidation, masses, hiatus hernia 2
below the diaphragm: free gas, lines and tubes (e.g. nasogastric tube), gastric distension, bowel obstruction
bones and soft tissues: fractures, masses, mastectomy, subcutaneous emphysema, evidence of previous surgery (e.g. axillary clips)
These first four are the classic review areas ref, sometimes the pulmonary hilum is included as an additional fifth region:
pulmonary hilum: mass, lymphadenopathy, vessel enlargement
See also
Quiz questions
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References
- 1. Elizabeth Puddy, Catherine Hill; Interpretation of the chest radiograph, Continuing Education in Anaesthesia Critical Care & Pain, Volume 7, Issue 3, 1 June 2007, Pages 71–75, https://doi.org/10.1093/bjaceaccp/mkm014
- 2. Oestreich AE. A helpful hint for chest radiology: "look behind the heart". (1982) Journal of the National Medical Association. 74 (10): 1029-31. Pubmed
Incoming Links
Articles:
- Review area
- Assessment of bones and soft tissue on chest x-ray
- Lines and tubes (radiograph)
- Assessment of pulmonary hila on chest x-ray (approach)
- Assessment of cardiomediastinal contours on chest x-ray (approach)
- Apical zone
- Adult chest radiograph pathology checklist
- Systematic chest radiograph assessment (approach)
- Assessment of chest x-ray technical adequacy (approach)
- Apical chest mass
- Assessment of lungs, pleura and airways on chest x-ray (approach)
Cases:
- Mastectomy (CXR)
- Normal chest radiograph
- Normal chest radiograph
- Normal chest radiograph
- Achalasia
- Underinspiration and poor positioning mimicking lung pathology in a pediatric patient
- T1b apical lung cancer
- Dense hilum sign
- Left apical lung cancer
- Shoulder dislocation (trauma chest x-ray)
- Lung cancer - retrocardiac
- Left lower lobe pneumonia - retrocardiac consolidation
Multiple choice questions:
Related articles: Chest
- imaging techniques
-
chest radiograph
- radiography
-
approach
- ABCDE
- ABCDEFGHI
- congenital heart disease
- medical devices in the thorax
- common lines and tubes
- nasogastric tubes
- endotracheal tubes
- central venous catheters
- esophageal temperature probe
- tracheostomy tube
- pleural catheters
- cardiac conduction devices
- prosthetic heart valve
- review areas
-
airspace opacification
- differential diagnoses of airspace opacification
- lobar consolidation
-
atelectasis
- mechanism-based
- morphology-based
- lobar lung collapse
- chest x-ray in the exam setting
- cardiomediastinal contour
- chest radiograph zones
- tracheal air column
- fissures
- normal chest x-ray appearance of the diaphragm
- nipple shadow
-
lines and stripes
- anterior junction line
- posterior junction line
- right paratracheal stripe
- left paratracheal stripe
- posterior tracheal stripe/tracheo-esophageal stripe
- posterior wall of bronchus intermedius
- right paraspinal line
- left paraspinal line
- aortic-pulmonary stripe
- aortopulmonary window
- azygo-esophageal recess
- spaces
- signs
- air bronchogram
- big rib sign
- Chang sign
- Chen sign
- coin lesion
- continuous diaphragm sign
- dense hilum sign
- double contour sign
- egg-on-a-string sign
- extrapleural sign
- finger in glove sign
- flat waist sign
- Fleischner sign
- ginkgo leaf sign
- Golden S sign
- Hampton hump
- haystack sign
- hilum convergence sign
- hilum overlay sign
- Hoffman-Rigler sign
- holly leaf sign
- incomplete border sign
- juxtaphrenic peak sign
- Kirklin sign
- medial stripe sign
- melting ice cube sign
- more black sign
- Naclerio V sign
- Palla sign
- pericardial fat tag sign
- Shmoo sign
- silhouette sign
- snowman sign
- spinnaker sign
- steeple sign
- straight left heart border sign
- third mogul sign
- tram-track sign
- walking man sign
- water bottle sign
- wave sign
- Westermark sign
- HRCT
-
chest radiograph
- airways
- bronchitis
- small airways disease
-
bronchiectasis
- broncho-arterial ratio
- related conditions
- differentials by distribution
- narrowing
-
tracheal stenosis
- diffuse tracheal narrowing (differential)
-
bronchial stenosis
- diffuse airway narrowing (differential)
-
tracheal stenosis
- diverticula
- pulmonary edema
-
interstitial lung disease (ILD)
- Anti-Jo-1 antibody-positive interstitial lung disease
- drug-induced interstitial lung disease
-
hypersensitivity pneumonitis
- acute hypersensitivity pneumonitis
- subacute hypersensitivity pneumonitis
- chronic hypersensitivity pneumonitis
- etiology
- bird fancier's lung: pigeon fancier's lung
- farmer's lung
- cheese workers' lung
- bagassosis
- mushroom worker’s lung
- malt worker’s lung
- maple bark disease
- hot tub lung
- wine maker’s lung
- woodsman’s disease
- thatched roof lung
- tobacco grower’s lung
- potato riddler’s lung
- summer-type pneumonitis
- dry rot lung
- machine operator’s lung
- humidifier lung
- shower curtain disease
- furrier’s lung
- miller’s lung
- lycoperdonosis
- saxophone lung
-
idiopathic interstitial pneumonia (mnemonic)
- acute interstitial pneumonia (AIP)
- cryptogenic organizing pneumonia (COP)
- desquamative interstitial pneumonia (DIP)
- non-specific interstitial pneumonia (NSIP)
- idiopathic pleuroparenchymal fibroelastosis
- lymphoid interstitial pneumonia (LIP)
- respiratory bronchiolitis–associated interstitial lung disease (RB-ILD)
- usual interstitial pneumonia / idiopathic pulmonary fibrosis (UIP/IPF)
-
pneumoconioses
- fibrotic
- non-fibrotic
-
lung cancer
-
non-small-cell lung cancer
-
adenocarcinoma
- pre-invasive tumors
- minimally invasive tumors
- invasive tumors
- variants of invasive carcinoma
- described imaging features
- adenosquamous carcinoma
- large cell carcinoma
- primary sarcomatoid carcinoma of the lung
- squamous cell carcinoma
- salivary gland-type tumors
-
adenocarcinoma
- pulmonary neuroendocrine tumors
- preinvasive lesions
-
lung cancer invasion patterns
- tumor spread through air spaces (STAS)
- presence of non-lepidic patterns such as acinar, papillary, solid, or micropapillary
- myofibroblastic stroma associated with invasive tumor cells
- pleural invasion
- vascular invasion
- tumors by location
- benign neoplasms
- pulmonary metastases
- lung cancer screening
- lung cancer staging
-
non-small-cell lung cancer
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