Tracheal air column

Last revised by Dr Daniel J Bell on 21 Jul 2022

The tracheal air column describes the appearance of the trachea on plain chest radiographs.

Radiographic appearance

Plain radiograph

On frontal chest radiographs, the air column extends as an almost vertical, radiolucent column midline in the mediastinum from the inferior margin of the cricoid cartilage (C6) to the bifurcation at the carina (T4). A gradual deviation towards the right of the trachea is the norm.

Practical points

Non-radiologists often erroneously describe the normal trachea as being vertical with no deviation, however a slight gradual deviation to the right is normal. Deviation, displacement or caliber change may all indicate pathology.

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