Physiotherapy chest x-rays

A-H analysis of normal x-ray/presentation

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A – Airway. Is the trachea central, can you see the carina and the division of the left and right main bronchus?

$B – Bones. Are there any fractures both within the thoracic cavity and/or surrounding structures?$

C – Cardiac. Is the heart positioned 2/3rd to the left and 1/3rd ? The heart should be less than half the diameter of the thoracic cavity.

D – Diaphragms. The diaphragms should be nicely domed with clear costophrenic and cardiophrenic angles. The right hemi diaphragm should sit slightly higher than the left.

E – Expansion. The 6th anterior rib should intersect the midpoint of the diaphragm.

F – Lung Fields. Can you see lung markings out to the peripheries? Do the left and right sides look the same?

H – Hilar regions. The hilar regions should be more prominent than the rest of the lung markings. These are where the pulmonary vessels originate from. ‘Fluffy looking’ or more pronounced hilar markings than expected may indicate vascular engorgement and fluid overload/pulmonary oedema.