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A chest X-ray (CXR) uses radiation to visualise the thorax, including the lungs, heart and bony structures.
When learning to interpret chest X-rays, it’s important to understand what a normal chest X-ray looks like. This provides the foundation for identifying chest X-ray abnormalities.
Normal chest X-ray
Features of a normal chest X-ray
- Airway: trachea central, normal right paratracheal strip, visible carina, symmetrical hila
- Breathing: visible lung markings extending to the edges of the lung fields across all zones, no significant opacities
- Cardiac: heart size <50% of thoracic width, right and left heart borders visible, normal retrocardiac space
- Diaphragm: both costophrenic angles visible with an acute angle, gastric bubble under the left hemidiaphragm
- Everything else: well-defined aortic arch, visible aortopulmonary window, no visualised bony defects, no radiographic artefacts, lines or devices
Want to learn more about chest X-rays?
Our comprehensive guide to chest X-ray interpretation covers how to interpret the image using a systematic approach.
We have several other resources relevant to chest X-rays:
- How to document a chest X-ray in the notes: a structured approach to documenting the findings in the patient’s notes
- Common chest X-ray findings in OSCEs: a guide to typical chest X-rays seen in medical student OSCEs, with example images
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