Interpreting the chest radiograph
A systematic approach will ensure you don’t miss major pathology
- By: Jen Jou Wong, John Curtis
Chest radiographs are common investigations that require careful and confident interpretation. Junior doctors might not always be able to rely on a senior opinion during on-call shifts. It is therefore important that you can confidently assess a chest radiograph and detect abnormalities, especially those that are life threatening. Using a systematic approach you should be able to detect major chest abnormalities, reach a diagnosis, and take appropriate and timely action.
Being familiar with normal anatomy in chest radiographs increases your chances of detecting an abnormality when one is present, even if you can’t diagnose the condition definitively. Regularly reviewing and presenting radiographs to senior colleagues while on the ward will help. Figure 1 is a normal chest radiograph—can you identify the labelled structures?
It is important to know how the lung lobes are divided because being aware of how the fissures move in different pathologies will aid diagnosis (fig 2).