Interpretation of chest radiographs
- By: David Holt
Cheap, readily available, and loaded with information: chest x ray scans are excellent diagnostic tools-as long as you know how to interpret them. The evidence, unfortunately, points to the contrary. A study of senior students at a US medical school, in which five chest x ray films were presented (pneumothorax, pneumonia, pleural effusion, wide mediastinum, and pneumoperitoneum) showed that the students made the correct diagnosis only 60% of the time.
A solid introduction is given by Harvard at http://brighamrad.harvard.edu/education/online/clerk_2/read.html. This learning module includes the steps involved in reading a scan, a short list of pitfalls, 11 cases, and a comparison with a normal chest computed tomogram. The great thing about this website is an image of a normal chest x ray scan with all the features identified by number on the scan itself. Recognising a normal radiograph is essential to being able to identify pathology.
A more comprehensive introduction is