Reading a Chest X-Ray

1. A = Airway: are the trachea and mainstem bronchi patent; is the trachea midline?
2. B = Bones: are the clavicles, ribs, and sternum present and are there fractures?
3. C = Cardiac silhouette: is the diameter of the heart > ½ thoracic diameter (enlarged)?
4. D = Diaphragm: are the costophrenic and costocardiac margins sharp? is one hemidiaphragm enlarged over another? is free air present beneath the diaphragm?
5. E = Effusion/empty space: is either present?
6. F = Fields (lungs): are there infiltrates, increased interstitial markings, masses, air bronchograms, increased vascularity, or silhouette signs?
7. G = Gastric bubble: is it present and on the correct (left) side?
8. H = Hilar region: is there increased hilar lymphadenopathy?
9. I = Inspiration: did the patient inspire well enough for 10 ribs to be counted, or was the patient rotated?