Indications for chest Radiography

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Lecture (21)
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• Indications for chest Radiography
• Clinical Problem
• Chest pain
• Acute aortic dissection
• Pulmonary embolus
• Pericardial effusion
• Pleural effusion
• Vascular disease
• Chest trauma
• Pneumonia follow up
• Haemoptysis
• Non specific chest pain
• Chest trauma
• Upper respiratory tract infection
• Chronic obstructive lung disease
• Chest masses
• Chest infection ( consolidation )
• Pneumothorax
• Hydropneumothorax

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• Chest Projections

Basic views PA/ AP Upright Lateral RAO /
LAO RPO/LPO
PA chest Exposure factors
Kv mAs FFD (cm) Grid Focus Cassette
75-80 15 180 non broad 35x43

• Patient Position
• Patient erect, feet spread slightly, weight
  Distributed on both feet
• Chin raised resting against cassette
• Hands on lower hips, palms out and
• elbows flexed

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• Part position
• Align Medial sagittal plane to midline
• of cassette
• Ensure no rotation of thorax
• Rotate shoulders forward to allow scapula
• to move laterally away from lung fields
• Depress shoulders to downward to move
• clavicles below the lung apices
• Make exposure at end of second full inspiration
• Central Ray
• Perpendicular to medial sagittal plane
• Center Point
• At level of T7 (Inferior angle of scapula )

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• Structure shown
• Both lungs from apices to costophrenic angles
• The air filled trachea from T1 down
• Hilum region markings
• Heart great vessels
• Bony Thorax

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• AP Chest (For Stretcher or bed patients

• Patient Position
• Patient is supine in cart
• If possible raised the headedcart or bed

• into a semi erect position
• Role patient shoulders forward by rotating
  armmedially or internally
• Part Position
• Align Medial sagittal plane to midline
• of cassette
• Ensure no rotation of thorax
• Top of film 4-5 cm above shoulders
• Place caste crosswise to avoid lateral cutoff
• Make exposure at end of second full inspiration
• Central Ray
• Angled caudad to be perpendicular to long
• axis of the sternum
• Center Point
• At level of T7 (3-4 inches below jugular noch

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• AP Chest (For Stretcher or bed patients

• Patient Position
• Patient is supine in cart
• If possible raised the headedcart or bed

• into a semi erect position
• Role patient shoulders forward by rotating
  armmedially or internally
• Part Position
• Align Medial sagittal plane to midline
• of cassette
• Ensure no rotation of thorax
• Top of film 4-5 cm above shoulders
• Place caste crosswise to avoid lateral cutoff
• Make exposure at end of second full inspiration
• Central Ray
• Angled caudad to be perpendicular to long
• axis of the sternum
• Center Point
• At level of T7 (3-4 inches below jugular noch

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• Structure shown
• Both lungs from apices to costophrenic angles
• The air filled trachea from T1 down
• Hilum region markings
• Heart will appear enlarged due to
• magnification from short FFD
• Bony Thorax
• Notes
• Crosswise alignment of cassette need accurate
  perpendicular
• alignment of central ray to cassette to avoid
  grid cutoff
• If pleural effusion is suspected decubitus
  position is recommended
• to demonstrate air-fluid level