Introduction
A chest X-ray is one of the most common medical imaging exams. Whether for a routine check-up or due to cough, fever, or chest pain, doctors frequently order a chest film. This guide systemizes how to read a chest X-ray using the ABCDE method.
The ABCDE Systematic Approach
- A (Airway): Check if the trachea is central. Deviations suggest pressure imbalances (e.g., tension pneumothorax).
- B (Breathing): Observe the lungs. Air-filled lungs appear black. White patches suggest fluid, consolidation (pneumonia), or masses.
- C (Circulation): Assess the heart. The heart size should not exceed 50% of the chest diameter.
- D (Diaphragm): Diaphragms should be dome-shaped. Check for free air beneath them and blunt costophrenic angles (indicating effusion).
- E (Everything else): Check ribs, clavicles, and soft tissues for fractures or abnormal air.
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