CXR’s can be misleading, some common points to be aware of:

Erect vs supine (fluid layering):

1erectsupine

AP view can magnify the heart (PA vs AP):

1paap

Rotation – are the spinous processes centered between the medial edges of the clavicles? Note how heart width changes with rotation.

1rotation

Penetration – vertebral bodies should be just visible behind the heart

1penet 1penet2

Inspiration – should be about 9-10 posterior ribs seen

1inspiaration1 1inspiration2

Labeled ribs:

1ribs2

1ribs1

 

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