- CXR INTERPRETATION -

Question 1

Outline the DRSABCDES approach to CXR Interpretation

Answer 1

Details/Identification
RIPE (assessing image quality)
(Soft tissues)
Airway & Mediastinum
Breathing & Bones
Circulation
Diaphragm
Extras/Equipment
Soft tissues

Question 2

Discuss what is involved in the ‘Details/Identification’ section of CXR Interpretation

Answer 2

• Always check you have the right patient with the right film
• That you have the right date/time of the film
• Is the X-ray AP or PA
• Supine or erect
• Where is the L or R marker

Question 3

Discuss what is involved in the ‘RIPE’ section of CXR Interpretation

Answer 3

Rotation
• are the clavicles meeting at the sternum? Is it centred?

Inspiration
• you should be able to see 8-10 posterior ribs

Picture
• can you see the entire lung fields and the scapulae?

Exposure
• can you see the spinous processes/spinal column

Question 4

Discuss what is involved in the ‘Airway’ section of CXR Interpretation

Answer 4

Position of trachea
Carina
ETT placement

Question 5

Discuss what is involved in the ‘Breathing/Bones’ section of CXR Interpretation

Answer 5

Breathing (Lungs)
• Lung markings/fields
• Is there a pneumothorax? Look at the apices
• Is there evidence of fluid or consolidation
• Is there any other lung pathology

Bones (Ribs, Clavicles, Scapula, Spine, Shoulder, Humerus)

Question 6

Discuss what is involved in the ‘Circulation’ section of CXR Interpretation

Answer 6

Heart
• size < 50% diameter of thoracic space
• borders
• position - 2/3 should be on L) side of chest
Mediastinum
• size
• position

Question 7

Discuss what is involved in the ‘Diaphragm’ section of CXR Interpretation

Answer 7

Diaphragm
Shape
• concave
Height
• R) 1-3cm higher than L)
Costaphrenic angle
Gastric bubble

Question 8

Discuss what is involved in the ‘Equipment’ section of CXR Interpretation

Answer 8

Monitoring
ETT
NGT
ICC
CVC
PA Catheters
PICC
PPM/AICD

Question 9

Discuss what is involved in the ‘Soft Tissue’ section of CXR Interpretation

Answer 9

Looking for things like:
• Subcutaneous air
(subcutaneous emphysema)