CXR Interpretation

Question 1

What pneumonics do you use to;

• Assess CXR image quality
• Interpret a CXR

Answer 1

Image quality: RIPE
Interpretation: ABCDE

(RIPE- Rotation, Inclusion/ Inspiration, Projection/ Penetration, Exposure)

(ABCDE- Airway, Breathing, Cardiac, Diaphragm, Everything else)

Question 2

Describe Rotation of RIPE

Answer 2

• Medial aspect of each clavicle should be equidistant from spinous processes
• SPs should be vertically orientated against vertebral bodies

Question 3

Describe Inspiration/ Inclusion of RIPE (Asking patient to breathe in deeply as possible)

Answer 3

Should see;

• 5th to 6th Anterior ribs
• Lung apices
• Both Costophrenic Angles

Question 4

Describe Projection/ Penetration of RIPE

Answer 4

PA unless otherwise specified

If heart looks enlarged could be AP view rather than Cardiomegaly

Question 5

Describe Exposure of RIPE

Answer 5

Left hemidiaphragm should be visible

Spine should be visible behind heart

Question 6

Describe Airway of ABCDE

Answer 6

• Trachea (May be deviated)
• Carina and Bronchi
• Hilar structures

Question 7

Describe Breathing, Cardiac, Diaphragm of ABCDE

Answer 7

• Lungs
• Pleura
• Heart size
• Heart borders
• Costophrenic angles
• Location of diaphragm in relation to ribs

Question 8

Describe Everything else of ABCDE

Answer 8

• Bones
• Soft tissues
• Air beneath diaphragm
• Pacemaker
• Wires
• Central Access devices