Recognizing a Technically Adequate Chest Radiograph

This chapter will enable you to evaluate the technical adequacy of a chest x-ray by helping you become more familiar with the diagnostic pitfalls certain technical artifacts can introduce. This is important so that you don't mistake technical deficiencies for abnormalities.

Evaluating the Chest Radiograph for Technical Adequacy

Evaluating five technical factors will help you to determine if a chest radiograph is adequate for interpretation or whether certain artifacts may have been introduced which can lead you astray ( Table 2.1 ):

Penetration
Inspiration
Rotation
Magnification
Angulation

TABLE 2.1

What Defines a Technically Adequate Chest Radiograph?

Factor	What You Should See
Penetration	The spine through the heart
Inspiration	At least eight to nine posterior ribs
Rotation	Spinous process should fall equidistant between the medial ends of the clavicles
Magnification	Anteroposterior (AP) films (mostly portable chest x-rays) will magnify the heart slightly
Angulation	The clavicle normally has an “S” shape and the medial end superimposes on the 3rd or 4th rib

Penetration

Unless x-rays adequately pass through the body part being studied, you may not visualize everything necessary on the image produced.
- To determine if a frontal chest radiograph is adequately penetrated, you should be able to see the thoracic spine through the heart shadow ( Fig. 2.1 ).