Evaluating Chest Radiographs: Technical Considerations

What is a sign of proper patient positioning for an AP or PA projection?

What can scapular densities prevent in the periphery of the lung?

How is sufficient inspiration evaluated on a frontal projection of the chest?

What can occur if the patient does not provide adequate inspiration?

What is not adequately visualized without adequate inspiration?

What is the primary responsibility of the radiographer before submitting the radiograph for review?

What information should be included on the radiograph?

Why is correct marker placement important?

What is the consequence of an underexposed radiograph?

What is the effect of an overexposed film on the radiograph?

What is the advantage of digital images?

How is adequate exposure evaluated on a chest radiograph?

Why is it important to ensure the thoracic vertebrae are visible on the radiograph?

Evaluating a Chest Radiograph

The radiographer should evaluate the radiograph before submitting it for review by the radiologist to ensure technical adequacy.

Demographic Information and Marker Placement

Correct demographic information should include the patient's name, date and time of the exam, and age (or date of birth).
The correct anatomical side marker (right or left) should be visible on the final radiograph, but care should be taken to avoid covering anatomy.

Exposure

Adequate exposure is crucial to avoid false positive or negative results.
Underexposure can simulate pulmonary opacities, while overexposure can burn out essential anatomy.
Digital images can be manipulated and enhanced after processing.
Adequate exposure is evaluated by visualizing the thoracic vertebrae behind the heart, which should be faintly visible.

Positioning

The radiograph should not show signs of rotation.
On a correctly positioned AP or PA projection, the medial ends of the clavicles should appear equidistant from the spinous processes of the thoracic vertebrae.
On a well-positioned chest radiograph, the scapulae should not be seen in the lung field to avoid obscuring peripheral lung abnormalities.

Inspiration

Sufficient inspiration is crucial to avoid misinterpretation of lung markings and heart shadow.
Sufficient inspiration is evaluated by visualizing 10 posterior ribs above the diaphragm on a frontal projection of the chest.
Inadequate inspiration can lead to crowded lung markings, misinterpreted as an abnormality.

This quiz assesses the technical evaluation of a chest radiograph, including correct demographic information, marker placement, exposure, and position. It's essential for radiographers to ensure these factors are accurate before submitting the radiograph for review.