Assess image quality
Next, you should assess the quality of the image: a mnemonic you may find useful is ‘RIPE’.

Rotation
The medial aspect of each clavicle should be equidistant from the spinous processes.

The spinous processes should also be in vertically orientated against the vertebral bodies.

Inspiration
The 5-6 anterior ribs, lung apices, both costophrenic angles and the lateral rib edges should be visible.

Projection
Note if the film is AP or PA: if there is no label, then assume it’s a PA film (if the scapulae are not projected within the chest, it’s PA).

Exposure
The left hemidiaphragm should be visible to the spine and the vertebrae should be visible behind the heart.


ABCDE approach
The ABCDE approach can be used to carry out a structured interpretation of a chest X-ray:

Airway: trachea, carina, bronchi and hilar structures.
Breathing: lungs and pleura.
Cardiac: heart size and borders.
Diaphragm: including assessment of costophrenic angles.
Everything else: mediastinal contours, bones, soft tissues, tubes, valves, pacemakers and review areas.




AND MUCH MORE.........

NOTE: IT MAY NEED INTERNET CONNECTION