Interpretation of plain chest roentgenogram.
Plain chest roentgenogram remains the most commonly ordered screening test for pulmonary disorders. Its lower sensitivity demands greater accuracy in interpretation. This greater accuracy can be achieved by adhering to an optimal and organized approach to interpretation. It is important for clinicians not to misread an abnormal chest radiograph (CXR) as normal. Clinicians can only acquire the confidence in making this determination if they read hundreds of normal CXRs. An individual should follow the same systematic approach to reading CXRs each time. All clinicians must make a concerted effort to read plain CXRs themselves first without reading the radiologist report and then discuss the findings with their radiology colleagues. Looking at the lateral CXR may shed light on 15% of the lung that is hidden from view on the posteroanterior film. Comparing prior films with the recent films is mandatory, when available, to confirm and/or extend differential diagnosis. This article outlines one of the many systematic approaches to interpreting CXRs and highlights the lesions that are commonly missed. A brief description of the limitations of CXR is also included.
Division of Pulmonary and Critical Care Medicine, New York Methodist Hospital, Brooklyn, NY. Electronic address: sur9016@nyp.org.
Suhail
S
Raoof
Department of Radiology, The Johns Hopkins University, Baltimore, MD.
David
D
Feigin
Division of Pulmonary and Critical Care Medicine, Beth Israel Medical Center, New York, NY.
Arthur
A
Sung
Department of Radiology, Jamaica Hospital Medical Center, Jamaica, NY.
Sabiha
S
Raoof
Division of Pulmonary and Critical Care Medicine, New York Methodist Hospital, Brooklyn, NY.
Lavanya
L
Irugulpati
Department of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.
Edward C
EC
Rosenow
D002983:Clinical Competence; D003937:Diagnosis, Differential; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging*; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed