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Patient identifiers
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Date & time of film
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Indication & previous imaging
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Quality: Projection (usually PA erect), Exposure/Inspiration (top to diaphragm, 5-6 ribs anteriorly), Penetration (vertebrae visible behind heart)
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Obvious abnormalities (include which zone), foreign bodies & artefacts (e.g. drains)
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Airways: tracheal deviation, masses, carina & bronchi, hilar structures
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Breathing: compare each lung field zone & trace pleural margins
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Cardiac: cardiothoracic ratio if PA, borders and angles
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Diaphragm: flattening, angles and air under the diaphragm
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Everything else: soft tissue, fractures, artefacts, aortic knuckle displacement
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Airways:
- Trachea deviates towards a collapse or pneumonectomy, away from a tension pneumothorax or pleural effusion
- Hila contain vessels and major bronchi. Enlargement can occur in sarcoidosis (usually bilateral) or malignancy (usually asymmetrical or unilateral)
- Divide into upper/middle & lower zones. Trace margins to identify a pneumothorax or pleural thickening
- The cardiothoracic ratio should be less than 50%. RA makes the right border and LV makes most of the left border. Unclear borders suggest consolidation and collapse.