Normal findings
- • Trachea midline, heart <50% of thoracic width (PA)
- • Costophrenic and cardiophrenic angles sharp
- • Both hila symmetric; vessels taper to periphery
Common abnormal findings
Consolidation
- • Lobar opacity with air bronchograms
- • Silhouette sign localises lobe
Pleural effusion
- • Blunted costophrenic angle
- • Meniscus on erect film
- • Layering on decubitus
Pneumothorax
- • Visceral pleural line
- • Absent lung markings beyond line
- • Tension = mediastinal shift away
Pulmonary oedema
- • Upper lobe diversion
- • Kerley B lines
- • Bat-wing perihilar shadowing
- • Effusions
Cardiomegaly
- • CTR >0.5 on PA film
- • Left atrial enlargement: double density, splayed carina
Interpretation tips
- • Always check ABCDEF: Airway, Bones, Cardiac, Diaphragm, Effusion, Fields
- • Compare with previous films when available
Clinical correlation
- • Correlate consolidation with cough, fever, raised inflammatory markers
- • Effusion → tap if >1 cm on decubitus
Common mistakes
- • Missing apical pneumothorax
- • Confusing skin fold for pneumothorax (no visceral line)
- • Missing free gas under diaphragm
Educational support only — not a substitute for clinical judgment.
