• Check patient name, position, technical quality.

• Soft tissue including breast, chest wall, companion shadow.

• Review soft tissues and skeletal structures of shoulder girdles and chest wall.

• Review abdomen for bowel gas, organ size, abnormal calcifications, free air, etc.

• Review soft tissues and spine of neck.

• Review spine and rib cage: check alignment, disc space narrowing, lytic or blastic regions, etc.

• Review mediastinum:
1. overall size and shape
2. trachea: position
3. margins: SVC, ascending aorta, right atrium, left subclavian artery, aortic arch, main pulmonary artery, left ventricle
4. lines and stripes: paratracheal, paraspinal,paraesophageal (azygoesophageal), paraaortic
5. retrosternal clear space

• Review hila:
1. normal relationships
2. size

• Review lungs and pleura:
1. compare lung sizes
2. evaluate pulmonary vascular pattern: compare upper to lower lobe, right to left, normal tapering to periphery
3. pulmonary parenchyma
4. pleural surfaces
a. fissures - major and minor - if seen
b. compare hemidiaphragms
c. follow pleura around rib cage

• Labeled Images - - LINK -

• Chest Review - - LINK -