Chest X-ray quality

Tutorial conclusion

Complete assessment of a chest X-ray requires consideration of image quality. This involves scrutiny of inclusion, projection, rotation, inspiration/lung volume, penetration and artifact.

A poor quality chest X-ray does not always need to be repeated. You should see if the clinical question can be answered and only request a repeat if the patient is likely to benefit.

You should assess the entire image even if is quickly seen to be less than perfect. Many technically sub-optimal chest X-rays show life-threatening abnormalities that require urgent action!

Tutorial Key Points

  • Image quality influences conclusions
  • Check the image for - Inclusion, Projection, Rotation, Inspiration, Penetration and Artifact
  • Quality is influenced by radiographic technique and patient factors
  • Check to see if a poor quality X-ray demonstrates a life threatening abnormality before dismissing it
  • Can the clinical question still be answered?

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