A systematic approach for viewing chest X-rays ensures no important structures are ignored, but a flexible approach is required to suit each clinical setting.

In an OSCE/viva it is necessary to demonstrate a logical system. Although there is no agreed order of observation, you may find the sequence described in the chest X-ray anatomy tutorial helpful.

Here it is in brief.

This tutorial will help you develop your own system, starting with patient and image data, and image quality. You will go on to learn how abnormalities can be described and located. The tutorial also discusses the review of areas where abnormalities are easily missed.

In an OSCE/viva you will score more highly if you attempt to link the X-ray findings with the clinical features, and suggest management.