Learn How to Read a Chest X-Ray Using ABCDE

The A in the ABCDE method describes looking at the airway and appliances. Looking at the airways includes reviewing the mediastinum, tracheal positioning, and looking for aortic calcifications. Appliances that may be seen on X-rays include foreign bodies, cardiac monitors, ET tubes, chest tubes, prostheses, and central lines.

The B in the ABCDE method describes looking at bones. In this stage, you examine the bones, count the ribs, and look for clavicle and spine alignment. In the lateral view, you observe the structure and integrity of the vertebrae.

The C in the ABCDE method describes "cardiac" or "circulatory." Pathologies to be aware of include cardiomegaly, pulmonary edema, dextrocardia, and pericardial effusions.

The D in the ABCDE method of reading chest X-rays describes the diaphragm. In this stage, we compare the elevation of the diaphragm, gas patterns under the diaphragm, and look for hiatal hernias.

E describes "Everything else" in the ABCDE method of reading a chest X-ray. At this stage, the soft tissue, breast tissue, and lung parenchyma are described. This is always compared to previous CXRs. More specifically, things like pulmonary vasculature, pulmonary edema, costophrenic angles, pleural effusions, masses, nodules, and consolidations are noted.

In the "Everything Else" stage of reading a chest X-ray, masses are looked for and described. These should be compared against previous studies to note when the mass arose and how its size has changed.

"Everything else" is where the pulmonary vasculature is described. This stage includes describing artery and vein enlargement and noting pulmonary edema.

The lung parenchyma is reviewed last in the "everything else" segment of the chest X-ray read. Here, the lung fields are compared to each other, and effusions, thickening, and calcifications can be described.