To check for this, you can look for fine markings in the lung fields to make sure they are visible. Finally, we need to make sure that the exposure isn’t too bright or too dark. If the lungs are not fully expanded, we might miss important diseases. Next, a good inspiration film should show at least the 10th or 11th posterior ribs. Rotation throws off the usual X-ray anatomy and introduces unwanted variation. For example, to ensure there isn’t excess rotation of the patient, you should make sure that the medial ends of the spinous processes are equally distant from the border of the vertebral bodies. You also need to assess image quality, because this will impact the accuracy of the test in detecting pathology. You want to verify the patient’s data with the exam data (medical record number, date of the exam, etc.) to ensure that you are looking at the right study and patient. To avoid errors and wasted time, you should always begin by assessing the patient and exam data. Let’s go through this chest X-ray using an easy-to-remember checklist - associated with the first 7 letters of the alphabet: ABCDEFG.Ī stands for Assessment. In contrast, the sharp, bright white areas are where the dense bone material blocks photons from getting through. The darkest parts of the film like the lungs are areas where more photons can penetrate the body. Conventional x-rays that show white bones on a black background are like photographic negatives. Just like visible light, X-rays are less likely to penetrate denser materials. You can think of X-rays as high-energy photos that penetrate the body tissues so that we can see what’s going on inside.
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