High-Yield Chest X-Ray Anatomy (NEET PG Focus)
Systematic Interpretation (ABCDE)
| Letter | Focus Area |
|---|---|
| A | Airway (Trachea central, carina) |
| B | Breathing (Lung fields, pleural spaces, costophrenic angles) |
| C | Circulation (Heart size/Cardiothoracic ratio, mediastinal borders) |
| D | Diaphragm (Right hemidiaphragm is usually higher) |
| E | Everything else (Bones, soft tissues, tubes, lines) |
NEET PG “Must-Know” Pearls
- Silhouette Sign: Loss of normal radiographic border between two structures of the same density (e.g., if the right heart border is obscured, the pathology is in the right middle lobe).
- Cardiothoracic Ratio: Should be < 0.5 on a PA film. If > 0.5, it suggests cardiomegaly.
- Costophrenic Angles: Blunting on X-ray is a classic sign of pleural effusion (requires ~200-300 mL to be visible on PA film).
- Air Bronchograms: Visualization of air-filled bronchi against an opacified lung; classic for consolidation (e.g., lobar pneumonia).
- Tension Pneumothorax: Look for mediastinal shift *away* from the affected side and a deep sulcus sign.
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