Chest x ray how many ribs

The rib series is often considered to be an unnecessary, unjustified projection in many radiology departments. Indeed the Royal College of Radiologists UK iRefer guidelines state "Demonstration of a simple rib fracture does not usually alter management but if a complication such as pneumothorax or infection is suspected, chest radiograph would be appropriate" 2.

Thus if the projection might change the patient management it may still be considered pertinent and worthy of discussion. The isolated referral of a rib series in the assessment of rib trauma is controversial 1 however, still widely used. Ensure the projection is not performed under a chest examination AEC setting, this will not achieve the correct exposure to adequately present the bony structures of the thoracic cage.

Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Updating… Please wait. Unable to process the form. Check for errors and try again. Thank you for updating your details. Occasionally you will see an important abnormality of the bones on a chest X-ray such as bone metastases. Bone abnormalities may be very subtle, so always look carefully at all the bones when viewing a chest X-ray.

Figure-4 and 5. Supine views are less useful and should be reserved for critical patients who cannot stand erect position. You are able to see all vertebral bodies with obvious intervertebral spaces. The interpretation of a chest X-Ray should be approached systematically. You should also check the side marker, and the film position PA or AP.

The trachea, carina and both main bronchi are called the upper airway and should all be visible on an AP view Figure Look for if there is any deviation of the trachea away from the midline.

Introduction of air into one side of the chest cavity will cause that side of the lung to collapse. The collapsed lung will push the trachea to the opposite side and resulting in a deviation that will show up on chest X-Ray. Figure Airway structures on the chest X-Ray. A chest X-Ray provides a good view to look for ribs and clavicle fractures.

Clavicular fractures are usually at the middle 3rd of the clavicle, which is easy to see in chest X-Rays. Rib fractures, however, can sometimes be hard to see. Each rib should be followed across its length to look for fracture lines or step-offs that could indicate a fracture. Hyperinflated lungs are seen as the result of chronic obstructive pulmonary disease where the patient is unable to fully expel the air that is inhaled with every breath. Because of this, overinflation will result in a greater number of ribs that can be visible on the chest X-Rays.

Normally, ribs are expected to be seen on the chest X-Ray Figure Numbers: ribs, red dashed line and arrows: clavicle, yellow dashed line and arrows: medial border of scapula, green dashed line and arrows: 3rd rib, pink dashed line: vertebras. This part involves the heart and surrounding structures. The silhouette of the heart should be identified, and the heart borders should be clear. The aortic arch and the left pulmonary artery should be visible as two semi-circles above the left atrium.

The left hilar point is slightly higher than the right hilar point. The hilar point should be at the level of the lateral extent of the right 6th rib. The inferior vena cava lies end of the right cardiophrenic angle. The structures should be visible behind the heart especially the spine, paraspinal region and azygoesophageal line. In ideal circumstances, mediastinum is maximum 6 cm in a PA chest x-ray, and further investigation is considered if it is more than 8 cm.

Pink dashed lines and arrows: heart borders, Yellow dashed line and arrow: Aortic Arch, Blue circle, and arrow: Aortopulmonary Window. Sign Up. Become a Gold Supporter and see no ads. Log in Sign up. Articles Cases Courses Quiz. About Recent Edits Go ad-free. Diagnosis almost certain. Edit case Share Add to. Report problem with Case Contact user. Citation, DOI and case data. Bickle, I.