X rays are radiation of short wavelengths which are produced when electrons hit a solid target. In the medical sense X rays are used to get a picture of the internal structure of the body namely the bones.  When an X ray is taken a film is put on the other side of the body and a shadow is produced. As different parts of the body absorb the rays differently the resulting picture can be interpreted easily.

INITIAL STEPS

  • Check the patients name is correct
  • Check the date, time & relevant health system numbers
  • Check how the image was taken PA vs. AP. (PA = through back of patient, AP= through front)
  • Check whether Supine or Erect

QUALITY OF IMAGE EXPOSURE

  • Pathologies may be missed if the image is under/over exposed
  • The interverterbral disc spaces should be visualized behind the heart
  • The pulmonary vasculature should be visualized

CHECK FOR ADDITIONAL INFORMATION

  • Inspiration?
  • Expiration?
  • Rotation? (Make sure the distance from each clavicle is equal)

SEARCH PATTERN

  • Start from the center of the image and work your way out to the periphery.
  • Look at the heart, mediastinum, lungs, pleural space, ribs, clavicles, diaphragm, subcutaneous tissues, neck and upper abdomen
  • Check Radiological Items
  1. Airway
  2. Bones
  3. Cardiac
  4. Diaphragm
  5. Effusion
  6. Fields (Lungfields)
  7. Gastric Air Bubble
  8. Hilum

WHAT ARE YOU SEEING?

WHITE = Bone (high absorption of X rays)

BLACK = Air

GREY = Tissue  (low absorption of X rays)