Check the available data about the patient and take a note about his history then start to follow these few easy steps to read his chest X-ray: Step 1 Find the airway. This involves looking for the trachea and the main bronchi and also checking to make sure that the trachea is centered. Step 2 Locate the clavicle, ribs and sternum. Check for fractures. Step 3 Look at the diaphragm and make sure the margins and edge of it are sharp. A fuzzy margin may indicate that there is fluid at the bottom of the lungs or around the diaphragm. Step 4 Look for the gastric air bubble. It should be on the right hand side of the X-ray and indicates that the stomach is located properly. Step 5 Look for areas of heightened contrast in the lungs. A localized area can indicate a tumor or localized infection. Source
These are the fissures that divide the lobes of the lungs from each other. The Costo-phrenic angle is the base or lower most corner of the left lung, and gets it's name from costal (pertaining to the ribs) and phrenum (to divide) and is where the diaphragm divides the lungs from the gastric area. More info here: en.wikipedia.org/wiki/Costophrenic_angle
I´m pneumonologyst and i learned to read a chest x ray in that way. My teachers were Felson´s disciples. Thanks a lot
Now there is a young member who enlightens us by telling that in costophrenic the part 'phrenic' is derived from phrenum that means 'to divide', while in all of the world it means diaphragm and costophrenic angle is the angle between the ribs and diaphragm!
centring of the x-ray......this is most important......as due to improper centering will lead to wrond diagnosis...
Chest radiographs are the most requested radiogrsphic investigation, simple, cheap and easy to interpret. so learning to report them will surely helpnin clinical practice.