Master Reading a Chest X-Ray with Picmonic for Medicine

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Reading a Chest X-Ray

Reading Chest X-Rays
Consistency is key, and using the ABCDE method for reading chest X-rays ensures that a structured approach is used to read these images. A is for appliances and airway, B is for bones, C is for cardiac, D is diaphragm, and E is everything else.
Airway and Appliances
A-airway deviation and Appliance

The A in the ABCDE method describes looking at the airway and appliances. Looking at the airways includes reviewing the mediastinum, tracheal positioning, and looking for aortic calcifications. Appliances that may be seen on X-ray include foreign bodies, cardiac monitors, ET tubes, chest tubes, prosthesis, and central lines.

B-bones Broken

The B in the ABCDE method describes looking at bones. In this stage you examine the bones, count the ribs, look for clavicle alignment, and spine alignment. In the lateral view, you observe the structure, and integrity of the vertebrae.

C-heart with fluid

The C in the ABCDE method describes "cardiac" or "circulatory." Pathologies to be aware of include cardiomegaly, pulmonary edema, dextrocardia, and pericardial effusions.


The D in the ABCDE method of reading chest X-rays describes the diaphragm. In this stage, we compare elevation of the diaphragm, gas patterns under the diaphragm, and look for hiatal hernias.

Everything Else
E-suitcase with Everything Else

E describes "Everything else" in the ABCDE method of reading a chest X-ray. At this stage the soft tissue, breast tissue, and lung parenchyma are described. This is always compare to previous CXRs. More specifically, things like pulmonary vasculature, pulmonary edema, the costophrenic angles, pleural effusions, masses, nodules, and consolidations are noted.


In the "Everything Else" stage of reading a chest X-ray, masses are looked for and described. These should be compared against previous studies to note when the mass arised, and how it's size has changed.

Pulmonary Vasculature
Lung Vessels

"Everything else" is where the pulmonary vasculature is described. This includes describing artery and vein enlargement, and noting pulmonary edema.

Lung Parenchyma
Lung Pear

The lung parenchyma is reviewed last, in the "everything else" segment of the chest X-ray read. Here, the lung fields are compared to each other, and effusions, thickening, and calcifications can be described.

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