VH Dissector: Chest X-Ray

Standard frontal view, and preferred position for routine adult CXR.

Patient stands upright with their chest placed against the film cassette. Shoulders are rotated forward enough to touch the film, ensuring that the scapulae do not obscure a portion of the lung fields.

During a full inspiration, the x-ray beam travels from behind the person in the posterior to anterior direction (hence, a PA film). 

As is typical in radiology, the PA film is interpreted as if the patient is standing facing you.

Complements the PA (frontal view). Seeing the front and side views, allows us to create a 3-D image out of two 2-D images - useful when localizing a lesion. 

Patient stands upright with usually the left side of the chest against the film cassette and the arms raised over the head. 

Allows “retrocardiac” space and diaphragmatic dome to be viewed.

Used when a patient is debilitated, immobilized, or unable to perform the PA procedure.

Commonly referred to as a “portable” or “bedside” film.

Film cassette is placed behind the patient's back with the patient in the upright or supine position. X-ray beam travels in the anterior to posterior direction (hence, an AP film).

The heart is at a greater distance from the film cassette in an AP compared to the PA view hence it appears more magnified than in a PA view.

The scapulae are usually visible in the lung fields because they are not rotated out of the view as they are in a PA film.

Heart is significantly magnified. So, note for the future - You cannot reliably determine cardiomegaly on AP film!