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Chest X-Ray
 
 

Chest X-Ray Projection

February 15th, 2021
 
 
 
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Overview

The projection of the chest x-ray refers to the direction that the x-rays travel through the body. This is determined by the placement of the x-ray generator and the x-ray plate.
Different projections are used in various clinical situations, and can affect the interpretation of the x-ray.

Posterior-Anterior (PA)

In order to take a PA film, the x-ray plate is placed in front of patient, with the beam travelling from posterior to anterior.
The PA film is the most common film, and is usually only taken in X-ray departments.
  • Example

  • A PA film - note the normal mediastinal size.
  • A PA film - note the normal mediastinal size.
     

Anterior-Posterior (AP)

In order to take an anterior-posterior film, the x-ray plate is placed behind the patient, resulting in enlargement of the mediastinum.
This type of film is usually taken in acute / critical care settings, where a patient is sitting up in bed and the plate can be placed behind them.
  • Example

  • An AP film - note the artificially enlarged mediastinum.
  • An AP film - note the artificially enlarged mediastinum.
     

Lateral

In order to take a lateral film, the x-ray plate is placed beside the patient.
A lateral film provides a side view of the chest - this is especially useful for identifying a lobe affected by consolidation.
  • Example

  • A lateral chest xray demonstrating right middle lobe consolidation.
  • A lateral chest xray demonstrating right middle lobe consolidation.
     

Overview

On an AP or PA film, don't comment on specific lobes of the lung as the lobes overlap. Instead refer to the right / left upper, middle and lower zones.
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