Normal Chest X-Ray PA view

📄 SonoAcademy

NORMAL
CXR-PA VIEW

Understanding a Healthy Chest X-Ray Appearance

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Reporting Panal

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Chest Pathology

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Case Study

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📋 FINDINGS:

PA chest radiograph demonstrates normal cardiac size and mediastinal contours. Both lungs are adequately expanded and clear. No focal parenchymal infiltrate, collapse, pleural effusion, or pneumothorax is identified. Hilar structures are normal. Costophrenic angles are preserved. No acute bony abnormality is evident on the visualized thorax.

🔖 CONCLUSION:

Normal PA chest examination.

💡 RECOMMENDATION:

Routine clinical follow-up. No radiographic evidence of active chest pathology.

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CHEST PA VIEW DIAGNOSTIC STRATEGY

1. Verify Image Quality – Check patient positioning, rotation, inspiration, exposure, and marker placement.
2. Airway – Trachea should be central without deviation.
3. Mediastinum – Assess width, contours, and hilar regions.
4. Heart – Evaluate cardiac size and cardiothoracic ratio.
5. Lungs – Examine both lung fields for infiltrates, masses, nodules, or collapse.
6. Pleura – Look for pleural effusion or pneumothorax.
7. Diaphragm – Assess contour, position, and costophrenic angles.
8. Bones & Soft Tissues – Review ribs, clavicles, scapulae, spine, and visible soft tissues.

NORMAL HOT KEYS

• Trachea central
• Cardiac silhouette normal size
• Mediastinum normal width
• Lungs clear bilaterally
• No focal consolidation
• No pleural effusion
• No pneumothorax
• Costophrenic angles sharp
• Hilar structures normal
• Diaphragms well defined
• No acute osseous abnormality

ABNORMAL HOT KEYS

• Tracheal deviation
• Cardiomegaly
• Mediastinal widening
• Focal lung opacity / infiltrate
• Lobar collapse (atelectasis)
• Pulmonary edema
• Pleural effusion
• Pneumothorax
• Mass or pulmonary nodule
• Hyperinflation (COPD)
• Fibrotic changes
• Rib fracture or destructive bony lesion

⚙️ CHEST PA VIEW EXPOSURE FACTORS

Patient Type	kVp	mAs	SID	Grid	AEC
Pediatric (5–10 yrs)	90–100	1–2	180 cm (72")	No	Optional
Small Adult	110–120	1–2	180 cm (72")	Yes	Center Cell
Average Adult	120–125	1.5–3	180 cm (72")	Yes	Center Cell
Large Adult	125–130	2–5	180 cm (72")	Yes	Center Cell
Bariatric Patient	130–140	4–8	180 cm (72")	Yes	Center Cell

💡 CHEST PA VIEW TECHNIQUE TIPS

• Projection: PA Erect
• IR Size: 35 × 43 cm (14 × 17 inch)
• SID: 180 cm (72 inch)
• Breathing: Full inspiration (2nd deep breath)
• AEC: Center chamber preferred
• Grid: Required for adult chest imaging
• Exposure Time: As short as possible (<10 ms preferred)
• Collimation: Include lung apices to costophrenic angles
• Patient Position: Upright, shoulders rolled forward