Lesson 1Cardiac silhouette and pericardial contours: right and left heart borders, normal cardiothoracic ratioCovers normal cardiac silhouette on PA chest radiographs, including right and left heart borders, great vessel interfaces, and cardiothoracic ratio. Teaches how to measure, describe, and differentiate normal variants from true cardiomegaly.
Right heart border and right atrial interfaceLeft heart border and left ventricular contourPulmonary artery segment and aortic knobMeasuring the cardiothoracic ratio on PAPericardial fat pads and normal variantsLesson 2Lungs zones and common normal variants: apices, mid zones, bases, emphysematous changes, scarring vs. acute processesExplores division of lungs into apical, mid, and basal zones on PA radiographs. Discusses common normal variants, including mild scarring, emphysematous changes, and age-related patterns, and how to separate them from acute pathology.
Defining apical, mid, and basal lung zonesNormal vascular pattern in each lung zoneApical pleural thickening and old scarringAge-related hyperinflation and emphysemaDistinguishing chronic change from acute opacityLesson 3Pleura and diaphragms: costophrenic angles, hemidiaphragm contours, normal pleural reflectionsReviews normal pleural reflections and diaphragmatic contours on PA chest radiographs. Focuses on costophrenic angles, hemidiaphragm shape, gastric bubble, and subtle pleural lines to avoid overcalling effusions or pneumothorax.
Sharp costophrenic and cardiophrenic anglesRight versus left hemidiaphragm heightGastric bubble and subdiaphragmatic gasNormal pleural reflections and fissure linesSubpulmonic effusion mimics and pitfallsLesson 4Common technical pitfalls and how they alter anatomy appearance: rotation, AP vs PA projection effects, under/overexposureExplains how technical factors modify apparent thoracic anatomy on PA and AP radiographs. Focuses on rotation, projection, exposure, and inspiration, showing how each can mimic or obscure disease and how to recognise suboptimal images.
Assessing rotation using clavicular headsAP versus PA projection and heart sizeEffects of underexposure on lung detailEffects of overexposure on mediastinal linesInadequate inspiration and crowding of vesselsLesson 5Mediastinal and central thoracic landmarks: trachea, carina, main bronchi, aortic knuckle, superior mediastinumReviews key mediastinal and central thoracic landmarks on PA chest radiographs. Emphasises recognition of normal positions, contours, and relationships of airway, great vessels, and superior mediastinum to distinguish normal from pathology.
Tracheal air column and midline alignmentCarina position and main bronchi anglesAortic knuckle and aortopulmonary windowSuperior mediastinal width and contoursRight and left paratracheal stripesLesson 6Chest wall and osseous structures: ribs, clavicles, scapulae, vertebral bodies and typical appearances on PA viewCovers normal appearance of chest wall and osseous structures on PA radiographs. Includes ribs, clavicles, scapulae, sternum, and thoracic spine, emphasising alignment, cortical outlines, and common benign variants that mimic disease.
Anterior and posterior rib contoursClavicular alignment and rotation cluesScapular borders and projection artifactsThoracic vertebral bodies and disc spacesSternal and costochondral joint variantsLesson 7Reference sources and image atlas orientation: how to use standard textbooks and online radiology teaching libraries to confirm normal appearancesGuides use of reference texts and online image atlases to confirm normal chest radiographic anatomy. Covers atlas navigation, search strategies, and comparing patient images with curated normal examples for self-directed learning.
Selecting core chest radiology textbooksNavigating online teaching file librariesComparing patient films with normal atlasesUsing annotated images to learn landmarksBuilding a personal reference image archiveLesson 8Systematic reporting checklist for a normal PA chest X-ray: at least 10 structures to comment on and sample normal descriptionsProvides a structured, reproducible checklist for reading a normal PA chest radiograph. Guides learners through stepwise review of lines, bones, soft tissues, lungs, pleura, mediastinum, heart, diaphragm, and upper abdomen with sample normal phrases.
Initial image details and technical assessmentSoft tissues, chest wall, and visible neckBones: ribs, clavicles, scapulae, spineMediastinum, trachea, and cardiac silhouetteLungs, hila, pleura, diaphragm, upper abdomenLesson 9External patient factors and correct PA technique: positioning, inspiration, rotation, exposureDescribes correct patient positioning and PA technique for chest radiography. Highlights effects of rotation, inspiration, scapular positioning, and exposure on image quality, and provides practical criteria for accepting or repeating images.
Standard PA positioning and focal distanceChin, scapulae, and arm placementEvaluating adequacy of inspiration on PARotation assessment using spinous processesExposure criteria for mediastinum and lungsLesson 10Pulmonary hila and vasculature: pulmonary arteries and veins, bronchovascular markings, hilar symmetryDetails normal appearance of pulmonary hila and vascular structures on PA radiographs. Emphasises relative positions, size, and density of hilar shadows, bronchovascular markings, and vascular tapering from central to peripheral lung zones.
Right versus left hilar position and heightNormal hilar vessel size and densityBronchovascular markings to lung peripheryVascular tapering and pruning patternsRecognizing normal hilar lymph node silhouettes
