Normal chest X-ray report template
A normal chest X-ray report for a PA view, PA and lateral views, and an AP portable film. Placeholders in [ ] are the parts to confirm on every study.
CHEST X-RAY, 1 VIEW (PA)
HISTORY: [ ]
COMPARISON: None.
FINDINGS:
The cardiac silhouette is unremarkable.
The hilar and mediastinal structures appear unremarkable.
There are no focal infiltrates.
There is no pleural effusion. No pneumothorax.
No acute osseous findings.
IMPRESSION:
No acute cardiopulmonary process.CHEST X-RAY, 2 VIEWS (PA AND LATERAL)
HISTORY: [ ]
COMPARISON: None.
FINDINGS:
The cardiac silhouette is unremarkable.
The hilar and mediastinal structures appear unremarkable.
There are no focal infiltrates.
There is no pleural effusion. No pneumothorax.
No acute osseous findings.
IMPRESSION:
No acute cardiopulmonary process.CHEST X-RAY, 1 VIEW (AP PORTABLE)
HISTORY: [ ]
COMPARISON: None.
FINDINGS:
The cardiac silhouette is unremarkable.
The hilar and mediastinal structures appear unremarkable.
There are no focal infiltrates.
There is no pleural effusion. No pneumothorax.
No acute osseous findings.
IMPRESSION:
No acute cardiopulmonary process.Plain text. Pastes cleanly into PACS, RIS, PowerScribe, Word, or a browser. Fields in [ ] need your input. Add it to your collection to keep your own edited copy and share it with colleagues.
What to check before you sign a normal Chest X-ray
A normal template is only safe if you have looked at everything it mentions.
- Projection and quality. Confirm PA or AP, rotation, inspiration, and penetration before judging heart size or the mediastinum.
- Review areas. Apices, behind the heart, below the diaphragm, and the hila are where nodules and consolidation hide.
- Pleura and costophrenic angles. A small effusion blunts the angle. A pneumothorax edge is easiest to see at the apex on an erect film.
- Lines and tubes on portable films. Every device needs its tip position stated, even when the lungs are normal.
- Bones and soft tissues. Ribs, clavicles, shoulders, and the upper abdomen (free gas under the diaphragm) are part of a normal report.
Common mistakes with this template
Heart size called on an AP film
AP projection magnifies the heart. 'Cardiomegaly' on a portable film is often wrong, and 'normal heart size' can be too.
Lines and tubes forgotten
The PA template has no device line. On ICU and ward films, use the portable version so the tube positions are not missed.
Lateral view described on a PA-only study
Using the PA and lateral template when only one view was taken puts findings in the report that were never seen.
Questions
How do you report a normal chest X-ray?
State the projection, then the lungs, pleura, heart, mediastinum and hila, diaphragm, and bones and soft tissues in a consistent order, and finish with an impression such as 'No acute cardiopulmonary abnormality'.
What are the five components of assessing chest X-ray quality?
A common checklist is projection, rotation, inspiration, penetration (exposure), and coverage of the whole chest from the apices to the costophrenic angles.
What is a normal cardiothoracic ratio?
On a PA film, a cardiothoracic ratio under about 0.5 is usually considered normal. The ratio is not reliable on AP films.
Who wrote this template
Written by Dr Gayathri Priyadharshinee, radiologist, from the normal templates she uses in her own reporting. You are free to copy it and adapt the wording to your department's style.
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