Normal Chest X-rayMany of my patients asked me about the normal chest x-ray criteria if they take an x-ray. I want to share about this to all mothers in the world, so if they have relative, children or her husband have x-ray photo of the lung know about the abnormality indications.

You can see the part names of the Chest first and show you the normal limit signs.  The normal criteria, you can stick from Chest x-ray examination. In this moment I just explain the general descriptions as follows :

1. Lung

Lung contains of 2 lobes, right and left regions. They are usually a black sign in normal condition. “Why is it a black sign?” –> Yes, because they have a lot of air inside. If your lung apex has a white sign, it indicates like bronchovascular markings are coarse or increased that is a sign of Tuberculosis or Specific Process. It can be old process of active pulmonary disease depending on the texture.

There is a white sign on the bronchilar or hilar regions, it’s called Bronchitis. Bronchopneumonia can be seen if the coarse on the lower area of the chest. Chest mass is also can be noticed if the white sign is compact, sharp border, round shape with specific contour.

2. Sinus (Costophrenic Angle)

Sinus of the lung can be right and left. They have a sharp shape for the normal chest. If you see the shape if not sharp (It’s blunting), it indicates some abnormalities like pleural effusion, pleuritis or pleural reaction. For pleural effusion, the sinuses contain fluid collection. Many causes of this disease because of lung infection, chest problem or impact of the liver problem.

3. Heart

The normal heart size if the CTR (Cor Thoracic Ratio) is not more than 50%. If the size is bigger than 50%, it’s called Cardiomegaly or Heart enlargement. You see on the picture, an aortic knob is normal, but if there is enlarged indicates a hypertension. Many of other heart diseases can be detected by chest x-ray like ASHD, Heart failure, calcification, post operation, etc. To support the chest x-ray diagnosis, it could be added by ECG Test (Electro Cardiography) which heart test to know about the physiology function of the Cor.

4. Bones

Bones on the chest are not only the ribs but also clavicle, scapula, spinal process, etc. Any fractures or abnormality can be seen by chest x-ray. Fracture kind of the rib such as line fracture, complete, greenstick, oblique or multiple fractures. For complicated or multiple fracture is needed for operation to fix it, but for small/line fracture, I think no need for further operation. You just take pain killer and some medications until your problem recovered. For patient who suffered the lung fractures is usually difficult to breath.


Diaphragm of the right side is higher than the left side due to the liver position. If you see the black sign of the left lower diaphragm, it’s an air within the stomach. Don’t worry, it isn’t an abnormality.

I think my descriptions of the normal chest x-ray criteria is enough and for more detail of this case, you can ask your Doctor or learn Standard Radiography of the Chest comparing with CT-Scan, so you can see in different view and the other aspects. In this post, at least you know the normal chest x-ray in generally.

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Filed under: Radiology

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