Chest X-Ray Interpretation for UPSC CMS: 15 Signs and Patterns Every Aspirant Must Recognize

Systematic Approach (ABCDE)#

Airways: Trachea midline/deviated. Endotracheal tube position.
Bones: Ribs, clavicles, scapulae, humeri. Fractures, lytic lesions.
Cardiac: Cardiac size (CTR <0.5), cardiac borders, aortic knuckle.
Diaphragm: Right higher than left, costophrenic angles sharp.
Everything else: Lung fields, mediastinum, hila.

15 Key Signs#

1. Air bronchogram = consolidation
2. Bat wing = pulmonary edema
3. Silhouette sign = right middle lobe collapse
4. Honeycombing = interstitial lung disease
5. Cavity = TB, abscess, cancer
6. Coin lesion = granuloma vs cancer
7. Pleural effusion = blunted costophrenic angle
8. Pneumothorax = visceral pleural line, no vessels beyond