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Virtual Pediatric Hospital: Paediapaedia: Normal Chest Paediapaedia: Chest and Airway Diseases

Normal Chest

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed

Clinical Presentation:
Not applicable

Not applicable

Not applicable

Imaging Findings:
When interpreting a chest x-ray in a child, the entire film should be examined, not just the chest. Use of the "ABC" approach ensures that all areas of the film are systematically examined.

A - Abdomen, check for: bowel gas pattern suggesting ileus or obstruction, free intraperitoneal air, abnormal calcification, abdominal situs, diaphragm position.

B - Bone, check for: fractures, lytic or blastic lesions, metabolic bone diseases.

C - Chest, check for: midline trachea and mediastinum, abnormal mediastinal and cardiac contours, position of the aortic arch, pleural effusions, pulmonary vascularity, pneumomediastinum, pneumothorax, pneumopericardium, infiltrates, atelectasis.

In older infants and children, a good inspiratory chest film is one in which the relationship of the 6th anterior rib ends intersect the domes of the diaphragm.


Haller JO, Slovis TL: Introduction to radiology in clinical pediatrics. Yearbook Medical Publishers (Chicago) 1984.

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