Common Reporting Phrases for Chest X-Rays
Chest radiography is one of the most common examinations in daily practice. Even in a short report, however, ambiguity can arise when technical adequacy, location, extent, and...
RadPhrases Editorial Team4 min read
REPORTING PHRASES · CHEST X-RAY
Chest radiography is one of the most common examinations in daily practice. Even in a short report, however, ambiguity can arise when technical adequacy, location, extent, and clinical significance are not communicated clearly. A good phrase does more than name a finding: it also states where the finding is, how conspicuous it is, and the limitations under which it was assessed.
The sentences below are not ready-made diagnostic statements; they are examples designed to help structure reporting language. Every phrase should be adapted to the patient’s radiograph, acquisition technique, prior examinations, and clinical question.
| Important usage note The sentences in this article are educational examples. Prefabricated text does not replace image review or the radiologist’s clinical judgment. Laterality, level, size, technical adequacy, comparison, and impression must be reverified for every case. |
|---|
Start with technical assessment
| Scenario / purpose | Example reporting phrase and usage note |
|---|---|
| Technically adequate PA chest radiograph | The examination was obtained as a PA chest radiograph. Inspiration and exposure are adequate for diagnostic assessment. |
| Portable AP radiograph | The examination was obtained in the portable AP projection. Cardiomediastinal width and the lung bases were assessed with consideration of technique-related limitations. |
| Low lung volume | Assessment of increased basal parenchymal opacity is limited by low lung volume. |
| Rotation | Patient rotation limits assessment of the mediastinal contours. |
| Single-view examination | Assessment of the retrosternal and retrocardiac regions is limited because no lateral radiograph is available. |
Normal examinations or no acute findings
| Scenario / purpose | Example reporting phrase and usage note |
|---|---|
| General normal statement | The cardiomediastinal silhouette is within normal limits. No focal air-space opacity is identified. No pleural effusion or pneumothorax is present. |
| No acute cardiopulmonary abnormality | No radiographic evidence of acute cardiopulmonary abnormality. |
| Costophrenic angles | The costophrenic angles are sharp. |
| Heart size | The cardiothoracic ratio is within normal limits, accounting for the acquisition technique. |
| Comparison with prior examination | No significant interval change is identified compared with the prior examination. |
Parenchymal opacity and consolidation
| Scenario / purpose | Example reporting phrase and usage note |
|---|---|
| Focal air-space opacity | There is a focal air-space opacity in the right lower zone, partially obscuring the cardiac border. |
| Consolidation | There is consolidation with air bronchograms in the projection of the left lower lobe. |
| Patchy opacities | Patchy bilateral air-space opacities are present, more pronounced in the lower zones. |
| Indeterminate small opacity | A nodular opacity measuring approximately ... mm is present in the right upper zone. Comparison with prior examinations and, when clinically appropriate, further cross-sectional imaging may be considered. |
| Phrase to avoid | The term “infiltrate” may be interpreted differently by different clinicians when used alone. Whenever possible, describe the distribution and morphology of the opacity, such as consolidation, reticular opacity, nodular opacity, or linear atelectatic opacity. |
Atelectasis, volume loss, and chronic changes
| Scenario / purpose | Example reporting phrase and usage note |
|---|---|
| Linear atelectasis | A thin linear atelectatic opacity is present at the left lung base. |
| Subsegmental atelectasis | A subsegmental atelectatic band is present in the right mid-to-lower zone. |
| Lobar volume loss | Right upper lobe volume loss is present, with superior displacement of the fissure. |
| Chronic scarring | Pleuroparenchymal fibrotic scarring is present at the left apex. |
| Comparative statement | The basal linear opacities are similar to the prior examination and are compatible with chronic atelectatic/fibrotic change. |
Pleural and urgent findings
| Scenario / purpose | Example reporting phrase and usage note |
|---|---|
| Pleural effusion | There is a small right pleural effusion causing blunting of the right costophrenic angle. |
| Bilateral pleural effusions | Bilateral pleural effusions are present, greater on the left. |
| Pneumothorax | A right apical pneumothorax measuring up to approximately ... mm in thickness is present. |
| Features of tension | The pneumothorax is accompanied by mediastinal shift and findings of increased right/left hemithoracic pressure; urgent clinical communication is recommended. |
| Negative statement | No pleural effusion or pneumothorax is identified. |
Cardiomediastinal and vascular findings
| Scenario / purpose | Example reporting phrase and usage note |
|---|---|
| Cardiomegaly | The cardiomediastinal silhouette is enlarged. |
| Pulmonary vascular congestion | There is prominence of the pulmonary vasculature with redistribution to the upper zones. |
| Findings suggestive of edema | Bilateral perihilar and basal interstitial-alveolar opacities with pleural effusions may be consistent with pulmonary edema in the appropriate clinical setting. |
| Aorta | Atherosclerotic calcifications are present in the aortic arch. |
| Mediastinum | No significant widening of the mediastinal contours is identified. |
Tubes, catheters, and device position
| Scenario / purpose | Example reporting phrase and usage note |
|---|---|
| Endotracheal tube | The endotracheal tube tip is approximately ... cm above the carina. |
| Central venous catheter | The tip of the right internal jugular central venous catheter projects over the lower superior vena cava. |
| Enteric tube | The enteric tube courses below the diaphragm, with its distal tip projecting over the stomach. |
| Chest tube | The tip of the right chest tube projects at the level of .... |
| Post-procedural complication | No pneumothorax is identified following placement of the new device. |
Quick check before signing the report
- Does the acquisition technique affect interpretation?
- Are the laterality, zone/lobe, and extent of the finding clear?
- Was the morphology described instead of using an ambiguous term such as “infiltrate”?
- Was any change from the prior examination stated?
- If an urgent finding is present, was the need for direct communication outside the report considered?
References
- American College of Radiology. ACR Practice Parameter for Communication of Diagnostic Imaging Findings. Revised 2025. Source (opens in a new tab)
- Hartung MP, Bickle IC, Gaillard F, Kanne JP. How to Create a Great Radiology Report. RadioGraphics. 2020;40(6). Source (opens in a new tab)
- Bankier AA, MacMahon H, Colby T, et al. Fleischner Society: Glossary of Terms for Thoracic Imaging. Radiology. 2024;310(2):e232558. Source (opens in a new tab)
Clinical use note
This content is educational and is not patient-specific medical advice. Every phrase, template, classification result, and recommendation must be verified and adapted by a physician using the complete examination, clinical context, current guidelines, and institutional protocol.
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