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 TeamJuly 31, 20264 min read

Modular reporting phrases converging into a coherent radiology report at a clinical workstation

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.

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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.

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.

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.

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.

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.

Common Reporting Phrases for Chest X-Rays

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Start with technical assessment

Normal examinations or no acute findings

Parenchymal opacity and consolidation

Atelectasis, volume loss, and chronic changes

Pleural and urgent findings

Cardiomediastinal and vascular findings

Tubes, catheters, and device position

Quick check before signing the report

References

Clinical use note

Stop rewriting these phrases from scratch

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.

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.

Related calculators

Continue learning

Start with technical assessment

Normal examinations or no acute findings

Parenchymal opacity and consolidation

Atelectasis, volume loss, and chronic changes

Pleural and urgent findings

Cardiomediastinal and vascular findings

Tubes, catheters, and device position

Quick check before signing the report

References

Clinical use note

Stop rewriting these phrases from scratch