1. Look for the presence of breast shadows ,it will help you to notice a mastectomy too
2.Try to use the patient's age to your advantage by making sensible suggestions. A 20 year old is much less likely to have malignancy than someone who is 60.
3.It's easy to get tied up in knots over this - and sometimes not get any further. The diaphragms should lie at the level of the 6th ribs anteriorly. The right hemidiaphragm is usually higher than the left because the liver pushes it up.
4. You should just be able to see the lower thoracic vertebral bodies through the heart.
5.The spinous processes of the thoracic vertebrae should be midway between the medial ends of the clavicles.
6.Most chest x ray films are taken posterior anterior (PA) - that is, the x rays shoot through from the back of the patient to the x ray plate in front of the patient. If the patient is too sick to stand up for this, an anterior posterior (AP) film will be done - that is, the x rays shoot through from front to back. An anterior posterior film will always be labelled as AP, so if nothing is written on the film it is safe to assume it is PA. PA films are better, particularly because the heart is not as magnified as on an AP film, making it easier to comment on the heart size.
7. some examiners like you to call x ray films radiographs; strictly speaking you can't actually see the x rays themselves!!!!
*So,simply you can describe it as"This is a postroanterior view of chest radiograph of a young male patient. The patient has taken a good inspiration and is not rotated; the film is well penetrated."