Oblique chest film: value in routine and selective use

A retrospective analysis is presented of 308 consecutive cases in which four views of the chest (right and left anterior oblique, posteroanterior, and lateral) were obtained. Most cases (257) were from adult cardiac clinics or thoracic surgery clinics, where the indications were for questionable cardiac abnormality, known cardiac abnormality, or thoracic malignancy. Fewer cases (37) were studied to attempt clarification of possible abnormality on routine films. Of the 257 routine studies, the oblique views yielded no further information in 97.6% of cases, and missed lesions in 1.3%. In the selective group, the oblique views provided information or confirmatory evidence in about 95% of cases when requested by radiologists. The results throw considerable doubt on the value of oblique films in routine studies, but suggest that they may still have a value in delineating possible abnormalities seen on other views or in cases of pleural disease.
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