Radiology Guides Anatomy Physio & Path Medicine Physics Contact


1. Shape

  • Appear as gentle C shapes on either side without lumps or bumps.
  • Contents: pulmonary arteries + veins, bronchi, lymph nodes.

2. Position

  • Left hila is ALWAYS (< 2cm) higher than the right.
  • A low left/right hilum could mean that it is either pushed/pulled up or down.

3. Size - Nodal vs. Vascular enlargement

  • Vascular enlargement - appear like ‘elephants’ trunks, bilateral. Cause: pulmonary hypertension.
  • Nodal enlargement - appears craggy. May be due to rotation or skeletal abnormality (scoliosis). Beware: the lesion may not be in the hila.

4. Interval change

  • For any suspected pathology, comparison to previous imaging is the first step to further evaluation.


1. Goodman, L. and Felson, B. (2015). Felson's principles of chest roentgenology. 3rd ed. Philadelphia, PA: Elsevier, Saunders.
2. Dähnert W. Radiology Review Manual. LWW. (2011) ISBN:1609139437. Read it at Google Books - Find it at Amazon
3. Elizabeth Puddy, Catherine Hill; Interpretation of the chest radiograph, Continuing Education in Anaesthesia Critical Care & Pain, Volume 7, Issue 3, 1 June 2007, Pages 71–75, https://doi.org/10.1093/bjaceaccp/mkm014

Ⓒ A. Manickam 2018

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