This is a short guide to interpretation of chest radiographs aimed at all those involved in clinical situations where reviewing chest radiographs is an integral part of practice. The author states at the beginning: “I offer a practical approach to chest X-ray interpretation, which may be of use to doctors and other healthcare professionals who need to develop these techniques as part of their assessment, diagnosis, and management of patients.” This is a commendable objective, but is let down in the most fundamental way by the very limited quality of the chest radiographs.

To facilitate observation of abnormalities such as pneumothorax, the images need to be of high quality. Even for a reader with an experienced eye and knowing the diagnosis, many of the abnormalities were imperceptible on the images provided in the book. In addition, inaccuracies in the text, such as on page ix where the author states an example of pulmonary oedema and then lists the reasons for this including cardiomegaly (although the chest radiograph is clearly labelled as supine and as such assessments of cardiac size cannot be made), reduce the credibility of the author and the text.

The author has attempted to lighten the text by offering hints such as reviewing the chest radiograph from the posterior aspect rather than the anterior aspect “as it is often easier to see posterior shadows this way.” There is no evidence that such manoeuvres are helpful and the author does not give any references where these techniques have been validated.

Overall this is a well-meaning pocket book with a number of good cases, but it is badly let down with the quality of the images and its rather old-fashioned approach to the chest radiograph that leads the reader to believe that the chest radiograph is a stand-alone imaging modality—which it is in a few cases—but it fails to put it in context with other more sophisticated methods of investigating the chest, such as volume CT and MRI.