The exam is expiratory, rotated, over or under penetrated, or limited by overlying structures or soft tissues, body habitus, patient positioning, or motion.

​There is a vascular line or lines present in an abnormal location or otherwise abnormal.

​There are other devices such as a chest tube or pleural drain, feeding, NG, or gastrostomy tube, LVAD or pacemaker, vascular stents, cardiac valves, anesthesia catheter, VP shunt, neurostimulator, or other drains or tubes present that are in an abnormal position or are otherwise abnormal.

​The superior mediastinum is abnormally widened considering the technique.

​There is abnormal shift of the mediastinum.

​There is a mass or other abnormal density in or overlying the mediastinum.

​There is an abnormality in the retrosternal, retrotracheal, or retrocardiac space on the lateral view.

​There is abnormal tracheal deviation or narrowing on the frontal and/or lateral view.

There is pneumomediastinum and/or pneumopericardium.

​There is enlargement of the cardiac silhouette.

The heart borders are abnormal.

​The right paratracheal stripe is thickened or enlarged.

​The azygoesophageal recess is displaced or otherwise obscured.

​The aorta is dilated, tortuous, ectatic, calcified, or there is a focal contour abnormality.

​The central pulmonary arteries or hila are enlarged.

​The aorto-pulmonary window is convex or obscured by a mass, adenopathy, or vasculature.

There is cephalization or haziness of the pulmonary vessels or congestion of the central pulmonary vasculature.

The lungs are hyperinflated or underinflated generally or segmentally.

​There is focal, multifocal, or diffuse airspace disease, mass, opacity, or nodularity.

There is focal or diffuse interstitial disease.

​There is focal or lobar atelectasis or total collapse of the lung.

​There is cavitary or cystic disease with or without air fluid levels or soft tissue nodularity.

​The position of the major and minor fissures is abnormal.

​The right or left hemidiaphragm is focally or diffusely obscured on the frontal and/or lateral view.

​There is elevation, depression, or contour abnormality of the right or left hemidiaphragm.

​There is focal or diffuse abnormality of the pleura or chest wall.

​There is a pleural effusion, blunting of the costophrenic angle, or posterior sulci.

​There is focal fluid in the fissures.

​There is asymmetric pleural thickening or capping of the apices.

There is a pneumothorax, hydro/pneumothorax, or hemo/pneumothorax.

​The ribs, clavicles, shoulder, spine, or other visualized bones are abnormal.

​There is free air beneath the diaphragm.

​The bowel or organs of the upper abdomen are abnormal.

​There is subcutaneous emphysema, focal or diffuse soft tissue abnormality, radiopaque foreign body, or post-surgical change or hardware.