What should a technologist do if a posteroanterior (PA) chest radiograph shows the trachea superimposed over the spinous processes?

When a posteroanterior (PA) chest radiograph shows the trachea superimposed over the spinous processes, this indicates that the patient's shoulders are not adequately rolled forward during the imaging process. The proper technique for a PA chest X-ray involves having the patient extend their arms over their head or rolling their shoulders forward to allow for proper alignment of the trachea and the spine. This technique helps prevent superimposition, ensuring a clear image of the thoracic structures.

Rolling the shoulders forward effectively moves the clavicles down and away from the area of interest, which assists in obtaining a clearer view of the lung fields and mediastinum. This adjustment minimizes the potential for misinterpretation of the radiographic anatomy and improves the overall quality of the radiograph. Therefore, repeating the radiograph with the shoulders rolled forward is essential for achieving optimal image positioning in this situation.