Retrospective Review Is the Best View: A Primer for Residents and Radiologists on Missed Findings in Chest Radiography.

Chest radiography (CXR) remains the most frequently performed imaging modality worldwide and serves as the first-line investigation for cardiopulmonary conditions. Despite its widespread use, interpretation is limited by the two-dimensional representation of three-dimensional anatomy, resulting in structural overlap and reduced lesion conspicuity. This review provides a structured, pattern-based approach to commonly overlooked regions on CXR, emphasizing key anatomical blind spots including the lung apices, pleura, trachea, lung bases, hila, mediastinum, retrocardiac region, thoracic skeleton, soft tissues, upper abdomen, and medical devices. Both perceptual and cognitive errors are highlighted, particularly satisfaction of search and under-recognition of subtle abnormalities.