When I saw this on Boing Boing a few days ago, the self appointed experts in the comments there seemed pretty sure that these images were illustrations and not an actual x-rays for various technical reasons that I can't remember. But it had something to do with the way that real x-ray images look.
I am not an RT (Brianna is) but I work with PACS (radiology computer systems). I would say that this might be a heavily doctored, and possibly composite, image. When you take a radiographic image of a body region, you generally try to get all the parts as flat as you can--that is, on the same plane*. So that as the radiation passes through the body it is absorbed uniformly, and an "even" amount reaches the receptors that capture data to produce an image. I say "data" and "produce" because digital radiology, which I assume this is, gives us a great leverage in manipulating the data. For instance, fiddling around with this image to produce something that traditional, film-based radiographs could never, EVER produce.
Incidentally, there is great consternation in the industry around the fact that new, younger RTs may never have worked in a world where you had to produce a good, diagnostic radiograph through properly applied technique. Nowadays, you can just "shop" the image when it gets to PACS.
What's the danger in that? Well, the joke goes that the doctor comes in to the exam room, with an x-ray, and tells the patient, "Your arm was broken, but we fixed it in Photoshop." This doesn't happen--but the point is that we may not be getting "true" images.
*There is even a difference between shooting a chest x-ray from front-to-back versus back-to-front.
