Chest x-ray (summary)

Last revised by Henry Knipe on 27 Apr 2020
This is a basic article for medical students and other non-radiologists

Chest x-rays are performed frequently in the assessment of a vast number of sick (and potentially very sick) patients. 

A chest x-ray can be performed in the radiology department (usually with the patient standing up) or by the bedside. The quality of the radiograph is vastly superior if performed in the department ("departmental film"), but this is not always possible - especially when the patient is acutely unwell.

Reference article

This is a summary article; read more in our article on chest radiograph.

Summary

  • indications (acute)
    • breathlessness
    • chest pain
    • productive cough
    • cough and weight loss
    • focal chest signs
  • benefits
    • quick and accessible
    • wide range of pathology can be identified
  • limitations
    • modest radiation dose
    • relatively insensitive for causes of pathology
  • procedure
    • PA
      • standing with chest facing detector
      • x-ray taken from behind the patient
    • AP
      • detector placed behind patient's back
      • x-ray taken from the front
  • variations
    • erect chest x-ray
      • performed after sitting up for 10 minutes
      • used for the detection of free intraperitoneal gas
  • similar tests
    • CT chest
      • CT to include all of the lungs
      • use of contrast depends on the question being asked
        • when contrast is given timing is critical to answering the question
      • assessment of lung parenchyma and mediastinum​

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