Chest x-ray
Also known as: Chest radiography, Serial chest x-ray or X-ray - chest
Definition
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
How the test is performed
The test is performed in a hospital radiology department or in the health care provider's office by an x-ray technician. Two views are usually taken: one in which the x-rays pass through the chest from the back (posterior-anterior view), and one in which the x-rays pass through the chest from one side to the other (lateral view). You stand in front of the machine and must hold your breath when the x-ray is taken.
How to prepare for the test
Inform the health care provider if you are pregnant. Chest x-rays are generally avoided during the first six months of pregnancy. You must wear a hospital gown and remove all jewelry.
How the test will feel
There is no discomfort. The film plate may feel cold.
Why the test is performed
Your doctor may order a chest x-ray if you have any of the following symptoms:
- A persistent cough
- Chest injury
- Chest pain
- Coughing up blood
- Difficulty breathing
It may also be done if you have signs of tuberculosis, lung cancer, or other chest or lung disease.
A serial chest x-ray (repeated) may be used to evaluate or monitor changes found on a previous chest x-ray.
What abnormal results mean
Abnormal results may be due to may things, including the following.
In the lungs:
- Collapsed lung
- Collection of fluid around the lung
- Lung cancer
- Lung tumor
- Malformation of the blood vessels
- Pneumonia
- Scarring of lung tissue
- Tuberculosis
In the heart:
- Problems with the size or shape of the heart determined
- Problems with the position and shape of the large arteries
In the bones:
- Fractures of ribs and spine
- Osteoporosis
- Other abnormalities in the ribs and spine
Abnormal results may also be due to:
- Achalasia
- Acute bronchitis
- Acute MI
- Acute mountain sickness
- Acute pulmonary eosinophilia (Loeffler syndrome)
- Adult Still’s disease
- Alcoholic cardiomyopathy
- Alpha-1 antitrypsin deficiency
- Anthrax
- Aortic dissection
- Aortic insufficiency
- Aortic stenosis
- ARDS (adult respiratory distress syndrome)
- Asbestosis
- Aspergillosis
- Aspiration pneumonia
- Atelectasis
- Atrial myxoma
- Atrial septal defect
- Atypical mycobacterial infection
- Atypical pneumonia
- Blastomycosis
- Breast cancer
- Bronchial adenoma
- Bronchial asthma
- Bronchiectasis
- Bronchiolitis
- Bronchopulmonary dysplasia
- Byssinosis (cotton dust)
- Caplan syndrome
- Cardiac tamponade
- Cerebral abscess
- Chronic bronchitis
- Chronic glomerulonephritis
- CMV pneumonitis
- Coal workers pneumoconiosis
- Coarctation of the aorta
- Coccidioidomycosis; acute (primary) pulmonary
- Coccidioidomycosis; chronic pulmonary
- Coccidioidomycosis; disseminated
- Diaphragmatic hernia
- Diffuse interstitial pulmonary fibrosis
- Dilated cardiomyopathy
- Disseminated tuberculosis (infectious)
- Drug-induced lupus erythematosus
- Drug-induced pulmonary disease
- Echinococcus
- Emphysema
- Empyema
- Goodpasture syndrome
- Heart failure
- Histoplasmosis; acute (primary) pulmonary
- Histoplasmosis; chronic pulmonary
- Histoplasmosis; disseminated
- Hodgkin’s lymphoma
- Hospital-acquired pneumonia
- Hypersensitivity pneumonitis
- Hypertensive heart disease
- Hypertrophic cardiomyopathy
- Hypothyroidism
- Hypothyroidism; primary
- Hypothyroidism; secondary
- Idiopathic cardiomyopathy
- Idiopathic diffuse interstitial pulmonary fibrosis
- Industrial bronchitis
- Infective endocarditis
- Inhalation anthrax
- Ischemic cardiomyopathy
- Left-sided heart failure
- Legionnaire’s disease
- Lyme disease, secondary
- Malignant hypertension (arteriolar nephrosclerosis)
- Meningitis
- Mesothelioma (benign-fibrous)
- Mesothelioma (malignant)
- Metastatic brain tumor
- Metastatic cancer to the lung
- Metastatic pleural tumor
- Mitral regurgitation; acute
- Mitral regurgitation; chronic
- Mitral stenosis
- Mitral valve prolapse
- Mycoplasma pneumonia
- Myocarditis
- Necrotizing vasculitis
- Neuroblastoma
- Neurosarcoidosis
- Non-Hodgkin’s lymphoma
- Occupational asthma
- Patent ductus arteriosus
- Pericarditis
- Pericarditis; bacterial
- Pericarditis; post-MI
- Peripartum cardiomyopathy
- Pneumocystis jiroveci pneumonia
- Pneumonia in immunocompromised host
- Pneumonia with lung abscess
- Premature infant
- Primary alveolar hypoventilation
- Primary pulmonary hypertension
- Pulmonary actinomycosis
- Pulmonary alveolar proteinosis
- Pulmonary aspergilloma (mycetoma)
- Pulmonary aspergillosis; allergic bronchopulmonary type
- Pulmonary aspergillosis; invasive
- Pulmonary edema
- Pulmonary embolus
- Pulmonary histiocytosis X (eosinophilic granuloma)
- Pulmonary nocardiosis
- Pulmonary valve stenosis
- Pulmonary tuberculosis
- Pulmonary veno-occlusive disease
- Q fever (early)
- Q fever (late)
- Renal cell carcinoma
- Respiratory distress syndrome (infants)
- Respiratory syncytial virus (RSV)
- Restrictive cardiomyopathy
- Rheumatoid lung disease
- Right-sided heart failure
- Sarcoidosis
- Senile cardiac amyloid
- Silicosis (classical)
- Silicosis (acute)
- Skin lesion of histoplasmosis
- Solitary pulmonary nodule (benign)
- Spontaneous pneumothorax
- SVC obstruction
- Systemic lupus erythematosus
- Systemic sclerosis (scleroderma)
- Tension pneumothorax
- Testicular cancer
- Tetralogy of Fallot
- Transient ischemic attack (TIA)
- Transposition of the great vessels
- Traumatic pneumothorax
- Ventricular septal defect
- Viral pneumonia
- Wegener’s granulomatosis
- Wilms tumor
What the risks are
There is low radiation exposure. X-rays are monitored and regulated to provide the minimum amount of radiation exposure needed to produce the image. Most experts feel that the risk is very low compared with the benefits. Pregnant women and children are more sensitive to the risks of x-rays.
References
Stark P. Imaging in pulmonary disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 84.
See Also: Diaphragmatic hernia, Skin lesion of histoplasmosis, Metastatic pleural tumor, Necrotizing vasculitis, Atrial septal defect, Mitral regurgitation - chronic, Aspiration pneumonia, Transposition of the great vessels, Clopidogrel (Plavix), Pulmonary actinomycosis, Byssinosis , Aortic stenosis, When you have urinary incontinence, Idiopathic pulmonary fibrosis, Metastatic cancer to the lung, Taking your blood pressure at home, Aortic insufficiency, Heart disease - risk factors, Chest pain, Hodgkin’s lymphoma, Pericarditis - bacterial, Alpha-1 antitrypsin deficiency, Transient ischemic attack, Dilated cardiomyopathy, Ileostomy and your diet, Sterile technique, Mitral stenosis, Echinococcus, Coughing up blood, Histoplasmosis - chronic pulmonary, Malignant hypertension, Collapsed lung, Goodpasture syndrome, Pulmonary alveolar proteinosis, Hypothyroidism - primary, Pulmonary nocardiosis, Osteoporosis, Mycoplasma pneumonia, Pulmonary aspergilloma, Anthrax, Mitral regurgitation - acute, SVC obstruction, Inhalation anthrax, Hypothyroidism, Blastomycosis, Lung disease, Ventricular septal defect, Implantable cardioverter defibrillator - discharge, Pleural effusion, Pulmonary embolus, Pneumocystis jiroveci pneumonia, Mesothelioma - malignant, Systemic lupus erythematosus, Bronchiolitis, Neurosarcoidosis, Hypertensive heart disease, Cardiac tamponade, Neuroblastoma, X-ray, Disseminated tuberculosis, Peripartum cardiomyopathy, Pericarditis - after heart attack, Pulmonary veno-occlusive disease, Legionnaire's disease, Myocarditis, Q fever - early, Heart attack, Kidney stones - lithotripsy - discharge, Sarcoidosis, Histiocytosis, Broken bone, Brain surgery - discharge, Home blood sugar testing, Ischemic cardiomyopathy, Asthma, Pneumonia - weakened immune system, Solitary pulmonary nodule, Brain abscess, Wilms tumor, Pulmonary edema, Non-Hodgkin's lymphoma, Coccidioidomycosis - chronic pulmonary, Drug-induced pulmonary disease, Silicosis , Tetralogy of Fallot, Industrial bronchitis, Bathroom safety - children, Meningitis, Occupational asthma, Renal cell carcinoma, Pneumonia, Breast cancer, Premature infant, Pulmonary valve stenosis, Pulmonary tuberculosis, Rheumatoid lung disease, Mitral valve prolapse, Wegener’s granulomatosis, Hypersensitivity pneumonitis, Diffuse interstitial lung disease, Hospital-acquired pneumonia, Mesothelioma (benign-fibrous), Aspergillosis, Acute mountain sickness, Chronic glomerulonephritis, Histoplasmosis - acute (primary) pulmonary, Coal worker's pneumoconiosis, Asbestosis, Atypical mycobacterial infection, Cardiac amyloidosis, Pulmonary hypertension, Lung cancer - small cell, Coarctation of the aorta, Coccidioidomycosis - acute pulmonary, Lyme disease - early disseminated , Infectious endocarditis, Arteriovenous malformation - cerebral, Testicular cancer, Primary alveolar hypoventilation, Atypical pneumonia, Hypertrophic cardiomyopathy, Getting out of bed after surgery, Caplan syndrome, Bronchopulmonary dysplasia, Adult Still's disease, Aortic dissection, Bronchiectasis, Histoplasmosis - disseminated, Drug-induced lupus erythematosus, Heart failure, Viral pneumonia, Restrictive cardiomyopathy, Respiratory syncytial virus (RSV), Angina - discharge, Atelectasis, Coccidioidomycosis - disseminated, Patent ductus arteriosus, Neonatal respiratory distress syndrome, Heart attack - discharge, Pericarditis, Scleroderma, Metastatic brain tumor, Empyema, Acute respiratory distress syndrome, Small bowel resection - discharge, Achalasia, and Simple pulmonary eosinophilia
Review date: August 13, 2010
Reviewed by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
