X-ray is typically performed as the first imaging test for symptoms of shortness of breath, a bad or persistent cough, chest pain, chest injury, or fever. Individuals with known or suspected medical conditions such as congestive heart failure or cancer may have chest x-rays to follow their response to treatment, or to determine changes that would require a change in their medical management.
A physician may recommend a chest x-ray for a patient with shortness of breath, a bad or persistent cough, chest pain, or a chest injury. In the instances of pneumonia, the site of pneumonia will appear white on the image.
A chest x-ray may also show advanced emphysema as well as other diffuse lung conditions, such as pulmonary fibrosis.
Lung cancers and tumors that spread to the lung may be visible on chest x-ray. However, lesions that are small or superimposed on normal structures may not always be visible.
Heart irregularities, such as fluid around the heart (pericardial effusion), an enlarged heart, or abnormal heart anatomy or congestive heart failure may also be visible on a chest x-ray.
Pleural effusions (fluid around the lungs) on one or both sides can be detected. Usually the cause of such fluid may be deduced from clinical data or other findings on the chest x-ray but it may be necessary to sample the fluid to determine its cause.
Frequently Asked Questions
- How should I prepare for the procedure?
This procedure requires no special preparation. Women should always inform their doctor or x-ray technologist if there is any possibility that they are pregnant.
- What will I experience during the procedure?
This is a painless procedure. The primary discomfort may come from the coldness of the recording plate. Individuals with arthritis or injuries to the chest wall, shoulders, or arms may have discomfort trying to maintain position for the chest x-ray. In these circumstances, the technologist will assist you in finding a position that still ensures diagnostic image quality.
- What are the limitations of X-Ray?
The x-ray is a very useful examination, but has limitations. Some conditions will not show up on the image. Therefore, a normal radiograph does not necessarily rule out problems. For example, patients with asthma exacerbations can have normal radiographs. Cancers that are small or inconspicuous may not be visible. Pulmonary embolism is rarely diagnosed from the x-ray; more sophisticated imaging such as CTPA (computed tomographic pulmonary arteriography) is ultimately necessary to establish the diagnosis. It is also known that CT scan detects smaller lung cancers than x-ray. However, CT also detects many more small abnormalities that ultimately prove to be benign after further testing. It is NOT known whether CT detection of lung cancers actually saves lives—this question is being evaluated at this time. It is important to realize that some conditions that involve the lungs are better evaluated with HRCT (high resolution CT). Chest x-ray and physical examination may be done jointly and should be correlated. The information each procedure provides can give a physician a clearer understanding of a patient’s health. A chest CT may be requested by the referring physician to further clarify a finding seen on the chest x-ray or to look for an abnormality not visible on a chest x-ray in order to answer the clinical problem.
- What are the risks?
• X-rays are a type of electromagnetic radiation, are invisible and create no sensation when they pass through the body. The chest x-ray is one of the lowest radiation exposure medical examinations performed today. • Special care is taken during chest x-ray examinations to ensure maximum safety for the patient by paying attention to correct x-ray beam energies. Shielding the abdomen and pelvis with a lead apron helps reduce unnecessary radiation to the abdomen and pelvis. Women should always inform their doctor or x-ray technologist if there is any possibility that they are pregnant. • The effective radiation dose from this procedure is about 0.1 mSv which is about the same as the average person receives from background radiation in 10 days.
- What steps are taken to further minimize the radiation risks?
• The use of x-ray sensitive materials (film) that require little radiation to produce an optimal image. • Technique standards established by national and international guidelines that have been designed and are continually reviewed by national and international radiology protection councils. Modern, state-of-the-art x-ray systems that have tightly controlled x-ray beams with significant x-ray beam filtration and dose control methods. Thus, stray or scatter radiation is minimized and those parts of a patient’s body not being imaged receive minimal exposure.