A chest
X-ray is a picture of the chest that shows your
heart,
lungs, airway, blood vessels, and
lymph nodes. A chest X-ray also shows the bones of
your spine and chest, including your
breastbone,
your ribs, your
collarbone, and the upper part of your
spine. A chest X-ray is the most common imaging test
or X-ray used to find problems inside the chest.
A chest X-ray
can help find some problems with the organs and structures inside the chest.
Usually two pictures are taken, one from the back of the chest and another from
the side. In an emergency when only one X-ray picture is taken, a front view is
usually done. Doctors may not always get the information they need from a chest
X-ray to find the cause of a problem. If the results from a chest X-ray are not
normal or do not give enough information about the chest problem, more specific
X-rays or other tests may be done, such as a
computed tomography (CT) scan, an
ultrasound, an
echocardiogram, or an
MRI scan.
Why It Is Done
A chest X-ray is done to:
Help find the cause of common symptoms such as
a cough, shortness of breath, or chest pain.
Find some heart problems, such as an enlarged heart,
heart failure, and problems causing fluid in the lungs
(pulmonary edema), and to monitor treatment for these
conditions.
Look for problems from a chest injury, such as rib
fractures or lung damage.
Find foreign objects, such as coins or
other small pieces of metal, in the tube to the stomach (esophagus), the
airway, or the lungs. A chest X-ray may not be able to see food, nuts, or wood
fibers. .
See if a tube, catheter, or other
medical device has been placed in the proper position in an airway, the heart,
blood vessels of the chest, or the stomach.
How To Prepare
Tell your doctor if you are or might be
pregnant. A chest X-ray usually is not done during pregnancy because the
radiation could harm the unborn baby (fetus). But the
chance of harm to the fetus is very small. If you need a chest X-ray, you will
wear a lead apron to help protect your baby.
Talk to your doctor
about any concerns you have regarding the need for the test, its risks, how it
will be done, or what the results mean. To help you understand the importance
of this test, fill out the
medical test information form(What is a PDF document?).
How It Is Done
A chest X-ray is taken by a radiology
technologist. The pictures are usually read by a
radiologist, who writes the report. Other types of
doctors, such as a
family medicine doctor,
internist, or
surgeon, also may review chest X-rays.
You will need to take off jewelry that might be in the way of the X-ray
picture. You may need to take off all or most of your clothes above the waist
(you may be allowed to keep on your underwear if it does not get in the way of
the test). You will be given a gown to wear during the test.
Two
X-ray views of the chest are usually taken. One view is taken from the back;
the other view is taken from the side of the body. But other views may be
needed, depending on what your doctor is looking for. In an emergency, only one
picture may be taken, usually from the front.
You usually stand
with your front against an X-ray plate for the pictures. If you need to sit or
lie down, someone will help you get into the correct position.
You
will need to hold very still during the X-ray to prevent blurring of the
picture. You may be asked to hold your breath for a few seconds while the X-ray
picture is taken.
Most hospitals and some clinics have portable
X-ray machines. If a chest X-ray is done with a portable X-ray machine at your
bedside in a hospital, an X-ray technologist and nurse will help you move into
the correct position. Usually only one picture from the front is taken.
How It Feels
You will not feel pain during a chest
X-ray. The X-ray plate may feel hard, and the room may be cool. If you have
pain from your chest problem, you may feel some discomfort if you need to hold
a certain position, breathe deep, or hold your breath while the X-ray is
done.
Risks
There is always a slight chance of damage to
cells or tissue from radiation, including the low levels of radiation used for
this test. But the chance of damage from the X-rays is usually very low
compared with the benefits of the test.
Results
A chest
X-ray is a picture of the chest to see your
heart,
lungs, airway, blood vessels, and
lymph nodes. A chest X-ray also shows the bones of
your chest, including your
breastbone,
your ribs, your
collarbone, and the upper part of your
spine.
In an emergency, the
results of a chest X-ray can be available within a few minutes for review by
your doctor. If it is not an emergency, results are usually ready in 1 or 2
days.
Chest X-ray
Normal:
The lungs look normal in size
and shape, and the lung tissue looks normal. No growths or other masses can be
seen within the lungs. The
pleural spaces (the spaces surrounding the lungs) also look normal.
The heart looks normal in
size, shape, and the heart tissue looks normal. The blood vessels leading to
and from the heart also are normal in size, shape, and appearance.
The bones including the spine
and ribs look normal.
No abnormal collection of
fluid or air is seen, and no foreign objects are seen.
All tubes, catheters, or other
medical devices are in their correct positions in the chest.
Abnormal:
An infection, such as
pneumonia or
tuberculosis, is present.
Problems such as a tumor,
injury, or a condition such as
edema from
heart failure may be seen. In some cases, more X-rays
or other tests may be needed to see the problem clearly.
A problem such as an enlarged
heart—which could be caused by heart damage,
heart valve disease, or fluid around the heart—is
seen. Or a problem of the blood vessels, such as an enlarged
aorta, an
aneurysm, or hardening of the arteries (atherosclerosis), is seen.
Broken bones (fractures) are
seen in the rib cage, collarbone, shoulder, or spine.
Enlarged lymph nodes are
seen.
A foreign object is seen in
the esophagus, breathing tubes, or lungs.
A tube, catheter, or other
medical device looks like it has moved out of the correct position.
What Affects the Test
Reasons why the test results may
not be helpful include:
Not being able to stay still and hold your
breath when asked during the test.
Metal objects (such as spinal
fixation rods and metal jewelry or belts) that get in the way of the X-ray
picture.
Obesity, which
can hide chest problems or make it hard to get a good X-ray
picture.
Chest pain that can make it hard for you to take a deep
breath during the X-ray.
Scarring from past lung surgery or changes
from a chronic disease, which may make the X-ray pictures hard to read.
A picture taken with a portable machine may not be as clear
as those made by a stationary machine.
What To Think About
Your X-ray test results may be different from
earlier test results because you were tested at a different medical center or
you had a different kind of test.
If a chest
X-ray is not normal, more specific X-rays or other tests such as a
CT scan,
ultrasound,
MRI scan, or a
biopsy may be done.
Some conditions may
not show up on a chest X-ray, such as a small cancer, a
pulmonary embolus, or other problem that is hidden by
the normal structures in the chest.
Certain workers, such as people
who work with asbestos, may need regular chest X-rays to check for problems
caused by asbestos.
References
Other Works Consulted
Fischbach FT, Dunning MB III, eds. (2009).
Manual of Laboratory and Diagnostic Tests, 8th ed.
Philadelphia: Lippincott Williams and Wilkins.
Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier.
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