Chest radiography; Serial chest x-ray; X-ray - chest
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
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How the Test is Performed
You stand in front of the x-ray machine. You will be told to hold your breath when the x-ray is taken.
Two images are usually taken. You will first need to stand facing the machine, and then sideways.
How to Prepare for the Test
Tell the health care provider if you are pregnant. Chest x-rays are generally not done during pregnancy, and special precautions are taken if they are needed.
How the Test will Feel
There is no discomfort. The imaging plate may feel cold.
Why the Test is Performed
Your provider may order a chest x-ray if you have any of the following symptoms:
- A persistent cough
- Chest pain from a chest injury (with a possible rib fracture or lung complication) or from heart problems
- Coughing up blood
- Difficulty breathing
It may also be done if you have signs of tuberculosis, lung cancer, or other chest or lung diseases.
A serial chest x-ray is one that is repeated. It may be done to monitor changes found on a past chest x-ray.
What Abnormal Results Mean
Abnormal results may be due to many things, including:
In the lungs:
- Collapsed lung
- Collection of fluid around the lung
- Lung tumor (noncancerous or cancerous)
- Malformation of the blood vessels
- Scarring of lung tissue
In the heart:
- Problems with the size, position or shape of the heart
- Problems with the position, size and shape of the large arteries
- Evidence of heart failure
In the bones:
- Fractures or other problems of the ribs and spine
In the mediastinum (middle part of the chest):
- Enlargement, which might be related to infection or tumor
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 benefits outweigh the risks. Pregnant women and children are more sensitive to the risks of x-rays.
Coughing up blood
Lung cancer - small cell
Collapsed lung (pneumothorax)
Cerebral arteriovenous malformation
Community-acquired pneumonia in adults
Acute mountain sickness
Simple pulmonary eosinophilia
Adult Still disease
Alpha-1 antitrypsin deficiency
Acute respiratory distress syndrome
Atrial septal defect (ASD)
Coal worker's pneumoconiosis
Coarctation of the aorta
Interstitial lung disease
Drug-induced lupus erythematosus
Drug-induced pulmonary disease
Anti-glomerular basement membrane disease
Histoplasmosis - acute (primary) pulmonary
Hypertensive heart disease
Idiopathic pulmonary fibrosis
Solitary fibrous tumor
Metastatic brain tumor
Metastatic pleural tumor
Mitral valve regurgitation
Mitral valve prolapse
Patent ductus arteriosus
Pericarditis - after heart attack
Pneumocystis jiroveci pneumonia
Pneumonia - weakened immune system
Primary alveolar hypoventilation
Pulmonary alveolar proteinosis
Pulmonic valve stenosis
Pulmonary veno-occlusive disease
Renal cell carcinoma
Neonatal respiratory distress syndrome
Respiratory syncytial virus (RSV)
Rheumatoid lung disease
Solitary pulmonary nodule
Systemic lupus erythematosus
Tetralogy of Fallot
Transient ischemic attack
Transposition of the great arteries
Ventricular septal defect
Granulomatosis with polyangiitis
Chernecky CC, Berger BJ. Chest radiography (chest x-ray, CXR) - diagnostic norm. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures. 6th ed. St Louis, MO: Elsevier Saunders; 2013:327-328.
Felker GM, Teerlink JR. Diagnosis and management of acute heart failure. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 49.
Jokerst CE, Gotway MB. Thoracic radiology: noninvasive diagnostic imaging. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 20.BACK TO TOP
Review Date: 7/31/2022
Reviewed By: Denis Hadjiliadis, MD, MHS, Paul F. Harron, Jr. Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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