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Chest X-Ray (cont.)

Medical Reasons for Chest X-ray Test

Doctors generally order chest X-ray tests in conjunction with taking a medical history and performing a physical exam to confirm or exclude a suspected chest. Some of the common reasons to order a chest X-ray test are listed below:

  • Cough
  • Shortness of breath
  • Chest pain
  • Poor oxygenation (hypoxia)
  • Back pain
  • Chest injury
  • Fever
  • Certain abnormalities detected on the doctor's physical examination of the lung, heart, or chest wall (abnormal heart sounds, abnormal lung sounds, chest wall deformity, etc.)
  • Pre-operative evaluation (before an operation to screen for any obvious lung disease)
  • Follow-up of a previously abnormal chest X-ray test
  • To confirm the proper placement of certain devices within the chest, such as pacemakers, endotracheal (breathing tubes - when someone is placed on artificial breathing machine), catheters in large veins of the chest (central lines), etc.

There are many other more specific reasons that a doctor may choose to order a chest X-ray depending on each individual situation.

Diseases and Conditions Diagnosed with Chest X-ray Test

Many diseases or conditions may be detected or diagnosed based on a chest X-ray test. A chest X-ray test can also be very helpful in ruling out suspected diagnoses. Some of the common conditions that can be evaluated by a chest X-ray tests are:

Chest X-ray Test Risks

Risks associated with having a chest X-ray test are minimal, but they need to weighed against the benefits for each individual case. Chest X-rays release radiation to the body in order to produce an image. The amount of radiation, however, is very small and it does not last in the body after the image is taken. Pregnant women who require a chest X-ray are advised to notify the doctor and the X-ray technician so proper precautions can be taken to minimize radiation exposure to the fetus.

Normal Chest X-ray Test

As mentioned earlier, the image on chest X-ray film is in shades of black and white, similar to a negative of a regular photograph. The shadows on a chest X-ray test depend on the degree of absorbed radiation by the particular organ based on its composition. Bony structures absorb the most radiation and appear white on the film. Hollow structures containing mostly air, such the lungs, normally appear dark. In a normal chest X-ray, the chest cavity is outlined on each side by the white bony structures that represent the ribs of the chest wall. On the top portion of the chest is the neck and the collar bones (clavicles). On the bottom, the chest cavity is bordered by the diaphragm under which is the abdominal cavity. On either side of the chest wall, the bones of the shoulders and arms are easily recognizable.

Inside the chest cavity, the vertebral column can be seen down the middle of the chest, splitting it nearly in equal halves. On each side of the midline, the dark appearing lung fields are seen. The white shadow of the heart is in the middle of the field, atop the diaphragm and more to the left side. The trachea (wind pipe), aorta (main blood vessel exiting the heart), and the esophagus descend down the middle, overlapping the vertebral column.

Medically Reviewed by a Doctor on 9/11/2017

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