Chest X-ray

Alternative names
Chest radiography; Serial chest X-ray; X-ray - chest

An X-ray of the chest, lungs, heart, large arteries, ribs, and the 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 1st and 2nd trimesters of pregnancy. You must wear a hospital gown and remove all jewelry.

For infants and children:
The preparation you can provide for this test depends on your child’s age and previous experience. For specific information regarding how you can prepare your child, see the following topics:

  • infant test or procedure preparation (birth to 1 year)  
  • toddler test or procedure preparation (1 to 3 years)  
  • preschooler test or procedure preparation (3 to 6 years)  
  • schoolage test or procedure preparation (6 to 12 years)  
  • adolescent test or procedure preparation (12 to 18 years)

How the test will feel
There is no discomfort. The film plate may feel cold.

Why the test is performed
A chest X-ray may be ordered when an person’s symptoms include a persistent cough, coughing up blood, chest pain, a chest injury, or difficulty in breathing. The test is also used when tuberculosis, lung cancer, or other chest or lung disease is suspected.

A serial chest X-ray (repeated or sequential) may be used to evaluate changes over time of an abnormality found on a chest X-ray (for example, an increase in the size of an abnormality over a period of weeks).

What abnormal results mean
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:

  • size and shape of the heart determined  
  • position and shape of the large arteries

In the bones:

  • osteoporosis  
  • fractures of ribs and spine  
  • other abnormalities in the ribs and spine

Additional conditions under which the test may be performed:

  • achalasia  
  • acute bronchitis  
  • acute MI  
  • acute mountain sickness  
  • acute pulmonary eosinophilia (Loeffler’s 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; left  
  • atrial myxoma; right  
  • atrial septal defect  
  • atypical mycobacterial infection  
  • atypical pneumonia  
  • blastomycosis  
  • breast cancer  
  • bronchial adenoma  
  • bronchial asthma  
  • bronchiectasis  
  • bronchiolitis  
  • bronchopulmonary dysplasia  
  • byssinosis (cotton dust)  
  • Caplan’s syndrome  
  • Cardiac tamponade  
  • cerebral abscess  
  • chronic bronchitis  
  • chronic glomerulonephritis  
  • CMV pneumoconiosis  
  • 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 hypothyroidism  
  • drug-induced lupus erythematosus  
  • drug-induced pulmonary disease  
  • echinococcus  
  • emphysema  
  • empyema  
  • Goodpasture’s 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 carinii 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 type  
  • 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 the X-ray.

Johns Hopkins patient information

Last revised: December 3, 2012
by Gevorg A. Poghosian, Ph.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.