Chest x-ray facts for kids

Positioning for a PA chest x-ray

In radiology, a chest radiograph, colloquially called a chest X-ray (CXR), or chest film, is a projection radiograph of the chest used to diagnose conditions affecting the chest, its contents, and nearby structures. Chest radiographs are the most common film taken in medicine.

Like all methods of radiography, chest radiography employs ionizing radiation in the form of X-rays to generate images of the chest.

Problems identified

Conditions commonly identified by chest radiography

Pneumonia Pneumothorax Interstitial lung disease Congestive heart failure Bone fracture Hiatal hernia

Chest x-rays are used to find many diseases inside the chest. A doctor can use an x-ray to examine bones, lungs, heart, and great vessels. Pneumonia and congestive heart failure are commonly diagnosed by chest radiograph. Chest x-rays are used to screen for job-related lung disease, for example in mining where workers breathe dust.

The main regions where a chest X-ray may identify problems may be summarized as ABCDEF by their first letters:

• Airways, including hilar adenopathy or enlargement
• Breast shadows
• Bones, e.g. rib fractures and lytic bone lesions
• Cardiac silhouette, detecting cardiac enlargement
• Costophrenic angles, including pleural effusions
• Diaphragm, e.g. evidence of free air, indicative of perforation of an abdominal viscus
• Edges, e.g. apices for fibrosis, pneumothorax, pleural thickening or plaques
• Extrathoracic tissues
• Fields (lung parenchyma), being evidence of alveolar flooding
• Failure, e.g. alveolar air space disease with prominent vascularity with or without pleural effusions.

Limitations

While chest radiographs are a cheap and relatively safe method of investigating diseases of the chest, there are a number of serious chest conditions that may be associated with a normal chest radiograph and other means of assessment may be necessary to make the diagnosis. For example, a patient with an acute myocardial infarction may have a completely normal chest radiograph.

Images for kids

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  A chest radiograph with the angle parts of the ribs and some other landmarks labeled.

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  Mediastinal structures on a chest radiograph.

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  Chest film showing increased opacity in both lungs, indicative of pneumonia

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  A chest film after insertion of an implantable cardioverter-defibrillator, showing the shock generator in the upper left chest and the electrical lead inside the right heart. Note both radio-opaque coils along the device lead.

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  Chest X-ray PA

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  Chest X-ray PA inverted and enhanced.

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  Lateral chest x-ray

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  Chest x-ray

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  A chest radiograph showing bronchopulmonary dysplasia.