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Chest x-ray facts for kids

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US Navy 090704-N-6259S-007 Hospital Corpsman 2nd Class Kleinne Lapid takes a chest X-ray of a patient during a Continuing Promise 2009 medical community service project at Hospital Espana in Chaminga, Nicaragua
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

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.

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