Chest X-rays may provide important information regarding the size, shape, contour, and anatomic location of the heart, lungs, bronchi, great vessels (aorta, aortic arch, pulmonary arteries), mediastinum (an area in the middle of the chest separating the lungs), and the bones (cervical and thoracic spine, clavicles, shoulder girdle, and ribs). Changes in the normal structure of the heart, lungs, and/or lung vessels may indicate disease or other conditions.
X-rays use invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs on film. X-rays are made by using external radiation to produce images of the body, its organs and other internal structures for diagnostic purposes. X-rays pass through body tissues onto specially treated plates (similar to camera film), and a “negative” type picture is made (the more solid a structure is, the whiter it appears on the film). X-rays are often created digitally now for analysis on computers rather than X-ray film.
Depending on the results of the chest X-ray, additional tests or procedures may be requested by a doctor for further diagnostic information.
Conditions that may be assessed with a chest X-ray include, but are not limited to, the following:
- Heart enlargement (which can occur with congestive heart failure, congenital heart defects, or cardiomyopathy).
- Pericardial effusion - A buildup of excess fluid in between the heart and the membrane that surrounds it, often due to inflammation.
- Pleural effusion - A collection of blood or fluid around the lung.
- Pneumothorax (collapsed lung) and hemothorax (blood in the lung cavity).
- Pneumonia, persistent cough, and other lung conditions.
- Aneurysms. Ballooning of the walls of the great blood vessels, such as the aorta.
- Bone fractures.
- Calcification of heart structures (such as heart valves or aorta).
- Tumors or cancer.
- Granulomas found in diseases such as tuberculosis and sarcoidosis.
- Herniation (a hole) or elevation (movement out of position) of the diaphragm (the breathing muscle).
- Pulmonary edema (“fluid in the lungs,” which can occur with congestive heart failure or congenital heart defects).
Other reasons for performing a chest X-ray may include:
- As part of the physical assessment before hospitalization and/or surgery or as part of a complete physical examination.
- To assess symptoms of conditions related to the heart or lungs.
- To assess progression of a condition and/or effectiveness of treatments.
- To check the position of implanted pacemaker wires and other internal devices, such as central venous catheters, endotracheal tubes, chest tubes, or nasogastric tubes.
- To check the status of lungs and chest cavity after surgery.
- To check for rib fractures or bone abnormalities.