Chest x-ray Information | Mount Sinai - New York

A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm. Share Facebook Twitter Linkedin Email Home HealthLibrary Chestx-ray Chestradiography;Serialchestx-ray;X-ray-chest Share Achestx-rayisanx-rayofthechest,lungs,heart,largearteries,ribs,anddiaphragm. Aorticrupture(atearintheaorta,whichisthemajorarterycomingfromtheheart)canbeseenonachestX-ray.Inthiscase,itwascausedbyatraumaticperforationofthethoracicaorta.ThisishowtheX-rayappearswhenthechestisfullofblood(right-sidedhemothorax)seenhereascloudinessontheleftsideofthepicture. Achestx-rayinapatientwithcentralcanceroftherightlung.Noticethewhitemassinthemiddleportionoftherightlung(seenontheleftsideofthepicture). Thischestx-rayshowsadenocarcinomaofthelung.Thereisaroundedlightspotintherightupperlung(leftsideofthepicture)atthelevelofthesecondrib.Thelightspothasirregularandpoorlydefinedbordersandisnotuniformindensity.Diseasesthatmaycausethistypeofx-rayresultwouldbetuberculousorfungalgranuloma,andmalignantorbenigntumors. Thischestx-rayshowscoalworker'slungs.Therearediffuse,small,lightareasonbothsides(1to3mm)inallpartsofthelungs.Diseasesthatmayresultinanx-raylikethisincludesimplecoalworkerspneumoconiosis(CWP)-stageI,simplesilicosis,miliarytuberculosis,histiocytosisX(eosinophilicgranuloma),andotherdiffuseinfiltratepulmonarydiseases. Thischestx-rayshowstheaffectsofafungalinfection,coccidioidomycosis.Inthemiddleoftheleftlung(seenontherightsideofthepicture)therearemultiple,thin-walledcavities(seenaslightareas)withadiameterof2to4centimeters.Tothesideoftheselightareasarepatchylightareaswithirregularandpoorlydefinedborders.Otherdiseasesthatmayexplainthesex-rayfindingsincludelungabscesses,chronicpulmonarytuberculosis,chronicpulmonaryhistoplasmosis,andothers. Thischestx-rayshowsstageIIcoalworkerspneumoconiosis(CWP).Therearediffuse,smalllightareasonbothsidesofthelungs.Otherdiseasesthatmayexplainthesex-rayfindingsincludesimplesilicosis,disseminatedtuberculosis,metastaticlungcancer,andotherdiffuse,infiltrativepulmonarydiseases. Thischestx-rayshowscoalworkerspneumoconiosis-stageII.Therearediffuse,small(2to4mmeach),lightareasthroughoutbothlungs.Intherightupperlung(seenontheleftsideofthepicture),thereisalightarea(measuringapproximately2cmby4cm)withpoorlydefinedborders,representingcoalescence(mergingtogether)ofpreviouslydistinctlightareas.Diseaseswhichmayexplainthesex-rayfindingsincludesimplecoalworkerspneumoconiosis(CWP)-stageII,silico-tuberculosis,disseminatedtuberculosis,metastaticlungcancer,andotherdiffuseinfiltrativepulmonarydiseases. Thispictureshowscomplicatedcoalworkerspneumoconiosis.Therearediffuse,small,lightareas(3to5mm)inallareasonbothsidesofthelungs.Therearelargelightareaswhichruntogetherwithpoorlydefinedbordersintheupperareasonbothsidesofthelungs.DiseaseswhichmayexplaintheseX-rayfindingsincludecomplicatedcoalworkerspneumoconiosis(CWP),silico-tuberculosis,disseminatedtuberculosis,metastaticlungcancer,andotherdiffuseinfiltrativepulmonarydiseases. Thispictureshowscomplicatedcoalworkerspneumoconiosis.Therearediffuse,massivelightareasthatruntogetherintheupperandmiddlepartsofbothlungs.Thesearesuperimposedonabackgroundofsmallandpoorlydistinguishablelightareasthatarediffuseandlocatedinbothlungs.Diseaseswhichmayexplainthesex-rayfindingsinclude,butarenotlimitedtocomplicatedcoalworkerspneumoconiosis(CWP),silico-tuberculosis,andmetastaticlungcancer. Tuberculosisisaninfectiousdiseasethatcausesinflammation,theformationoftuberculesandothergrowthswithintissue,andcancausetissuedeath.ThesechestX-raysshowadvancedpulmonarytuberculosis.Therearemultiplelightareas(opacities)ofvaryingsizethatruntogether(coalesce).Arrowsindicatethelocationofcavitieswithintheselightareas.TheX-rayontheleftclearlyshowsthattheopacitiesarelocatedintheupperareaofthelungstowardtheback.Theappearanceistypicalforchronicpulmonarytuberculosisbutmayalsooccurwithchronicpulmonaryhistiocytosisandchronicpulmonarycoccidioidomycosis.Pulmonarytuberculosisismakingacomebackwithnewresistantstrainsthataredifficulttotreat.Pulmonarytuberculosisisthemostcommonformofthedisease,butotherorganscanbeinfected. Thisx-rayshowsasinglelesion(pulmonarynodule)intheupperrightlung(seenasalightareaontheleftsideofthepicture).Thenodulehasdistinctborders(well-defined)andisuniformindensity.Tuberculosis(TB)andotherdiseasescancausethistypeoflesion. Sarcoidcausesdamagetothelungtissuethathealsbyscarring.Thefilmshowsadiffusemilkyandgranularappearanceinthenormallydarklungareas.Thisindividualhasmarkeddecreaseinlungfunction. Thisfilmshowsadvancedsarcoid,scarringofthelungs(thelightstreaking),andcavityformation(thedarkareasintheupperrightsideofthepicture). Thisindividualhasamassintheupperpartofthelung.Althoughthecauseofthemasscanbesuspected,basedonthisperson'shistory,therearemanydiseasesthatcanproducelunglesions. Thisisachestx-rayofapersonwithbronchialcancer.Thisisafrontview.Thelungsarethetwodarkareas.Theheartandotherstructuresarewhiteareasvisibleinthemiddleofthechest.Thelightareasthatappearassubtlebranchesextendingfromthecenterintothelungsarecancerous. ThisisachestX-ray(CXR)ofanoduleintherightlung. ThispictureisachestX-rayofapersonwithalungmass.Thisisafrontview,wherethelungsarethetwodarkareasandtheheartandotherstructuresarevisibleinthemiddleofthechest.TheX-rayshowsamassintherightupperlung,indicatedwiththearrow(seenontheleftsideofthepicture). ThisisachestX-rayshowingmassintherightlowerlungnearheart(seenontheleftsideofthepicture). HowtheTestisPerformed Youstandinfrontofthex-raymachine.Youwillbetoldtoholdyourbreathwhenthex-rayistaken.Twoimagesareusuallytaken.Youwillfirstneedtostandfacingthemachine,andthensideways. HowtoPreparefortheTest Tellthehealthcareproviderifyouarepregnant.Chestx-raysaregenerallynotdoneduringpregnancy,andspecialprecautionsaretakeniftheyareneeded. HowtheTestwillFeel Thereisnodiscomfort.Thefilmplatemayfeelcold. WhytheTestisPerformed Yourprovidermayorderachestx-rayifyouhaveanyofthefollowingsymptoms:ApersistentcoughChestpainfromachestinjury(withapossibleribfractureorlungcomplication)orfromheartproblemsCoughingupbloodDifficultybreathingFeverItmayalsobedoneifyouhavesignsoftuberculosis,lungcancer,orotherchestorlungdiseases.Aserialchestx-rayisonethatisrepeated.Itmaybedonetomonitorchangesfoundonapastchestx-ray. WhatAbnormalResultsMean Abnormalresultsmaybeduetomanythings,including:Inthelungs:CollapsedlungCollectionoffluidaroundthelungLungtumor(noncancerousorcancerous)MalformationofthebloodvesselsPneumoniaScarringoflungtissueTuberculosisAtelectasisIntheheart:ProblemswiththesizeorshapeoftheheartProblemswiththepositionandshapeofthelargearteriesEvidenceofheartfailureInthebones:FracturesorotherproblemsoftheribsandspineOsteoporosis Risks Thereislowradiationexposure.X-raysaremonitoredandregulatedtoprovidetheminimumamountofradiationexposureneededtoproducetheimage.Mostexpertsfeelthatthebenefitsoutweightherisks.Pregnantwomenandchildrenaremoresensitivetotherisksofx-rays. References CherneckyCC,BergerBJ.Chestradiography(chestx-ray,CXR)-diagnosticnorm.In:CherneckyCC,BergerBJ,eds.LaboratoryTestsandDiagnosticProcedures.6thed.StLouis,MO:ElsevierSaunders;2013:327-328.FelkerGM,TeerlinkJR.Diagnosisandmanagementofacuteheartfailure.In:ZipesDP,LibbyP,BonowRO,MannDL,TomaselliGF,BraunwaldE,eds.Braunwald'sHeartDisease:ATextbookofCardiovascularMedicine.11thed.Philadelphia,PA:Elsevier;2019:chap24.GotwayMB,PansePM,GrudenJF,ElickerBM.Thoracicradiology:noninvasivediagnosticimaging.In:BroaddusVC,MasonRJ,ErnstJD,etal,eds.MurrayandNadel'sTextbookofRespiratoryMedicine.6thed.Philadelphia,PA:ElsevierSaunders;2016:chap18. VersionInfo Lastreviewedon:8/3/2020 Reviewedby:DenisHadjiliadis,MD,MHS,PaulF.HarronJr.AssociateProfessorofMedicine,Pulmonary,Allergy,andCriticalCare,PerelmanSchoolofMedicine,UniversityofPennsylvania,Philadelphia,PA.AlsoreviewedbyDavidZieve,MD,MHA,MedicalDirector,BrendaConaway,EditorialDirector,andtheA.D.A.M.Editorialteam. 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