Chest X-Ray

What is a chest x-ray?

A chest x-ray is a diagnostic test that uses x-rays to visualize the structures inside your chest. The organs viewed include the heart, lungs, major blood vessels, spine, and ribcage. A chest x-ray is one of the most common imaging tests prescribed by doctors.

What are x-rays?

X-rays are a kind of radiation termed electromagnetic waves. X-rays were discovered in 1895 by Wilhelm Conrad Roentgen (a Professor at Wuerzburg University in Germany). X-rays are electromagnetic radiation of the same nature as light, but their wavelength is much shorter. The wavelength of visible light is on the order of 6000 angstroms while the wavelength of x-rays is in the range of one angstrom. This short wavelength provides x-rays the ability to penetrate materials that light cannot.

Why has my doctor advised me to go for a chest x-ray?

Your physician may ask you to undergo a chest x-ray if you present with-

– Hemoptysis (blood in sputum)
– Persistent cough
– Prolonged fever
– Chest pain
– Trauma to the chest
– Difficulty in breathing
– A positive TB skin test

How widespread are respiratory diseases in India?

Respiratory illnesses are the number one reason for doctor visits in India. As per the latest statistics, India contributes to 32% of the total global burden of respiratory diseases, despite being home to 18% of the total world population. 1 out of every 10 deaths in India can be traced back to COPD. More than 30% of cases of all respiratory diseases, most commonly COPD can be directly attributed to poor quality of air.

What are the abnormalities diagnosed by a chest x-ray?

A chest x-ray is normally ordered so that your physician can analyze if your heart and lungs are functioning optimally. He may also need to find out if there is a fracture in your ribcage or spine in case you have suffered from trauma. A chest x-ray can reveal a lot about the structures inside your chest. It can throw light on-

– The condition of your lungs– A chest x-ray can detect lung infections (tuberculosis, pneumonia, bronchitis), lung cancer, collection of fluid/air around the lungs, chronic lung diseases (cystic fibrosis, emphysema) and the presence of occupational lung disease (pneumoconiosis). A chest x-ray can also detect if your ailing heart is affecting the health of your lungs; as is the case in pulmonary edema which is a manifestation of congestive cardiac failure.

– The condition of your heart– A chest x-ray can diagnose a multitude of heart diseases including cardiac failure, valvular abnormalities, congenital heart disease, cardiomegaly (an increase in the size of the heart) and pericardial effusion (collection of fluid in the sac covering the heart).

– The condition of your blood vessels– An abnormality of the major blood vessels (aorta, pulmonary vessels) can be detected by a chest x-ray. As the outlines of the blood vessels are visible on a chest x-ray, an aneurysm or a congenital anomaly can be diagnosed.

– Fractures- A fracture of the ribs or the spine can be detected by a chest x-ray.

– Post-operative changes– Following surgery on your lungs, heart or upper gastrointestinal tract, your surgeon may ask you to undergo a chest x-ray. This is done to assess the response to surgery and to check if the devices inserted in your chest during surgery are in place. These may include endotracheal tubes, nasogastric tubes, and central venous catheters.

– Implants in your chest wall– A chest x-ray can also be carried out to see if the positioning of medical devices such as a cardiac pacemaker or a defibrillator is correct.

Can I undergo a chest x-ray if I am pregnant?

The procedure of a chest x-ray involves the use of radiation which can be a source of hazard to the fetus. However, the dose of radiations used is very small. Moreover, during a chest x-ray, your reproductive organs are not exposed to radiation.  A lead apron can be worn to keep away the radiation. To be on the safer side, it is advisable to defer the x-ray exam to the second trimester of pregnancy.

What are the risks involved?

A chest x-ray examination is a safe, non-invasive and painless procedure. There is a hazard of exposure to radiation, but the doses used are very small. Unless you are undergoing repeated x-rays, there won’t be a deleterious effect on your body.

How should I prepare for a chest x-ray?

You do not need to make any special preparations before undergoing a chest x-ray. As is the routine with other diagnostic tests, talk to your physician regarding your medical history. Inform your physician if you have had exposure to radiation in the recent past (in the form of a diagnostic test employing radiation) and above all, tell him if you are pregnant. Remove jewelry or any metallic objects (including any body piercings on your chest) worn by you as these may obstruct the x-rays.

Do I need to fast before a chest x-ray exam?

There is no need to fast before undergoing a chest x-ray.

How is a chest x-ray performed?

– A chest x-ray is performed on an outpatient basis (unless the patient is already admitted to a hospital).

– No sedation is required. You will be awake and fully conscious during the entire procedure.

– You will be escorted to a room housing the x-ray machine.

– You will be asked to undress from the waist up and wear a hospital gown.

– Your body will be positioned between an x-ray machine that emits x-rays and an x-ray plate that creates an image. The image may be created digitally or with the help of an x-ray film.

– As a routine, two views are taken. One is with you facing the x-ray plate as the x-rays are shot at your back. This is known as the P-A view (posteroanterior view). In this position, a radiology technician will ask you to place your hands on your hips and press your chest firmly against the x-ray plate.

– In a lateral view, the x-rays bombard your body from the side. You need to stand with your arms elevated for this view.

-The technician will ask you to take a deep breath and hold your breath for some time while he shoots x-rays at your chest. In this position, the chances of blurring of the image due to movement is minimized.

– You will be required to stand still during the exam to avoid blurring the end images.

– While an x-ray is being done, the technician will protect himself from the radiations by staying behind a wall or better still, move into an adjacent room and do the needful.

In case you are suffering from an injury or a musculoskeletal condition that makes it difficult for you to stand, the procedure may be carried out with you in a sitting position.

How long does it take for a chest-ray exam?

The entire process of getting a patient ready for the exam, exposing the patient to x-rays and obtaining the images takes about 15 to 20 minutes.

What does a chest x-ray look like?

A chest x-ray yields black and white images. The organs or structures which let the x-rays to pass through appear as white. The structures which block the rays appear as black. Bones, being dense structures, appear black. The heart appears a few shades lighter while the air-filled lungs have a slightly darker shade.

What is the cost of performing a chest x-ray in India?

The cost of performing a chest x-ray in India ranges from Rs 100 to 500.

What are the other types of x-ray examinations commonly performed?

Apart from detecting the disease of the chest cavity (chest x-ray), x-rays can be employed to visualize almost all the regions of the body. A few specialized x-ray techniques are-

– KUB- kidney, ureter, bladder x-ray
– Sinus x-ray
– Mammography- an x-ray of the breasts
– Standard Computed Tomography