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Chest X-ray | Chest radiograph

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What is chest radiograph & Chest X-ray?

It is the oldest and the most commonly used imaging technique to screen the lungs and the other structures in the chest. It uses X-rays which has the ability to pass through the body and produce images on the special type of receptors which is then converted into an image.

It is the easiest and fastest way to assess the lungs, heart, pulmonary blood vessels, airway, spine/vertebrae, ribs and bones which are part of the shoulder joint. In this article you will get to know about technology behind chest radiograph and chest x-ray, Why is it done? and What you all can see?

chest x-ray and chest radiograph

Technology behind Chest X-ray & Chest Radiograph

• Initially, a photostimulable phosphor image receptor plate was used where phosphor plates stored some of the energy of the incident x-ray as a latent image.

• On scanning the plate with a laser beam the stored energy is emitted as light and is detected by a photomultiplier and converted to a digital signal.

• Recent advanced methods are where digital amorphous silicon flat-panel X-ray detector based on caesium iodide and amorphous silicon is used.

• Thin film transistor (TFT ) flat panel detector systems are used, these have the advantage of high detection efficiency and rapid image display and have excellent image quality.

Getting Chest X-ray done

• Change your clothes, wear gowns provided by diagnostic centre (because they are free of buttons and any other clothing related objects obscuring the imaging), make sure nothing metallic, buttons, necklaces/pendants or anything is kept in the pocket.

• Technologist will position you for frontal or lateral projections, accordingly, the chest x-ray beam will be projected on your body and image will be collected.

• Lateral decubitus position is given to patients with community-acquired pneumonia and to see pleural effusion <1cms.

• Portable chest radiology is done in bed ridden or comatose patients, has disadvantage of scattered radiation, poor image quality and inability to cover entire area of interest generally due to poor patient cooperation or positioning.

Why is it done?

• Acute conditions like trauma to see for fracture or look for air around the lung (pneumothorax- emergency condition)

• See lung changes in case of infection


• Lung cancer


• Occupational hazard patients


• As a part of follow up cases, ex: nodules and follow up plan of assessment of treatment

• To assess Heart size and morphology

• For assessment of pulmonary vessels

• See for spine and ribs pathologies or fractures.

• See for ET, NT, pacemakers, catheters and post-operative changes.


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What all can you see?

• Lung field/parenchyma

• Hilum

• Bones

• Blood vessels

• Heart

• Diaphragm

• Pleura

• Mediastinum


• There is always a slight chance of cancer from excessive exposure to radiation. However, the benefit of an accurate diagnosis far outweighs the risk.

• The effective radiation dose for this procedure varies.

• Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant/history of missed period. Its contraindicated in pregnancy due to risk to infant’s life and development.

Precautions for Chest Radiograph:

Wear lead aprons or shields to cover other parts of body that are not being examined. One should cover the thyroid gland and gonads if chest x-ray is being taken.


• Minute details like air-trapping, emphysematous changes or interstitial lung disease changes require HRCT to be done in order to see properly.

• Blood clots in vessels or small lung nodules/cancer can be missed on plain chest radiograph.

Interpretation of results

• Lung fields appear dark in colour. It appears black in colour since it lets the chest x-ray and chest radiograph pass through it.

• Structures like bones and soft tissue appear dense white in colour since they block these x-rays from passing through them.

• A radiologist, doctor trained in interpretation of x-ray is best to consult and get the results from.


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