Chest X-ray is a frequently prescribed medical imaging technique. It contributes to the diagnosis of pulmonary or cardiovascular pathology. Update with Dr. Samia Boussouar, radiologist.
Indications: why do a chest X-ray?
The chest X-ray is prescribed by a doctor on prescription. “This provides the radiologist with details of the pathologies sought and the patient’s relevant history. She is therefore prescribed for the diagnosis, screening and monitoring of pulmonary pathologies“, specifies Dr. Samia Boussouar, radiologist. The chest X-ray is one of the most frequently performed radiological examinations even if the use of chest CT is more and more common, “in addition to or instead of radiography”. The main indications for chest X-rays are:
- The results of shortness of breath (dyspnea)
- The research of infectious pneumonia
- The research of pneumothorax
- The balance sheet of chest pain
- The research pleural effusion
- The preoperative assessment (in some cases)
- monitoringasthma, COPD
- The examination of contact cases from pulmonary tuberculosis
- The suspicion of foreign body
- The research of rib fracture, vertebral
- THE systematic review occupational medicine
- Equipment installation follow-up especially in resuscitation or intensive care
What is a chest X-ray?
X-ray is to project x-rays through the body, placed between an X-ray machine and a sensor. The rays pass through the body while the sensor collects the images and prints them. “The amount of radiation absorbed varies in different parts of the body. Those that absorb the most radiation, such as bones, appear white on the x-ray. Parts that absorb less radiation (eg the heart) appear in varying shades of gray. Regions containing air, such as the lungs, appear black“details the Heart Institute of theUniversity of Ottawa.
It is important to inform the radiographer of a risk of pregnancy
The chest X-ray is painless and does not require a prick. No preparation is necessary and the patient does not need to be fasting. The examination, carried out by a qualified radio manipulator, lasts only a few minutes. Jewelry and piercings are removed. “The patient stands standing, shirtless, placed between the X-ray tube and the capture plate containing the film, he holds his breath in deep inspiration for a few seconds, his arms raised, remaining motionless while the shot is taken (a few seconds). Two shots are often taken, one from the front and the other in profile. A chest X-ray can optionally be performed semi-sitting or in bed if the patient cannot stand“, explains our expert. She adds: “it is important to inform the radiographer of a risk of pregnancy due to X-rays even if the X-ray doses are very low“.
The outfit worn by the patient has no effect on the examination since the patient is bare-chested during the X-ray.
What do you see on a chest X-ray?
“The chest X-ray allows us to visualize the lungs, pleura (sheets that surround the lung), the mediastinum (region between the 2 lungs containing the heart, vessels, esophagus, lymph nodes, trachea and main bronchi), vertebrae, ribs and diaphragmatic domes. One can also appreciate the soft parts and the breast silhouette“, enumerates our expert.
What is a normal chest X-ray?
Stains, larger than normal organs, too much water or air in the chest, fractures… the specialist to interpret what he sees on the chest x-ray based on the clinical examination of the patient and the suspected pathologies.
What is a problematic chest X-ray?
The chest X-ray answers the questions posed by the clinician. It allows to diagnose:
- a pulmonary infection
- A pneumothorax
- heart overload (acute pulmonary edema)
- A pleural effusion
- A pericardial effusion
- a tumor
- of the lung metastases
- a pulmonary fibrosis
- chest distention as part of a COPD post-smoking or emphysema
- the presence of a foreign body
- a fracture costal or vertebral
- a diaphragmatic dysfunction with an elevation of the diaphragmatic dome
- good or bad positioning of materials (catheter, nasogastric tube, Picc line, etc.)
What is the cost of a chest X-ray and is it reimbursed?
Like other x-ray examinations, the chest x-ray is 70% coverage the tariff established by Social Security. The rest is now covered by complementary health insurance.. The X-ray must however be prescribed during a course of coordinated care, by a general practitioner or a specialist.
Thanks to Dr. Samia Boussouar, radiologist in the Cardiovascular and Thoracic Imaging Department (ICT) of the Pitié-Salpêtrière Hospital.