A chest radiograph is used to diagnose conditions affecting the chest
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Chest radiographs are used to diagnose many conditions involving the chest wall, including its bones, and also structures contained within the thoracic cavity including the lungs, heart, and great vessels. Pneumonia and congestive heart failure are very commonly diagnosed by chest radiograph. Chest radiographs are also used to screen for job-related lung disease in industries such as mining where workers are exposed to dust.
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A chest radiograph, colloquially called a chest X-ray (CXR), or chest film, is a projection radiograph of the chest used to diagnose conditions affecting the chest, its contents, and nearby structures. Chest radiographs are the most common film taken in medicine.
Like all methods of radiography, chest radiography employs ionizing radiation in the form of X-rays to generate images of the chest. The mean radiation dose to an adult from a chest radiograph is around 0.02 mSv (2 mrem) for a front view (PA, or posteroanterior) and 0.08 mSv (8 mrem) for a side view (LL, or latero-lateral). Together, this corresponds to a background radiation equivalent time of about 10 days.
For some conditions of the chest, radiography is good for screening but poor for diagnosis. When a condition is suspected based on chest radiography, additional imaging of the chest can be obtained to definitively diagnose the condition or to provide evidence in favor of the diagnosis suggested by initial chest radiography. Unless a fractured rib is suspected of being displaced, and therefore likely to cause damage to the lungs and other tissue structures, x-ray of the chest is not necessary as it will not alter patient management.
The main regions where a chest X-ray may identify problems may be summarized as ABCDEF by their first letters:
Airways, including hilar adenopathy or enlargement
Breast shadows
Bones, e.g. rib fractures and lytic bone lesions
Cardiac silhouette, detecting cardiac enlargement
Costophrenic angles, including pleural effusions
Diaphragm, e.g. evidence of free air, indicative of perforation of an abdominal viscus
Edges, e.g. apices for fibrosis, pneumothorax, pleural thickening or plaques
Extrathoracic tissues
Fields (lung parenchyma), being evidence of alveolar flooding
Failure, e.g. alveolar air space disease with prominent vascularity with or without pleural effusions