Abnormal chest X-ray

What is an abnormal chest x-ray?

A chest X-ray is an imaging test that utilises low doses of radiation in short blasts to create images of the inside of a patient’s chest. In this way, doctors can examine the heart, lungs, bones and blood vessels.

If the X-ray images show abnormalities, this means that there is something unusual on the image of the chest. This is usually indicative of a problem, and could be immediately obvious, such as a broken or fractured rib, or could simply be a shadow that needs further investigation.

Some doctors specialise in dealing with abnormalities in chest X-ray results, and may order follow-up tests to determine the cause.

What causes an abnormal chest X-ray?

An abnormal chest X-ray can be caused by a number of conditions, including:

Lungs:

• Pneumonia (unusual white or hazy shadow on the normally dark lungs on the X-ray can indicate this)
• Abscesses
• Pulmonary oedema (fluid build-up in the lungs)
• Lung cancer and other masses in the lungs
• Cavities in the lungs or cavitary lesions (caused by diseases like tuberculosis and sarcoidosis)

Heart:

• An enlarged heart (cardiomegaly), which can, in turn, be caused by various conditions, such as hypertension or coronary artery disease.
• Heart failure

Bones:

• Broken ribs
• Broken or fractured vertebrae
• Dislocated shoulder

Other:

• Pleural effusion (fluid build-up between the lungs and chest wall)
• Pneumothorax (build-up of air between the lungs and chest wall)
• Hiatal hernia
• Aortic aneurysm

What's the next step?

If the doctor is concerned by an abnormal chest X-ray, but doesn’t have enough information to make a diagnosis, they may order further tests, including a chest CT scan or a PET scan. By analysing the results of all these tests, the problem can be identified, and the doctor can plan a course of action with the patient to treat the condition.