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.

  

Why does a doctor order a chest x-ray?

A doctor may order a chest x-ray if a patient is presenting with symptoms such as:

persistent coughing difficulty breathing wheezing coughing up blood chest pain chest injury fever shortness of breath

Other reasons a chest x-ray may be ordered is to reveal:

fractures heart-related problems problems with blood vessels changes after having an operation lung conditions outline and size of the heart position of pacemaker, defibrillator, or catheter

 

What causes an abnormal chest X-ray?

An abnormal chest X-ray can be caused by a number of conditions.

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) bronchitis asthma

Heart:

an enlarged heart (cardiomegaly), which can, in turn, be caused by various conditions, such as hypertension or coronary artery disease. heart failure fluid around the heart

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 cysts

  

What does an abnormal chest x-ray look like?

Lungs: the whiter the lungs appear on the scan, the more dense they will be; the darker they are, the less dense. A doctor will assess which side of the lungs or if both sides are abnormal based on key surrounding features.

Heart: the heart blocks radiation so will appear lightly in the scan. Any abnormalities with the heart or surrounding it will appear as lighter or darker areas.

Bones: bones are the densest natural structure seen in a chest x-ray. Fractures will be quickly and easily seen in the scan as dark lines through the bone.

A radiologist will look for clues indicating there is an abnormality and will report with the doctor who ordered the chest x-ray.

 

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.