A chest x-ray is a type of diagnostic radiology procedure used to
examine the chest and the organs and structures located in the chest.
Chest x-rays may be used to assess the lungs, as well as the heart
(either directly or indirectly) by looking at the heart itself. Certain
conditions of the heart may cause changes in the lungs and/or the
vessels of the lungs. Changes in the normal structure of the heart,
lungs, and/or lung vessels may indicate disease or other conditions.
Chest x-rays may provide important information regarding the size,
shape, contour, and anatomic location of the heart, lungs, bronchi,
great vessels (aorta, aortic arch, pulmonary arteries), mediastinum (an
area in the middle of the chest separating the lungs), and the bones
(cervical and dorsal spine, clavicles, shoulder girdle, and ribs).
What are x-rays?
X-rays use invisible electromagnetic energy beams to produce images of
internal tissues, bones, and organs on film. X-rays are made by using
external radiation to produce images of the body, its organs and other
internal structures for diagnostic purposes. X-rays pass through body
tissues onto specially treated plates (similar to camera film) and a
“negative” type picture is made (the more solid a structure is, the
whiter it appears on the film).
Depending on the results of the chest x-ray, additional tests or
procedures may be requested by your physician for further diagnostic
Other related procedures that may be used to diagnose problems of the
chest and respiratory tract include chest fluoroscopy, chest ultrasound,
computed tomography (CT scan) of the chest, lung biopsy, lung scans,
mediastinoscopy, positron emission tomography (PET scan) of the chest,
pleural biopsy, thoracentesis, sinus x-rays, pulmonary angiogram,
bronchoscopy, and bronchography. Please see these procedures for
Anatomy of the respiratory system
respiratory system is made up of the organs involved in the interchanges
of gases, and consists of the:
The upper respiratory tract includes the:
ethmoidal air cells
The lower respiratory tract includes the lungs, bronchi, and alveoli.
What are the functions of the lungs?
The lungs take in oxygen, which cells need to live and carry out their
normal functions. The lungs also get rid of carbon dioxide, a waste
product of the body's cells.
The lungs are a pair of cone-shaped organs made up of spongy,
pinkish-gray tissue. They take up most of the space in the chest, or the
thorax (the part of the body between the base of the neck and
The lungs are enveloped in a membrane called the pleura.
The lungs are separated from each other by the mediastinum, an area that
contains the following:
the heart and its large vessels
The right lung has three sections, called lobes. The left lung has two
lobes. When you breathe, the air enters the body through the nose or the
mouth. It then travels down the throat through the larynx (voice box)
and trachea (windpipe) and goes into the lungs through tubes called
One main-stem bronchus leads to the right lung and one to the left lung.
In the lungs, the main-stem bronchi divide into smaller bronchi and then
into even smaller tubes called bronchioles. Bronchioles end in tiny air
sacs called alveoli.
Reasons for the Procedure
Chest x-rays may be used to assess heart status (either directly or
indirectly) by looking at the heart itself, as well as the lungs.
Changes in the normal structure of the heart, lungs, and/or lung vessels
may indicate disease or other conditions.
Conditions that may be assessed with a chest x-ray include, but are not
limited to, the following:
heart enlargement (which can occur with congenital heart defects
pericardial effusion – a buildup of excess fluid in between the
heart and the membrane that surrounds it, often due to
pleural effusion – a collection of blood or fluid around the
pneumonia, persistent cough, and other lung conditions
aneurysms – ballooning of the walls of the great blood vessels,
such as the aorta
calcification of heart structures (such as heart valves or
tumors or cancer
herniation of the diaphragm (the breathing muscle, the
diaphragm, moves out of place)
pleuritis – inflammation of the lining of the lung
pulmonary edema (“fluid in the lungs,” which can occur with
congenital heart disease or congestive heart failure)
Other reasons for performing a chest x-ray may include:
as part of the physical assessment before hospitalization and/or
surgery or as part of a complete physical examination
to assess symptoms of conditions related to the heart or lungs
to assess progression of a condition and/or effectiveness of
to check the position of implanted pacemaker wires and other
internal devices such as central venous catheters, endotracheal
tubes, chest tubes, or nasogastric tubes
to check status of lungs and chest cavity after surgery
There may be other reasons for your physician to recommend a chest
Risks of the Procedure
You may want to ask your physician about the amount of radiation used
during the procedure and the risks related to your particular situation.
It is a good idea to keep a record of your past history of radiation
exposure, such as previous scans and other types of x-rays, so that you
can inform your physician. Risks associated with radiation exposure may
be related to the cumulative number of x-ray examinations and/or
treatments over a long period of time.
If you are pregnant or suspect that you may be pregnant, you should
notify your physician. Radiation exposure during pregnancy may lead to
There may be other risks depending upon your specific medical condition.
Be sure to discuss any concerns with your physician prior to the
Before the Procedure
The physician will explain the procedure to you and offer you
the opportunity to ask any questions that you might have about
Generally, no prior preparation, such as fasting or sedation, is
Notify the radiologic technologist if you are pregnant or
suspect that you may be pregnant.
Dress in clothes that permit access to the area to be tested or
that are easily removed.
Notify the radiologic technologist if you have any body piercing
on your chest.
Based upon your medical condition, your physician may request
other specific preparation.
During the Procedure
chest x-ray may be performed on an outpatient basis or as part of your
stay in a hospital. Procedures may vary depending on your condition and
your physician’s practices.
Generally, a chest x-ray follows this process:
You will be asked to remove any clothing, jewelry, or other
objects that may interfere with the procedure.
You will be given a gown to wear.
The particular view that the physician orders will determine how
you are positioned for the x-ray such as lying, sitting, or
standing. You will be positioned carefully so that the desired
view of the chest is obtained. The physician will also specify
the number of films to be made.
For a standing or sitting film, you will stand or sit in front
of the x-ray plate. You will be asked to roll your shoulders
forward, take in a deep breath, and hold it until the x-ray
exposure is made. For patients who are unable to hold their
breath, the radiologic technologist will take the picture at the
appropriate time by watching the breathing pattern.
It will be important for you to remain still during the
exposure, as any movement will blur the film.
For a side-angle view of the chest, you will be asked to turn to
your side and raise your arms above your head. You will be
instructed to take in a deep breath and hold it as the x-ray
exposure is made.
The radiologic technologist will step behind a protective window
while the images are being made.
While the x-ray procedure itself causes no pain, the manipulation of the
body part being examined may cause some discomfort or pain, particularly
in the case of a recent injury or invasive procedure such as surgery.
The radiologic technologist will use all possible comfort measures and
complete the procedure as quickly as possible to minimize any discomfort
After the Procedure
Generally, there is no special type of care after a chest x-ray.
However, your physician may give you additional or alternate
instructions after the procedure, depending on your particular
The content provided here is for informational purposes only, and was
not designed to diagnose or treat a health problem or disease, or
replace the professional medical advice you receive from your physician.
Please consult your physician with any questions or concerns you may
have regarding your condition.
This page contains links to other Web sites with information about this
procedure and related health conditions. We hope you find these sites
helpful, but please remember we do not control or endorse the
information presented on these Web sites, nor do these sites endorse the
information contained here.
For more information, call 1.866.CALL.MLH.