Friday, September 29, 2023

Do You Need A Chest X Ray For Pneumonia

Is A Chest X

Chest X Ray Interpretation Explained Clearly – How to read a chest Xray

Always tell your healthcare provider if there is a possibility that you are pregnant. Radiation exposure can cause damage to a developing baby. In general, the amount of radiation used for simple chest x-rays is so small that it’s considered safe during pregnancy, but your healthcare provider will help make the decision to do the x-ray based on the urgency of your symptoms.

How Bad Does Pneumonia Have To Be To Be Hospitalized

Pneumonia can be life-threatening if left untreated, especially for certain at-risk people. You should call your doctor if you have a cough that wont go away, shortness of breath, chest pain, or a fever. You should also call your doctor if you suddenly begin to feel worse after having a cold or the flu.

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What Diseases Can Be Diagnosed With Chest X

Many diseases or conditions may be detected or diagnosed based on a chest X-ray test. A chest X-ray test can also be very helpful in ruling out suspected diagnoses. Some of the common conditions that can be evaluated by a chest X-ray tests are pneumonia, congestive heart failure, emphysema, lung mass or lung nodule, tuberculosis, fluid around the lung , fracture of the vertebrae , rib fractures, or cardiomegaly, or enlarged heart.

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What Happens During A Chest X

You may have a chest X-ray as an outpatient or as part of your stay in ahospital. The way the test is done may vary depending on your condition andyour healthcare providers practices.

Generally, a chest X-ray follows this process:

  • You will be asked to remove any clothing, jewelry, or other objects that may get in the way of the test.

  • You will be given a gown to wear.

  • You may be asked to lie down, sit, or stand. Your position depends on what images the technologist needs.

  • For a standing or sitting image, 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 is made. If you are unable to hold your breath, the technologist will take the picture by watching how you breathe.

  • You will need to stay still during the X-ray. Moving during the X-ray may affect the quality of the image.

  • 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 told to take in a deep breath and hold it as the X-ray is made.

  • The technologist will step behind a special window while the images are being made.

  • The chest X-ray is not painful. But you may have some discomfort or painfrom moving into different positions if you have had recent surgery or aninjury. The technologist will use all possible comfort measures and do thescan as quickly as possible to minimize any discomfort or pain.

    Key Points About Pneumonia

    Chest x
    • Pneumonia is an infection of one or both of the lungs caused by bacteria, viruses, or fungi.

    • There are more than 30 different causes of pneumonia, and theyre grouped by the cause. The main types of pneumonia are bacterial, viral, and mycoplasma pneumonia.

    • A cough that produces green, yellow, or bloody mucus is the most common symptom of pneumonia. Other symptoms include fever, shaking chills, shortness of breath, low energy, and extreme tiredness.

    • Pneumonia can often be diagnosed with a thorough history and physical exam. Tests used to look at the lungs, blood tests, and tests done on the sputum you cough up may also be used.

    • Treatment depends on the type of pneumonia you have. Antibiotics are used for bacterial pneumonia. It may also speed recovery from mycoplasma pneumonia and some special cases. Most viral pneumonias dont have a specific treatment and just get better on their own. Other treatment may include a healthy diet, more fluids, rest, oxygen therapy, and medicine for pain, cough, and fever control.

    • Most people with pneumonia respond well to treatment, but pneumonia can cause serious lung and infection problems. It can even be deadly.

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    Pneumonia Cannot Be Reliably Diagnosed Without X

    Dutch researchers, who published their findings in the European Respiratory Journal, found that of 140 patients who had their pneumonia diagnosed by x-ray, doctors initially thought only 41 of them had the severe lung infection.

    “That’s worse than flipping a coin,” said Richard Watkins, who was not involved in the study but has researched how doctors diagnose pneumonia. “I think that’s an argument for doing chest x-rays.”

    People with pneumonia may have a cough, fever, nausea, vomiting, chills or chest pain. Under some circumstances, the infection can put patients into an intensive care unit and even turn fatal.

    In 2009, the U.S. Centers for Disease Control and Prevention said that about 1.1 million Americans were hospitalized with pneumonia, and about 50,000 died of it.

    According to researchers led by Saskia van Vugt from the University Medical Center in Utrecht, most doctors use their best judgment in deciding who has pneumonia, because it’s not possible to give everyone an x-ray to check for signs of the infection.

    Little was known, however, about how accurate doctors were with their diagnoses, the researchers wrote.

    For the study, van Vugt and her colleagues used information collected between October 2007 and April 2010 on 2,810 adult patients of doctors in 12 European countries.

    Of those 72 initial diagnoses, the x-rays showed that 31 did not have pneumonia. In the rest of the group, the researchers found the doctors missed 99 cases.

    How Do I Prepare For A Chest X

    Chest X-rays require little to no preparation. When you get ready for the appointment, wear loose, comfortable clothing that does not contain metal and leave jewelry at home.

    If you have body piercings, ask your X-ray center for specific instructions. Body jewelry can interfere with clear images. You may need to remove it or replace it with an acrylic retainer.

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    What Happens During The Chest X

    To prepare for a chest X-ray, the patient is typically instructed to wear a gown and remove all metal-containing objects around the upper body as these will interfere with the visualization of the tissues. No other specific preparation, such as fasting, is necessary for a routine chest X-ray.

    The patient is then asked by the technician to stand in front of a surface adjacent to the film that records the images. The front of the chest is closest to the surface. Another part of the machine that releases the radiation is then placed about 6 feet away, behind the patient. When the positioning is appropriate , the technician may advise the patient to take a deep breath and hold it and then takes the image by activating the device . The image is then captured on the film within a few seconds. The film can be developed within a few minutes to be reviewed by the doctor.

    Usually, one image is done from back to front and, as described above, a second image using a sideways view from side-to-side can be done as well.

    Doctors generally order chest X-ray tests in conjunction with taking a medical history and performing a physical exam to confirm or exclude a suspected chest.

    To confirm the proper placement of certain devices within the chest, such as pacemakers, endotracheal , catheters in large veins of the chest , etc. There are many other more specific reasons that a doctor may choose to order a chest X-ray depending on each individual situation.

    Pneumonia Detection In Chest X

    Pneumonia (Right Middle Lobe): Explanation of Chest X-ray Findings
    • Roles Formal analysis, Software, Writing original draft

      Affiliation Department of Electrical Engineering, Jadavpur University, Kolkata, India

    • Roles Funding acquisition, Supervision, Writing review & editing

      Affiliation College of IT Convergence, Gachon University, Seongnam, South Korea

    • Roles Formal analysis, Supervision, Writing review & editing

      Affiliation Department of Computer Science & Engineering, Jadavpur University, Kolkata, India

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    What Are The Differential Diagnoses

    Ground glass appearance, consolidation, and linear opacities can also be caused by

    • Other atypical pneumonias and the early stages of community acquired pneumonias

    • Pulmonary aspiration

    • Inflammatory lung disease, such as pulmonary eosinophilia

    • Vasculitides, eg Wegeners

    • Haemorrhage.

    Causes of other atypical pneumonias include SARS and MERS, mycoplasma infection, Coxiella burnetti, and legionella19 .

    Causes of bacterial community acquired pneumonias include Streptococcus pneumoniae, Haemophilus influenzae, and Klebsiella20 . Chest radiograph changes from community acquired pneumonias are typically unilateral affecting only one part of the lung. Community acquired pneumonias are predominantly associated with consolidation on chest radiography, not ground glass opacity or linear opacities.20

    Recent reports suggest that vaping causes radiological abnormalities,21 and these appearances have been described as being similar to covid-19.

    What Increases Your Risk Factors For Walking Pneumonia

    Like pneumonia, the risk for developing walking pneumonia is higher if you are:

    • over age of 65 years old
    • 2 years old or younger
    • immunocompromised

    Since walking pneumonia tends to be mild, some people with the illness choose not to get a formal diagnosis. But other serious diseases can cause symptoms that look like walking pneumonia. If symptoms continue to worsen after a few days, consider checking in with a healthcare professional for a diagnosis and treatment.

    Treatment for walking pneumonia depends on whats causing the disease. Walking pneumonia from bacteria can be treated with antibiotics. A healthcare professional may use antiviral medications to treat cases caused by viruses.

    For very mild cases of walking pneumonia, treatment may simply involve managing symptoms at home and resting.

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    Features And Limitations Of Chest Radiographs In Covid


    • Central mediastinum and heart appear normal

    • Lungs predominantly contain air

    • Lung markings are present, representing blood vessels extending from the hilum to the lung periphery

    • The diaphragm is curvilinear in outline with sharp costophrenic margins

    Ground glass opacity

    • The initial abnormalities suggesting covid-19 pneumonia on a chest radiograph are loss of the normal black appearance in the lung

    • This is seen as increased whiteness, , but not enough to totally obscure lung markings giving a ground glass appearance

    • Ground glass opacities can be difficult to observe radiologist confirmation is recommended

    • Horizontal linear opacities may be seen with ground-glass change9

    • Location: usually bilateral but can be unilateral.7 More often reported in a peripheral lung8 adjacent to the chest wall and diaphragm and usually with a distribution in the mid and lower zones8911Fig 4b shows ground glass opacities in the right upper zone, as will be the case in approximately 20% of patients with covid-19 pneumonia


    • Ground-glass opacities become denser and progress to consolidation with complete loss of lung markings

    • Location: The areas of consolidation are likely to have progressed from sites of ground glass opacities


    Value Of The Chest Radiograph


    Not surprisingly many consider that chest radiology, which is a relatively inexpensive test, plays a fundamental and important role in the diagnosis of pneumonia, together with clinical assessment and sometimes appropriate microbiological testing . Its primary purpose is to diagnose or exclude pneumonia, but it will also show the extent of the pneumonia, the presence or absence of associated comorbid conditions or complications, all of which may act as prognostic indicators, and it can also be used for subsequent follow-up to check for resolution . The chest radiograph is much less helpful in suggesting the likely microbial aetiology of CAP although sometimes specific patterns are seen and may be helpful particularly in immunocompromised individuals . Certainly, in the case of patients admitted to hospital there is evidence that the early performance of a chest radiograph is associated with clinical benefit, including a significantly shorter hospital length of stay and antibiotic use after radiology .

    • In any patient demonstrating at least one of the following abnormal vital signs:

    • Temperature > 37.8 °C

  • In any patient with at least two of the following clinical findings:

  • Decreased breath sounds

  • Absence of asthma

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    How Is A Chest X

    The X-ray occurs in a special room with a movable X-ray camera attached to a large metal arm. You will stand next to a plate. This plate may contain X-ray film or a special sensor that records the images on a computer. Youll wear a lead apron to cover your genitals. This is because your sperm and eggs could be damaged from the radiation.

    The X-ray technician will tell you how to stand and will record both front and side views of your chest. While the images are taken, youll need to hold your breath so that your chest stays completely still. If you move, the images might turn out blurry. As the radiation passes through your body and onto the plate, denser materials, such as bone and the muscles of your heart, will appear white.

    After the images have been captured which should take 20 minutes or so your part is complete. You can change back into your clothes and go about your day.

    Why It Is Done

    A chest X-ray is done to:

    • Help find the cause of common symptoms such as a cough, shortness of breath, or chest pain.
    • Find lung conditionssuch as pneumonia, lung cancer, chronic obstructive pulmonary disease , collapsed lung , or cystic fibrosisand monitor treatment for these conditions.
    • Find some heart problems, such as an enlarged heart, heart failure, and problems causing fluid in the lungs , and to monitor treatment for these conditions.
    • Look for problems from a chest injury, such as rib fractures or lung damage.
    • Find foreign objects, such as coins or other small pieces of metal, in the tube to the stomach , the airway, or the lungs. A chest X-ray may not be able to see food, nuts, or wood fibres.
    • See if a tube, catheter, or other medical device has been placed in the proper position in an airway, the heart, blood vessels of the chest, or the stomach.

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    What Your Chest X

    X-rays can be and often are used to diagnose broken bones, but thats not the only purpose a chest X-ray can serve. A chest X-ray can help your doctor diagnose problems with your heart or the blood vessels in your chest your lungs or the rest of your airway or even the bones in your chest and spine.

    X-rays work by using radiation to take pictures that let doctors see the structures inside your body. The radiation passes through soft tissues, like skin and muscle, and these areas appear dark on the resulting image. However, denser tissues, like bones and the thick muscles of the heart, block some of the radiation, so that these areas appear lighter on the resulting picture. Fluid build-up in or around the organs also blocks the passage of radiation, so that if youre suffering from congestive heart failure, pulmonary edema, or similar conditions, your doctor will be able to tell from looking at the X-ray, because areas of the picture that should appear dark will appear lighter.

    Some things that your doctor can see on an X-ray include:

    Your doctor may also want to use a chest X-ray to monitor your recovery from a chest X-ray, or to verify the correct placement of a catheter, defibrillator, or pacemaker.

    The Role Of Chest Radiography In Confirming Covid

    How to read a chest X-ray (in 20 mins) !
  • Joanne Cleverley, consultant radiologist1,
  • James Piper, senior clinical teaching fellow 2 3,
  • Melvyn M Jones, general practitioner and clinical associate professor4 5
  • 1Department of Radiology, Royal Free Hospital NHS Trust, London, UK
  • 2Royal Free Hospital NHS Trust, London, UK
  • 3UCL Medical School, Royal Free Campus, London, UK
  • 4Research Department of Primary Care & Population Health, UCL, Royal Free Campus, London, UK
  • 5Institute of Biomedical Education, St Georges University of London, London, UK
  • Correspondence to M Jones
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    A Note From Cleveland Clinic

    A chest X-ray is a test that looks at your heart, lungs and bones. Chest X-rays use a small dose of radiation to create a black-and-white image. Healthcare providers can look at this image to diagnose and treat broken bones, heart conditions and lung problems. Chest X-rays are quick, noninvasive procedures done in a healthcare providers office or the hospital. In non-emergency situations, you will know your chest X-ray results in one to two days.

    Who Can Interpret Chest X

    Many doctors are trained to interpret chest X-rays. In addition to radiologists, who have special training in reading all radiology films, primary care physicians, internists, pediatricians, emergency room doctors, anesthesiologists, heart doctors , lung doctors and lung surgeons are the doctors who frequently interpret chest X-rays as a part of their routine practice.

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    How Do You Prepare For A Chest X

    As noted above, usually a gown is worn and metal-containing materials are removed from the body before an X-ray is taken. Pregnant women need to notify the doctor and the technician as some or all images may not be taken in order to avoid unnecessary X-ray radiation exposure to the fetus. Precautions, such as protective lead covers may be placed on the abdomen to avoid radiation to the fetus when an X-ray is absolutely necessary.

    What May Be Advised To Help Manage The Problem

    Chest X

    This will depend on the cause that is found for your chest pain. Follow the links above to the separate leaflets for more information about the treatment for the different causes.

    If the problem is not an emergency, your doctor may refer you to a consultant for further specialist investigations, as described above.

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