What is a chest X-ray?
A chest X-ray is a test that uses a small amount of radiation to create an image of the structures within your chest, including your heart, lungs, blood vessels and bones. During an X-ray, a focused beam of radiation is passed through your body and a black-and-white image is recorded on special film or a computer. The X-ray image that is created looks like a negative from a black-and-white photograph.
Out of all the radiology tests, chest X-rays are the most common.
How does a chest X-ray work?
X-rays work because your body's tissues vary in density (thickness). Each tissue allows a different amount of radiation to pass through and expose the X-ray-sensitive detectors, which results in a shadow image of your organs. Your bones, for example, are very dense, and most of the radiation is prevented from passing through to the detector. As a result, your bones appear white on an X-ray. Tissues that are less dense –– such as your lungs –– allow more of the X-rays to pass through to the detector and appear on the image in shades of gray.
The following are visible on an X-ray:
- Fluid in or around your lungs.
- Air surrounding your lungs.
- Blood vessels.
- Aorta. (Your largest artery, which is connected to your heart.)
- Calcium deposits.
- Fractures. (Broken bones.)
Why is a chest X-ray used?
A chest X-ray may be used to help diagnose and plan treatment for various conditions, including:
- Lung disorders such as pneumonia, emphysema, tuberculosis and lung cancer.
- Heart disorders such as congestive heart failure (which causes the heart to enlarge).
- Fractures (breaks) of the bones in the chest, including the ribs and collarbone as well as breaks in the bones of the upper spine.
- Reasons for shortness of breath, a bad or persistent cough or chest pain.
Your healthcare provider might also order a chest X-ray as a precaution before surgery.
Where are chest X-rays performed?
Emergency departments, hospitals, some doctors’ offices, nursing homes and outpatient radiology facilities may have X-ray machines.
Who performs the chest X-ray?
A radiology technologist, a skilled medical professional who is trained in X-ray procedures, will perform your test. A radiologist, a healthcare provider who specializes in evaluating X-rays and other radiology procedures, will interpret your X-rays and report the test results to your healthcare provider.
How do I prepare for a chest X-ray?
There is no special preparation for your chest X-ray. It’s important to tell the technologist if you are or may be pregnant. X-rays generally are not used on pregnant women because of the possible risk of radiation exposure to the developing baby. X-rays can be taken on a pregnant woman, with adequate lead shielding that is used to block the X-rays from the abdomen. Also, please tell the technologist if you have an insulin pump.
Before the test begins, you’ll be asked to remove your clothing – usually just from the waist up – and put on a hospital gown. You’ll also be asked to remove all jewelry and any other objects containing metal (such as glasses and hair pins). This is done because metal can block the image and interfere with the test results.
Can the test be performed on both adults and children?
Yes, you can be X-rayed and so can your child. If you’re unable to stand, lift your chin or hold your arms above your head, that may complicate the process, but your technologist will assist.
What happens during a chest X-ray?
The technologist will cover you from the waist down with a lead shield or apron. This shield protects your pelvic and reproductive organs from exposure to the radiation. The technologist will also position your body against the X-ray detector mounted on the wall in a way that produces the clearest image. (If you can’t stand, you will lie down on top of the detector. The tube that takes the X-ray will be pointed at you from about six feet away. In most cases, chest X-rays are taken from two positions: from back to front (called a posterior-anterior, or PA, view) and from the side (called a lateral view).
For the PA view, you will stand in front of the X-ray unit with your hands on your hips, your shoulders rolled forward and your chin lifted. The technologist will ask you to be very still and take a deep breath and hold it while the X-rays are passed through your body. (This only takes a few seconds.) It’s necessary to hold your breath because movement, which occurs when you breathe in and out, can blur the X-ray image.
For the lateral view, you will be asked to turn to the side, raise your arms over your head and lift up your chin. Again, you will be asked to be still and hold your breath while the exposure is made.
Tell the technologist if you’re unable to stand, lift your chin or hold your arms above your head. The technologist will do their best to accommodate your needs during the test.
How long does the test last?
Plan on about five minutes for the test. This includes time for preparation, positioning, processing the films and repeating any images, if necessary.
What happens after the test?
After the X-rays are taken, the technologist will look at the images. You may be asked to wait a few minutes while the technologist makes sure your X-rays are acceptable; for example, to be sure they’re not blurred. If necessary, you may be asked to repeat the test to obtain a clearer image. Everything is computerized now and no film is used, so images can be viewed within seconds of exposure.
Your report will be sent to your healthcare provider, who will discuss the results with you. Results are usually available quickly.
What will I feel during the test?
A chest X-ray is painless. You will not feel the radiation as it passes through your body. The positions required for the chest X-ray may feel awkward or uncomfortable, but you only have to stay in those positions for a few seconds. The X-ray room may be cool, because air conditioning is used to keep the equipment at a constant temperature. The detector also may feel cold.
What are the risks of a chest X-ray? Are there any complications or side effects?
In general, chest X-rays are very safe and unlikely to produce side effects. The amount of radiation used is very small, so the risks are minimal. However, young children and a developing fetus carried by a pregnant woman are more sensitive to X-rays and are at greater risk for complications such as minor tissue damage. If a pregnant woman absolutely has to be X-rayed in an emergency, the technologist will give her a special lead gown.
Note that not every chest problem can be seen on an X-ray. Examples include:
- Pulmonary embolism.
- Blood clots in the lungs.
- Small cancers.
Results and Follow-Up
How is a chest X-ray read?
A technician sends the images electronically and then a radiologist reads and interprets them. They’ll look at the organs and come to a conclusion, which they’ll include in a report to your healthcare provider. For years, physical films were printed and held against light. Now there is software and the radiologist can examine the images on a computer screen instantly.
What happens if the test shows that something is wrong?
The office of the healthcare provider who ordered the X-ray will get in contact with you.
Can a chest X-ray show heart failure?
Can a chest X-ray show esophageal cancer?
Can a chest X-ray show pneumonia?
A note from Cleveland Clinic
A chest X-ray is a simple, quick, painless and low-risk test. It’s a vital diagnostic tool for healthcare providers. If you have chest pain, a persistent cough or other symptoms related to your chest area, don’t hesitate to see a healthcare provider because you may need a chest X-ray.