n CME : Your SA Journal of CPD - The abnormal chest X-ray - when to refer to a specialist : main article

Volume 25, Issue 11
  • ISSN : 0256-2170



  • Chest X-rays are an important investigation in lung disease. However, history and physical examination are crucial steps in the evaluation of the patient and should be performed before reading chest X-rays.
  • X-ray abnormalities need to be combined with clinical findings to make a diagnosis.
  • If you are not sure, seek assistance from a specialist.
  • Consolidation or air-space shadowing is caused by opacification of air-containing spaces of the lung.
  • Collapse or atelectasis is due to partial or complete volume loss in a lung or lobe.
  • Physical examination is required to determine if the mass is intrapulmonary or cutaneous.
  • Intrapulmonary lesions are well defined and are projected over the lung on frontal and lateral projections. Extrapulmonary mass lesions are in contact with other soft-tissue structures.
  • The summation of multiple, small, linear opacities on the chest X-ray may produce the appearance of multiple small nodules. Likewise the superimposition of multiple small nodules may produce a granular or ground-glass pattern.
  • Hilar abnormalities may be vascular and non-vascular.
  • Pleural effusions collect in the posterior costophrenic angle and as little as 100 - 200 ml may appear above the diaphragm.

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