X-ray of the thorax (chest X-ray)

Definition

The X-ray examination of the thorax (medical term: thorax), usually referred to as X-ray thorax, is a frequently performed standard examination. It is used to assess various organs such as the lungs, heart or ribs. For this purpose, the thorax is x-rayed with a relatively small amount of X-rays and pictures are taken. During the evaluation, the doctor can assess possible abnormalities and changes. Depending on the findings, therapy, further examinations or a repeat of the X-ray examination may be necessary during the course of the procedure.

Indications

The indications for an X-ray examination of the thorax are manifold and can be used for the initial diagnosis of a disease as well as for a follow-up examination. For example, if there is a suspicion of lung disease due to symptoms such as shortness of breath or coughing, an X-ray of the chest can be performed to assess the lungs. Diseases such as pneumonia, structural changes in the lung tissue (emphysema or pulmonary fibrosis), but also space-occupying conditions can usually be easily detected.

The latter can be either benign or malignant processes. In some cases, further diagnostics, e.g. by taking a sample (biopsy), is appropriate for clarification. Furthermore, the X-ray thorax is used to assess the heart and the blood vessels in the thorax.

For example, cardiac insufficiency can lead to abnormal findings. These include water retention in the lungs (pulmonary edema) and a conspicuous enlargement of the heart. In addition, if bony damage to the thorax is suspected, such as broken ribs, there is an indication for an X-ray examination of the chest.

However, this is often only an orienting assessment and further diagnostics may have to follow. Furthermore, an X-ray examination of the thorax is indicated for control after medical interventions. After the installation of a pacemaker, for example, the correct position of the probes on the heart can be checked.

If a patient suffers from symptoms that indicate pneumonia, an X-ray of the chest is often taken to investigate this suspicion. Signs of pneumonia include coughing with sputum and fever. The X-ray image usually shows so-called shadowing in one or more areas of the lung in the case of pneumonia.

The inflammation causes, among other things, more water to enter the affected lung sections, so that they stand out visually from the rest of the lung tissue in the X-ray image. If pneumonia is diagnosed and treated (usually with an antibiotic), it may be advisable to take another chest x-ray for monitoring purposes. When evaluating the chest x-ray, a statement can be made as to whether congestion is present.

Such a congestion usually occurs in the case of a cardiac insufficiency (heart failure). The task of the heart is to pump the blood through the circulation. Before the blood enters the body’s circulation, it flows through the blood vessels in the lungs.

If the heart is not pumping well, the blood can back up in the upstream blood vessels and water in the lungs. In such a congestion, the vessels become more prominent and the lung tissue can also appear dense. This means that an X-ray examination of the chest can be used to check for any suspected congestion and to monitor it during the course of therapy.