This does not normally alter clinical management of asymptomatic patients, or those with upper respiratory tract infections, minor chest trauma, uncomplicated asthma or exacerbation of chronic obstructive pulmonary disease (COPD), acute-on-chronic chest pain and hypertension. Indications for chest X-rayīox 1 lists the common indications for requesting a chest X-ray. For example, an infiltrate in the lungs might be fluid (oedema), pus, blood or cells (in malignancy) correlation with the clinical situation will usually discriminate between these possibilities. It is always useful to view the imaging findings in the context of the clinical findings, to avoid overdiagnosis or the wrong diagnosis. The AP technique can obscure pathology that is present and produce artefactual opacities. Anterior–posterior (AP) imaging is used when the patient is non-ambulatory but usually results in reduction of image quality, including magnification of heart size and poorer detail of lung structure. For PA imaging, which is preferred, patients are required to stand with their arms around a rectangular imaging system (film cassette or electronic imaging system). It typically includes posterior–anterior (PA) and lateral views, and gives an overview of the lungs and cardiovascular system. The chest X-ray remains the starting point in the imaging armamentarium. The reader is directed to the online version of the article for additional illustrative figures of salient points. This article discusses the two most common techniques used to evaluate diseases of the chest and briefly mentions some lesser used or emerging techniques. In many simple disease processes, such as uncomplicated infection, imaging may not be required. Magnetic resonance imaging (MRI) is a standard tool for assessment of congenital cardiac and vascular diseases but at this time is not in general use for imaging primary diseases of the lungs. Modalities available for imaging chest diseases include chest X-ray, computed tomography (CT) and nuclear medicine, including ventilation–perfusion lung scanning and positron emission tomography (PET).
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