Indications:
§ Dyspnea
§ Chest trauma
§ Chest pain
§ Chronic cough
§ Hemoptysis
§ Suspected lung neoplasm (primary or metastatic)
§ Suspected infectious process (e.g., tuberculosis [TB], pneumonia, abscess)
§ Inhalation injury
§ Pulmonary nodule
§ Suspected pleural effusion
§ Pneumothorax
§ Pulmonary plaques
§ Pneumonia follow-up
§ Assessment before cardiopulmonary surgery
§ Confirmation of feeding tube placement, Swan-Ganz catheter, central venous catheter, endotracheal tube, transvenous ventricular pacemaker
§ Suspected acute respiratory distress syndrome (ARDS), CHF
§ Mesothelioma
§ Interstitial lung disease
§ Sarcoidosis
§ Lymphoma
Strengths:
§ Low cost
§ Readily available
§ Low radiation
§ Can be performed at bedside
Weaknesses:
§ Low diagnostic yield
§ For portable chest x-radiographs, poor results in obese patients, heart overmagnification caused by film taken anteroposteriorly, poor respiratory effort, and poor positioning of patients; the degree of inspiration is likely to be substantially less in a portable chest x-ray than with an erect film, making the heart appear relatively larger and providing less optimal visualization of the lungs because they are not optimally expanded.
Comments:
§ Proper exposure for evaluating the cardiac structures is present when the spine is just visible behind the heart.