8 - Plain Radiographs of the Pediatric Chest

Summary

INDICATIONS

Plain film radiographs of the chest ordered from the ED are indicated in stable patients to provide contributory information in the diagnostic process of health complaints potentially involving the chest. The radiographic findings on plain film chest radiographs are often nonspecific and/or subtle, but serve as a useful screening measure to confirm or rule out the presence of various chest conditions.

DIAGNOSTIC CAPABILITIES

Plain film radiographs contrast differences in the standard five radiographic densities (metallic, calcific/bone, soft tissue/water, fat, and air) to assist in the diagnostic process. The dominant structures in the chest are the lungs (mostly air and soft tissue densities) and the heart (soft tissue density). In a standard chest x-ray (CXR), two basic views are generally obtained: the posteroanterior (PA) view and the lateral view. In most instances, these are both done with the patient upright. However, when the child is very ill, upright positioning is often not feasible. Although upright positioning in older children, teens, and adults is easy to achieve in most instances, upright positioning in infants and young children is difficult. Most imaging departments use some type of positioning device to keep the infant in the upright position with his or her arms up in the air for proper positioning.