| Chest x-ray is one of
the most important diagnostic tools in evaluating patients with pulmonary problems.
Physical examination of the chest has inherent limitations. Lesions located in the
mediastinum, interstitium, and in the center of the lung are rarely picked up by physical
exam. Utility
Ease of availability of chest x-ray has made many physicians avoid time consuming physical
exam which in most cases fails to reveal all of the problems. As a result, over a period
of time, physicians have lost the skill of physical exam. In the United States, chest
x-rays are routinely obtained for hospitalized adult patients. Pulmonary specialists will
almost never provide a consultation without having seen a chest x-ray. In under developed
countries chest x-rays are obtained very selectively and physicians rely mostly on
physical exam and history for diagnosis.
Limitations
Just as physical examination has limitations, chest x-ray also has limitations. It should
be recognized that a normal chest x-ray does not rule out pulmonary problems. In certain
cases, interstitial, airway and pulmonary vascular disease cannot be recognized by chest
x-ray However, it is easily evident on physical exam, e.g., asthmatics can have normal
chest x- rays.
Physical exam and chest x-ray compliment each other in providing information and
they are not mutually exclusive. In general, physical exam is recommended for acute
illness, while chest x- ray is recommended for chronic illness. |
