Chest X-Ray and Children
What are X-rays?
X-rays are made by using low levels of external radiation to produce images of the
body, the organs, and other internal structures for diagnostic purposes. X-rays pass
through body structures onto specially treated plates (similar to camera film) and
a "negative" type picture is made. The more solid a structure is, the whiter it appears
on the film. For this reason, bones appear very white on an X-ray film, but less dense
tissue such as muscle, blood, skin, and fat appears darker.
Why might I have a chest X-ray?
Chest X-rays may be used to assess heart status by looking at the heart itself, and
evaluating the lungs and the adjacent bony structures. Changes in the normal structure
of the heart, lungs, lung vessels and bones may indicate disease or other conditions.
Conditions which may be assessed with a chest X-ray may include:
Heart enlargement. This can occur with congenital heart defects, cardiomyopathy or
other acquired heart conditions
Pericardial effusion. A buildup of excess fluid in-between the heart and the membrane
that surrounds it, often due to inflammation. Pericardial effusions are more often
examined with echocardiography, a different imaging test.
Pleural effusion. A collection of blood or fluid around the lung.
"Fluid in the lungs," known as pulmonary edema. This can occur with congenital heart
disease or congestive heart failure.
Pneumonia, cancer and other lung diseases
Chest X-rays may also be ordered:
As part of a physical exam.
Before hospitalization or surgery.
To assess symptoms of conditions related to the heart or lungs.
To check the position of implanted pacemaker wires and other internal devices such
as central venous catheters.
To check status of lungs and chest cavity after surgery.
More definitive tests, such as a computed (CT) tomography scan, magnetic resonance
imaging (MRI), echocardiography, or cardiac catheterization may be done to make a
final diagnosis of cardiac conditions.
How is a chest X-ray done?
A chest X-ray may be done in the hospital, clinic, or in your child's doctor's office.
There may be a table in the room, and there will be a large X-ray camera suspended
from the ceiling which can be moved in many directions to obtain various views. Portable
X-ray equipment can be used to make films on patients in areas of the hospital, such
as the operating room, the emergency department, or the intensive care unit.
A chest X-ray may be done in a standing, sitting, or lying position, depending on
the condition of the child and the reason for the X-ray. For a standing or sitting
film, your child will stand or sit in front of an X-ray plate. If the X-ray is taken
in the lying position, the plate is placed beneath your child while he and she is
lying on his and her back or side. If your child is an infant, he or she may be placed
in a special device that will hold your child still while the X-ray is being taken.
The technologist will position your child properly in front of the plate, and then
will step away to the controls of the machine. If your child is old enough to cooperate,
he and she will be asked to take in a deep breath and hold it for a few seconds while
the X-ray exposure is made. Otherwise, the technician will try to take the picture
at the appropriate time by watching your child breathe.
In some situations, the doctor may want a film made from a side angle. This procedure
is the same as the one just described, except that your child will stand, sit, or
lie at a right or left angle to the X-ray plate and his or her arms will be raised
out of the way.
Parents are usually able to stay in the room with their children to provide support
and encouragement. You will be asked to wear a lead apron to protect you from unneeded
exposure to radiation during the X-ray.
Portable X-ray machines may be used when it is difficult or unsafe to transport the
child to the radiology department. Portable X-ray machines are generally used when
the child is in an intensive care unit (ICU).
Depending on the results of the chest X-ray, additional tests or procedures may be
scheduled to gather further diagnostic information.