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==Overview==
==Overview==


There are no x-ray findings associated with [disease name].
An x-ray may be helpful in the diagnosis of common causes of chest pain.
 
==X Ray==
{| class="wikitable"
|-
| Colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
|-
| Bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1''' In [[patients]] presented with acute [[chest pain]], [[chest radiograph]] is useful for evaluation of other potential causes of [[symptom]] including [[cardiac]], [[pulmonary]], [[thoracic]] origin .'' ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence C]])<nowiki>"</nowiki>''
 
|}
 
{|
! colspan="2" style="background: PapayaWhip;" align="center" + |The above table adopted from 2021 AHA/ACC/ASE Guideline<ref name="pmid34709879">{{cite journal |vauthors=Gulati M, Levy PD, Mukherjee D, Amsterdam E, Bhatt DL, Birtcher KK, Blankstein R, Boyd J, Bullock-Palmer RP, Conejo T, Diercks DB, Gentile F, Greenwood JP, Hess EP, Hollenberg SM, Jaber WA, Jneid H, Joglar JA, Morrow DA, O'Connor RE, Ross MA, Shaw LJ |title=2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines |journal=Circulation |volume=144 |issue=22 |pages=e368–e454 |date=November 2021 |pmid=34709879 |doi=10.1161/CIR.0000000000001029 |url=}}</ref>
|-
|}
 
 
 
 
 
 
 


OR


An x-ray may be helpful in the diagnosis of [disease name]. Findings on an x-ray suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].


OR


There are no x-ray findings associated with [disease name]. However, an x-ray may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].


==X Ray==
An x-ray may be helpful in the diagnosis of common causes of chest pain. Findings on an x-ray  include:
An x-ray may be helpful in the diagnosis of common causes of chest pain. Findings on an x-ray  include:


*'''Aortic dissection<ref>de Lacey G, Morley S et-al. The Chest X-Ray: A Survival Guide. Saunders Ltd. ISBN:0702030465. </ref><ref name="pmid22415593">{{cite journal |vauthors=Lai V, Tsang WK, Chan WC, Yeung TW |title=Diagnostic accuracy of mediastinal width measurement on posteroanterior and anteroposterior chest radiographs in the depiction of acute nontraumatic thoracic aortic dissection |journal=Emerg Radiol |volume=19 |issue=4 |pages=309–15 |date=August 2012 |pmid=22415593 |pmc=3396328 |doi=10.1007/s10140-012-1034-3 |url=}}</ref><ref> Gleeson CE, Spedding RL, Harding LA, et al The mediastinum—Is it wide? Emergency Medicine Journal 2001;18:183-185.</ref>'''
==='''Aortic dissection<ref>de Lacey G, Morley S et-al. The Chest X-Ray: A Survival Guide. Saunders Ltd. ISBN:0702030465. </ref><ref name="pmid22415593">{{cite journal |vauthors=Lai V, Tsang WK, Chan WC, Yeung TW |title=Diagnostic accuracy of mediastinal width measurement on posteroanterior and anteroposterior chest radiographs in the depiction of acute nontraumatic thoracic aortic dissection |journal=Emerg Radiol |volume=19 |issue=4 |pages=309–15 |date=August 2012 |pmid=22415593 |pmc=3396328 |doi=10.1007/s10140-012-1034-3 |url=}}</ref><ref> Gleeson CE, Spedding RL, Harding LA, et al The mediastinum—Is it wide? Emergency Medicine Journal 2001;18:183-185.</ref>'''===
**[[Widened mediastinum]], (> 8cm at the level of the aortic knob on portable [[Chest X-ray|AP chest radiographs]])
*[[Widened mediastinum]], (> 8cm at the level of the aortic knob on portable [[Chest X-ray|AP chest radiographs]])
**Left [[pleural effusion]]
*Left [[pleural effusion]]
**double and irregular aortic contour
*double and irregular aortic contour
**Displaced [[Tunica intima|intimal]] [[Calcification of the aorta|calcification]] >5mm (ring sign)
*Displaced [[Tunica intima|intimal]] [[Calcification of the aorta|calcification]] >5mm (ring sign)
**[[Esophagus|Esophageal]] and [[tracheal deviation]] to the right
*[[Esophagus|Esophageal]] and [[tracheal deviation]] to the right
**Blurred aortic knob
*Blurred aortic knob
**Depression of left [[mainstem bronchus]]
*Depression of left [[mainstem bronchus]]
**Apical capping on the left
*Apical capping on the left
**Loss of paratracheal stripe
*Loss of paratracheal stripe


[[File:Aortic-dissection-23.png|thumb|left|500px|Aortic dissection with marked widening of the mediastinum<ref>Case courtesy of Dr Wayland Wang, Radiopaedia.org, rID: 50763</ref>]]
[[File:Aortic-dissection-23.png|thumb|left|500px|Aortic dissection with marked widening of the mediastinum<ref>Case courtesy of Dr Wayland Wang, Radiopaedia.org, rID: 50763</ref>]]
[[File:Aortic-dissection-34.jpeg|thumb|center|400px|Aortic dissection with marked pleural effusion (blue arrow), left upper mediastinal mass (yellow arrow), and tracheal deviation (orange arrow)<ref>Case courtesy of Dr  Devanshi Pathania, Radiopaedia.org, rID: 68763</ref>]]
[[File:Aortic-dissection-34.jpeg|thumb|center|400px|Aortic dissection with marked pleural effusion (blue arrow), left upper mediastinal mass (yellow arrow), and tracheal deviation (orange arrow)<ref>Case courtesy of Dr  Devanshi Pathania, Radiopaedia.org, rID: 68763</ref>]]


*'''Pulmonary embolism<ref name="pmid8372182">{{cite journal |vauthors=Worsley DF, Alavi A, Aronchick JM, Chen JT, Greenspan RH, Ravin CE |title=Chest radiographic findings in patients with acute pulmonary embolism: observations from the PIOPED Study |journal=Radiology |volume=189 |issue=1 |pages=133–6 |date=October 1993 |pmid=8372182 |doi=10.1148/radiology.189.1.8372182 |url=}}</ref><ref name="pmid10845470">{{cite journal |vauthors=Rossi SE, Goodman PC, Franquet T |title=Nonthrombotic pulmonary emboli |journal=AJR Am J Roentgenol |volume=174 |issue=6 |pages=1499–508 |date=June 2000 |pmid=10845470 |doi=10.2214/ajr.174.6.1741499 |url=}}</ref><ref name="pmid14272525">{{cite journal |vauthors=CHANG CH, DAVIS WC |title=A ROENTGEN SIGN OF PULMONARY INFARCTION |journal=Clin Radiol |volume=16 |issue= |pages=141–7 |date=April 1965 |pmid=14272525 |doi=10.1016/s0009-9260(65)80007-1 |url=}}</ref><ref name="pmid6603760">{{cite journal |vauthors=Palla A, Donnamaria V, Petruzzelli S, Rossi G, Riccetti G, Giuntini C |title=Enlargement of the right descending pulmonary artery in pulmonary embolism |journal=AJR Am J Roentgenol |volume=141 |issue=3 |pages=513–7 |date=September 1983 |pmid=6603760 |doi=10.2214/ajr.141.3.513 |url=}}</ref>'''
==='''Pulmonary embolism<ref name="pmid8372182">{{cite journal |vauthors=Worsley DF, Alavi A, Aronchick JM, Chen JT, Greenspan RH, Ravin CE |title=Chest radiographic findings in patients with acute pulmonary embolism: observations from the PIOPED Study |journal=Radiology |volume=189 |issue=1 |pages=133–6 |date=October 1993 |pmid=8372182 |doi=10.1148/radiology.189.1.8372182 |url=}}</ref><ref name="pmid10845470">{{cite journal |vauthors=Rossi SE, Goodman PC, Franquet T |title=Nonthrombotic pulmonary emboli |journal=AJR Am J Roentgenol |volume=174 |issue=6 |pages=1499–508 |date=June 2000 |pmid=10845470 |doi=10.2214/ajr.174.6.1741499 |url=}}</ref><ref name="pmid14272525">{{cite journal |vauthors=CHANG CH, DAVIS WC |title=A ROENTGEN SIGN OF PULMONARY INFARCTION |journal=Clin Radiol |volume=16 |issue= |pages=141–7 |date=April 1965 |pmid=14272525 |doi=10.1016/s0009-9260(65)80007-1 |url=}}</ref><ref name="pmid6603760">{{cite journal |vauthors=Palla A, Donnamaria V, Petruzzelli S, Rossi G, Riccetti G, Giuntini C |title=Enlargement of the right descending pulmonary artery in pulmonary embolism |journal=AJR Am J Roentgenol |volume=141 |issue=3 |pages=513–7 |date=September 1983 |pmid=6603760 |doi=10.2214/ajr.141.3.513 |url=}}</ref>'''===
**Hampton hump: peripheral wedge-shaped density above the diaphragm
**Hampton hump: peripheral wedge-shaped density above the diaphragm
**Westermark sign: vasoconstriction distal to the pulmonary embolus
**Westermark sign: vasoconstriction distal to the pulmonary embolus
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**Palla's sign: enlarged right descending pulmonary artery
**Palla's sign: enlarged right descending pulmonary artery


**Pneumothorax<ref name="SharmaJindal2008">{{cite journal|last1=Sharma|first1=Anita|last2=Jindal|first2=Parul|title=Principles of diagnosis and management of traumatic pneumothorax|journal=Journal of Emergencies, Trauma and Shock|volume=1|issue=1|year=2008|pages=34|issn=0974-2700|doi=10.4103/0974-2700.41789}}</ref>
===Pneumothorax<ref name="SharmaJindal2008">{{cite journal|last1=Sharma|first1=Anita|last2=Jindal|first2=Parul|title=Principles of diagnosis and management of traumatic pneumothorax|journal=Journal of Emergencies, Trauma and Shock|volume=1|issue=1|year=2008|pages=34|issn=0974-2700|doi=10.4103/0974-2700.41789}}</ref>===
**Absent [[lung]] markings
*Absent [[lung]] markings
**White [[Pleural cavity|pleural]] lines
*White [[Pleural cavity|pleural]] lines
**[[Mediastinum]] deviation to the opposite side
*[[Mediastinum]] deviation to the opposite side
**[[Atelectasis]]  
*[[Atelectasis]]  
**Air fluid level in [[Pleural cavity|pleural]] space
*Air fluid level in [[Pleural cavity|pleural]] space
**Outline of [[Thoracic diaphragm|diaphragm]] under the heart
*Outline of [[Thoracic diaphragm|diaphragm]] under the heart
**[[Deep sulcus sign]]
*[[Deep sulcus sign]]
**Increased rib separation  
*Increased rib separation  
**Ipsilateral flattening of [[heart]] border
*Ipsilateral flattening of [[heart]] border
**Midiaphragmatic [[depression]]
*Midiaphragmatic [[depression]]


[[File:Tension-pneumothorax-1.jpg|thumb|center|369x369px|Pneumothorax [https://radiopaedia.org/cases/tension-pneumothorax-1 Source:Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 8250]]]
[[File:Tension-pneumothorax-1.jpg|thumb|center|369x369px|Pneumothorax [https://radiopaedia.org/cases/tension-pneumothorax-1 Source:Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 8250]]]


*'''Gastroesophageal reflux disease'''''Italic text''
===Gastroesophageal reflux disease===
** Findings on barium swallow imaging suggestive of GERD include the following:  
* Findings on barium swallow imaging suggestive of GERD include the following:  
*** Free [[acid reflux]]
** Free [[acid reflux]]
*** [[Oesophagitis]] with [[scarring]]
** [[Oesophagitis]] with [[scarring]]
*** [[Strictures]]
** [[Strictures]]
*** [[Barrett's esophagus|Barrett's oesophagus]]
** [[Barrett's esophagus|Barrett's oesophagus]]
[[Image:Gastro-oesophageal-reflux-disease.jpg|thumb|center|350px|Source: Case courtesy of Dr Hani Salam, From the case "https://radiopaedia.org/cases/9585">rID: 9585<]]
[[Image:Gastro-oesophageal-reflux-disease.jpg|thumb|center|350px|Source: Case courtesy of Dr Hani Salam, From the case "https://radiopaedia.org/cases/9585">rID: 9585<]]


Latest revision as of 07:31, 16 December 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aisha Adigun, B.Sc., M.D.[2]

Overview

An x-ray may be helpful in the diagnosis of common causes of chest pain.

X Ray

Class I
"1 In patients presented with acute chest pain, chest radiograph is useful for evaluation of other potential causes of symptom including cardiac, pulmonary, thoracic origin . (Level of Evidence C)"
The above table adopted from 2021 AHA/ACC/ASE Guideline[1]







An x-ray may be helpful in the diagnosis of common causes of chest pain. Findings on an x-ray include:

Aortic dissection[2][3][4]

Aortic dissection with marked widening of the mediastinum[5]
Aortic dissection with marked pleural effusion (blue arrow), left upper mediastinal mass (yellow arrow), and tracheal deviation (orange arrow)[6]

Pulmonary embolism[7][8][9][10]

    • Hampton hump: peripheral wedge-shaped density above the diaphragm
    • Westermark sign: vasoconstriction distal to the pulmonary embolus
    • Elevated hemidiaphragm
    • Pleural effusion
    • Palla's sign: enlarged right descending pulmonary artery

Pneumothorax[11]

Pneumothorax Source:Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 8250

Gastroesophageal reflux disease

Source: Case courtesy of Dr Hani Salam, From the case "https://radiopaedia.org/cases/9585">rID: 9585<

References

  1. ↑ Gulati M, Levy PD, Mukherjee D, Amsterdam E, Bhatt DL, Birtcher KK, Blankstein R, Boyd J, Bullock-Palmer RP, Conejo T, Diercks DB, Gentile F, Greenwood JP, Hess EP, Hollenberg SM, Jaber WA, Jneid H, Joglar JA, Morrow DA, O'Connor RE, Ross MA, Shaw LJ (November 2021). "2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 144 (22): e368–e454. doi:10.1161/CIR.0000000000001029. PMID 34709879 Check |pmid= value (help).
  2. ↑ de Lacey G, Morley S et-al. The Chest X-Ray: A Survival Guide. Saunders Ltd. ISBN:0702030465.
  3. ↑ Lai V, Tsang WK, Chan WC, Yeung TW (August 2012). "Diagnostic accuracy of mediastinal width measurement on posteroanterior and anteroposterior chest radiographs in the depiction of acute nontraumatic thoracic aortic dissection". Emerg Radiol. 19 (4): 309–15. doi:10.1007/s10140-012-1034-3. PMC 3396328. PMID 22415593.
  4. ↑ Gleeson CE, Spedding RL, Harding LA, et al The mediastinum—Is it wide? Emergency Medicine Journal 2001;18:183-185.
  5. ↑ Case courtesy of Dr Wayland Wang, Radiopaedia.org, rID: 50763
  6. ↑ Case courtesy of Dr Devanshi Pathania, Radiopaedia.org, rID: 68763
  7. ↑ Worsley DF, Alavi A, Aronchick JM, Chen JT, Greenspan RH, Ravin CE (October 1993). "Chest radiographic findings in patients with acute pulmonary embolism: observations from the PIOPED Study". Radiology. 189 (1): 133–6. doi:10.1148/radiology.189.1.8372182. PMID 8372182.
  8. ↑ Rossi SE, Goodman PC, Franquet T (June 2000). "Nonthrombotic pulmonary emboli". AJR Am J Roentgenol. 174 (6): 1499–508. doi:10.2214/ajr.174.6.1741499. PMID 10845470.
  9. ↑ CHANG CH, DAVIS WC (April 1965). "A ROENTGEN SIGN OF PULMONARY INFARCTION". Clin Radiol. 16: 141–7. doi:10.1016/s0009-9260(65)80007-1. PMID 14272525.
  10. ↑ Palla A, Donnamaria V, Petruzzelli S, Rossi G, Riccetti G, Giuntini C (September 1983). "Enlargement of the right descending pulmonary artery in pulmonary embolism". AJR Am J Roentgenol. 141 (3): 513–7. doi:10.2214/ajr.141.3.513. PMID 6603760.
  11. ↑ Sharma, Anita; Jindal, Parul (2008). "Principles of diagnosis and management of traumatic pneumothorax". Journal of Emergencies, Trauma and Shock. 1 (1): 34. doi:10.4103/0974-2700.41789. ISSN 0974-2700.

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