Value Of Routine Chest Radiography Research Articles

No Value for Routine Chest Radiography in the Work-Up of Early Stage Cervical Cancer Patients.

AimEvidence supporting the recommendation to include chest radiography in the work-up of all cervical cancer patients is limited. We investigated the diagnostic value of routine chest radiography in cervical cancer staging.MethodsAll consecutive cervical cancer patients who presented at our tertiary referral center in the Netherlands (January 2006 – September 2013), and for whom ≥6 months follow-up was available, were included. As part of the staging procedure, patients underwent a routine two-directional digital chest radiograph. Findings were compared to a composite reference standard consisting of all imaging studies and histology obtained during the 6 months following radiography.ResultsOf the 402 women who presented with cervical cancer, 288 (71.6%) underwent chest radiography and had ≥6 months follow-up. Early clinical stage (I/II) cervical cancer was present in 244/288 (84.7%) women, while 44 (15.3%) presented with advanced disease (stage III/IV). The chest radiograph of 1 woman – with advanced pre-radiograph stage (IVA) disease – showed findings consistent with pulmonary metastases. Radiographs of 7 other women – 4 early, 3 advanced stage disease – were suspicious for pulmonary metastases which was confirmed by additional imaging in only 1 woman (with pre-radiograph advanced stage (IIIB) disease) and excluded in 6 cases, including all women with early stage disease. In none of the 288 women were thoracic skeletal metastases identified on imaging or during 6 months follow up. Radiography was unremarkable in 76.4% of the study population, and showed findings unrelated to the cervical carcinoma in 21.2%.ConclusionRoutine chest radiography was of no value for any of the early stage cervical cancer patients presenting at our tertiary center over a period of 7.7 years.

Value of routine chest radiography in the diagnostic work-up of ill returned travelers

BackgroundRespiratory tract infections frequently occur in ill returned travelers, a minority of whom present with pneumonia. The most accurate and cost-effective diagnostic work-up remains an area of uncertainty. In this retrospective cohort study, the utility of routine chest radiography was evaluated.MethodsThis study was performed at the Institute for Tropical Diseases in Rotterdam and included all returned travelers in the period between 2007 and 2009 that were ill with symptoms lasting less than 1 month and had chest radiography on admission. Travelers’ demographic (including travel history), clinical, and laboratory data were collected on admission and evaluated for their diagnostic power to predict radiographic evidence of a pulmonary infiltrate.ResultsFifty-three (7%) of 750 ill returned travelers had radiographic evidence of a pulmonary infiltrate. Presentation with cough (odds ratio [OR] 2.80, 95% confidence interval [CI] 1.46–5.38), or elevated C-reactive protein values (OR 1.13, 95% CI 1.09–1.17), and white blood cell count (OR 1.08, 95% CI 1.05–1.17) strongly correlated with the presence of a pulmonary infiltrate. Recursive partitioning analysis identified a subset of 384 patients presenting with both cough and fever, or C-reactive protein values in excess of 23 mg/L that would optimally benefit from chest radiography.ConclusionThe results of this study indicate that a more judicious use of chest radiography in the routine work-up of ill returned travelers is warranted.

Diagnostic value of routine chest radiography in febrile, neutropenic children for early detection of pneumonia and mould infections

Despite recent studies failing to demonstrate the value of routine chest radiography (CXR) in the initial evaluation of the febrile neutropenic patient with cancer, this screening test is advocated by some experts. We evaluated the benefits of CXR for early diagnosis of pulmonary infection at St. Jude Children's Research Hospital (SJCRH) with emphasis on early recognition of mould infections. We reviewed the courses of 200 consecutive febrile neutropenic pediatric patients to determine if routine CXR at initial evaluation was useful in the identification of clinically occult pneumonia. We also reviewed all cases of proven or probable mould infections from the opening of SJCRH in 1962 until 1998 when routine CXR was no longer practiced in our institution to identify cases that were first recognized by routine CXR. Of 200 febrile neutropenic patients, pulmonary abnormalities consistent with pneumonia were detected by routine CXR in only five patients without pulmonary signs or symptoms. In only one case was a change in management considered. Of the 70 patients with pulmonary mould infection identified from 1962 to 1998, routine CXR was performed in 45 patients at the onset of a febrile, neutropenic episode in which a mould infection was diagnosed. Routine CXR was pivotal in the recognition of the mould infection in only two cases over this 36-year period. CXR is warranted in the evaluation of the newly febrile neutropenic pediatric oncology patient only when respiratory signs or symptoms are present.

Value of routine chest radiography in the medical screening of internationally adopted children

To assess the value of the routine chest radiography as part of the medical evaluation of newly arrived, internationally adopted children. We evaluated the use of routine chest radiography (CXR) in the medical screening of 1598 internationally adopted children. CXR showed abnormalities in 128 cases: 38 of these findings were already known and/or consistent with obvious clinical signs or symptoms, and 54 had no clinical relevance. In two patients, CXR raised the suspicion of tuberculosis. The routine use of CXR in the screening of internationally adopted children rarely yields new, clinically relevant, information and should be performed on indication only.

Chest radiography in patients with early stage prostatic carcinoma. Effect on treatment planning and cost analysis.

An evaluation of the impact of routine preoperative chest radiographs was retrospectively undertaken in a pilot group of 292 patients with prostatic carcinoma who were part of a prospective study of prostate specific antigen screening for prostate carcinoma. Retrospective. Hospital-based outpatients. A cost-effectiveness model was used to assess the value of routine chest radiography in this patient population. Chest radiography findings were categorized into four groups based on follow-up and impact. Forty-three patients (15 percent) had a total of 45 positive findings on their chest radiographs. No patient had intrathoracic metastases from prostatic carcinoma. Only two patients (both with unsuspected second neoplasms) had findings that impacted on their treatment and one avoided retropubic radical prostatectomy. Total cost was $2,000 (based on Medicare reimbursement), or $14,000 (based on physician and hospital charges). Although benefit is small in terms of number of patients affected, clinical impact, in the two patients with significant findings, was great. Although cost-effectiveness cannot be confirmed on the basis of this series, further evaluation of its utility for this application should be undertaken.

The role of chest radiography in patients presenting with anterior chest pain to the Accident & Emergency Department.

The chest radiological findings and outcomes of 120 consecutive patients attending the Accident & Emergency Department with anterior chest pain were recorded prospectively to investigate the value of routine chest radiography in their management. Twenty-one patients (17.5%) were excluded because of incomplete information. Thirty-seven radiological abnormalities were identified in 33 (33%) of the remaining 99 chest X-rays. Seventeen of the abnormalities identified in 14 (14%) of the chest X-rays were clinically significant. The casualty officer's interpretation of 70 (70%) of the chest X-rays was correct, but 36 errors were made interpreting the other 29 chest X-rays. Of these errors, 19 were false negative errors, resulting in the mismanagement of two patients and 17 false positive errors, resulting in the mismanagement of four patients. It appears that a routine chest X-ray provides little information of practical value in the management of patients with anterior chest pain attending an Accident & Emergency Department, unless the training of medical students and junior doctors in the interpretation of chest X-rays is improved.

The value of routine chest radiography in offshore workers.

The value of routine chest radiography in offshore workers.

Value of routine chest radiography in an acute geriatric unit.

Les radiographies thoraciques ne devraient pas etre faites systematiquement chez tous les vieillards hospitalises, mais seulement chez ceux qui presentent des symptomes cardiorespiratoires, un etat confusionnel toxique ou des douleurs osseuses thoraciques

The usefulness of chest radiographs in first asthma attacks.

To assess the value of routine chest radiography during acute first attacks of asthma, we studied 371 consecutive children over one year of age who presented with an initial episode of wheezing. Three hundred fifty children (94.3 per cent) had radiographic findings that were compatible with uncomplicated asthma and were considered negative. Twenty-one (5.7 per cent) had positive findings: atelectasis and pneumonia were noted in seven, segmental atelectasis in six, pneumonia in five, multiple areas of subsegmental atelectasis in two, and pneumomediastinum in one. The patients with positive films were more likely to have a respiratory rate above 60 or a pulse rate above 160 (P less than 0.001), localized rales or localized decreased breath sounds before treatment (P less than 0.01), and localized rales (P less than 0.005) and localized wheezing (P less than 0.02) after treatment; also, these patients were admitted to the hospital more often (P less than 0.001). Ninety-five per cent (20 of 21) of the children with positive films could be identified before treatment on the basis of a combination of tachypnea, tachycardia, fever, and localized rales or localized decreased breath sounds. Most first-time wheezers will not have positive radiographs; careful clinical evaluation should reveal which patients will have abnormal radiographs and will therefore benefit from the procedure.

Value of Routine Chest Radiography in General Medical and Geriatric Wards

International Journal of Clinical PracticeVolume 37, Issue 6 p. 223-224 Article Value of Routine Chest Radiography in General Medical and Geriatric Wards M. G. Patel MB, LRCP & S, M. G. Patel MB, LRCP & S Senior House Officer Department of Geriatric and General Medicine, Preston Hospital, North Shields, Tyne and WearSearch for more papers by this authorS. K. Datta MD, MRCP, S. K. Datta MD, MRCP Registrar Department of Geriatric and General Medicine, Preston Hospital, North Shields, Tyne and WearSearch for more papers by this authorS. K. Mandal MBBS, FRCP, S. K. Mandal MBBS, FRCP Consultant Physician Department of Geriatric and General Medicine, Preston Hospital, North Shields, Tyne and WearSearch for more papers by this author M. G. Patel MB, LRCP & S, M. G. Patel MB, LRCP & S Senior House Officer Department of Geriatric and General Medicine, Preston Hospital, North Shields, Tyne and WearSearch for more papers by this authorS. K. Datta MD, MRCP, S. K. Datta MD, MRCP Registrar Department of Geriatric and General Medicine, Preston Hospital, North Shields, Tyne and WearSearch for more papers by this authorS. K. Mandal MBBS, FRCP, S. K. Mandal MBBS, FRCP Consultant Physician Department of Geriatric and General Medicine, Preston Hospital, North Shields, Tyne and WearSearch for more papers by this author First published: 01 June 1983 https://doi.org/10.1111/j.1742-1241.1983.tb07185.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume37, Issue6June 1983Pages 223-224 RelatedInformation

Value of routine chest radiography of psychiatric patients

Value of routine chest radiography of psychiatric patients

Value of routine chest radiography of psychiatric patients.

Value of routine chest radiography of psychiatric patients.