The X-ray examination of the chest (Medical: thorax), usually referred to as a chest X-ray, is a standard examination that is often performed. It is used to assess various organs such as the lungs, the heart or the ribs. For this purpose, the chest is x-rayed with a relatively small amount of X-rays and images are taken. During the assessment, the doctor can assess possible abnormalities and changes. Depending on the findings, therapy, further examinations or a repetition of the X-ray examination may be necessary in the course of the process.


The indications of an X-ray examination of the chest are diverse and can be used both for the initial diagnosis of a disease and as a follow-up. If, for example, symptoms such as shortness of breath and coughing suggest that a lung disease may be present, an X-ray of the chest can be performed to assess the lungs. Diseases such as pneumonia, structural changes in the lung tissue (emphysema or Pulmonary fibrosis) but also spatial demands can usually be recognized well. The latter can be either benign or malicious processes. In some cases, further diagnostics, for example by taking a sample (biopsy) appropriate. The chest x-ray is also used to assess the heart and blood vessels in the chest. Heart failure (heart failure), for example, can lead to abnormal findings. Mention should be made here of a water backlog in the lungs (Pulmonary edema) and a noticeable enlargement of the heart. In addition, if there is a suspicion of bony damage to the thorax, for example in the case of broken ribs, an X-ray examination of the chest is indicated. Often, however, only a preliminary assessment is possible and further diagnostics may have to follow. A chest x-ray is also indicated as a check-up after medical interventions. After installing a pacemaker, this can be used, for example, to check the correct position of the probes on the heart.

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lung infection

If a patient has symptoms suggestive of pneumonia, a chest x-ray will often be taken to investigate this suspicion. Signs of pneumonia include coughing with sputum and fever. In the case of pneumonia, X-rays usually show so-called shadows in one or more areas of the lungs. Among other things, the inflammation causes more water to penetrate the affected lung sections, so that they stand out from the rest of the lung tissue in the X-ray image. If pneumonia is diagnosed and treated (usually with an antibiotic), it may be useful to take another chest X-ray as a check-up.

Read more on the topic: How do I recognize pneumonia?

Congestion in the vessels

When assessing the X-ray image of the chest, a statement can be made as to whether there is a congestion. This usually occurs with a heart failure (Heart failure). The heart's job is to pump blood through the circulation. Before the blood enters the body's circulation, it flows through the blood vessels in the lungs. If the heart is pumping, the blood can back up in the upstream blood vessels and water in the lungs. With such a congestion, the vessels stand out more strongly and the lung tissue can also appear compressed. This means that the suspected congestion can be investigated by the chest x-ray examination and a check can be carried out during the course of therapy.

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Prepare for the examination

No special preparation is required on the part of the patient so that an X-ray examination of the chest can be carried out. In general, you should remember to bring old x-rays, if necessary your x-ray pass, and your insurance card to the examination. In addition, the questions asked by the doctor in advance should be answered truthfully to the best of your knowledge. In the case of women of childbearing potential in particular, it is important that it is clear whether a pregnancy could exist or whether this is impossible. In addition, the doctor must check in advance whether there is a justifying indication for the examination. This is the case if the examination is appropriate and sensible from a medical point of view. Since certain breathing maneuvers should often be performed during the examination, these are usually discussed in advance.

Procedure of the investigation

Before the actual examination, the upper body must usually be stripped. Any kind of jewelry on the upper body should also be removed. Shortly before the chest x-ray is taken, the staff leaves the room where the x-ray is being carried out. The recording itself then only takes a few milliseconds. Afterwards, you can usually leave the practice or department straight away.

You may also be interested in this topic: X-ray examination of the child

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Assessment of the image

The diagnosis of an X-ray examination of the chest is carried out by a specialist in radiology either in the practice or in the X-ray department of the hospital where the examination was carried out. The findings are then sent to the referring physician or the doctor who requested the X-ray. If medically necessary, this can also be done on the same day.

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Duration of the investigation

A chest x-ray only takes a few minutes. Most of the time is spent on preparation. The actual recording only takes a moment in the range of a few milliseconds.

Do I have to take off my chest for an X-ray?

As a rule, in order to carry out an X-ray examination of the chest, you will be asked to undress your upper body and remove your neck jewelry. Even if the X-rays can penetrate clothing, they can be falsified by overlapping. During the examination, however, you are alone in the X-ray room and, as a rule, privacy is guaranteed. In exceptional cases it is permitted to keep a thin undershirt on, for example.

Which doctor does this?

The actual x-ray examination of the chest is usually not carried out directly by the doctor but by a suitably trained specialist. The order or indication can generally be carried out by the doctor. The X-ray image is assessed and evaluated by a specialist in radiology. This is done either in the hospital or in a radiology practice.

Is radiation exposure dangerous?

The radiation exposure from an X-ray examination of the chest is relatively low and comparable to the radiation exposure to which one is exposed by a transatlantic flight. The examination is therefore usually not directly dangerous. Nevertheless, the possible benefit should always be weighed against the potential damage with every X-ray examination. X-rays that are unnecessary and too frequent should be avoided, as this increases the risk of developing cancer. A chest x-ray in pregnant women can be dangerous for the unborn child. Any exposure to radiation increases the risk of malformation or developmental disorders. Since children are particularly susceptible to damage from radiation, the indication should be particularly strict for them.

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X-rays during pregnancy - is that possible?

Any form of radiation exposure should be avoided during pregnancy, as the unborn child is susceptible to radiation. Therefore, before every X-ray examination, for example of the chest, it must be excluded that there is a pregnancy. In rare and well-founded exceptional cases, a chest x-ray can still be performed during pregnancy. Compared to, for example, computed tomography, X-ray radiation is relatively low.

Learn more at: X-ray during pregnancy

Investigation costs

The costs for an X-ray examination of the chest are reimbursed for patients with statutory health insurance according to the uniform assessment standard and for private patients according to the fee schedule for doctors. In the case of a medically indicated chest x-ray examination, the costs are covered in both cases. If the patient pays the costs himself, these may differ depending on the practice. They are roughly in the range of € 30 to € 50.

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