Patients must remove their clothing, including undergarments that may contain metal. Most medical centers will give the patient a loose-fitting gown to wear. Patients will also be asked to remove all metallic jewellery that may interfere with the x-rays. Normally, a frontal or posteroanterior view is obtained, in which the patient stands with the chest pressed to the photographic plate, with hands on hips and elbows pushed in front in a somewhat exaggerated position. The technologist will ask the patient to be still and to take a deep breath and hold it. Breath-holding after a deep breath reduces the possibility of a blurred image and also enhances the quality of the x-ray image, since abnormalities in air-filled lungs are easier to see than in deflated lungs.
Next, the technologist walks into a cubicle or small room to activate the radiographic equipment, which sends a beam of x-rays from the x-ray source behind the patient, through the patient's chest, to the recording medium (film or digital cassette). Some equipment is designed to accommodate patients who cannot stand for chest x-rays.
The technologist may need to take additional views to properly see all parts of the chest or may take a side view, or lateral view, of the chest. For a lateral view, the patient stands sideways to the photographic plate with arms elevated, and the process is repeated. Views from other angles may be obtained if the radiologist needs to evaluate additional areas of the chest. Finally, a chest x-ray may be repeated within hours, days or months to evaluate for any changes. These repeated, sequential examinations are called serial chest x-rays.
When the chest x-rays are completed you will be asked to wait until the technologist checks the images for motion and makes sure that the entire chest is included. Ultimately, a radiologist will interpret the chest x-ray images using a lighted view box to review films or a computer and monitor to review digital images.