Pneumonia chest x ray

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2], Priyamvada Singh, M.D. [3] ; Alejandro Lemor, M.D. [4]


An important test for making a diagnosis of pneumonia is a chest x-ray. Chest x-rays can reveal areas of opacity (seen as white) which represent consolidation. Pneumonia is not always seen on x-rays, either because the disease is only in its initial stages, or because it involves a part of the lung not easily seen by x-ray.

Chest X-Ray


Patients with the following conditions should be evaluated with a chest X-ray:[1]


Hospital Acquired

  • The American Thoracic Society recommends that all patients with a suspicion of nosocomial pneumonia should have a chest x-ray to confirm diagnosis and determine the severity of the disease.[3]
  • A chest X-ray also helps to determine pleural effusions or cavitations, as a possible complication.
  • Ideally, the chest X-ray should be posteroanterior and lateral, but this will depend on the patient's condition.
  • Findings include the following:[4]
  • Chest x-ray is also used to assess improvement or lack of clinical response in hospitalized patients.

Chest X-ray Gallery

Right middle lobe consolidation pneumonia Source:Case courtesy of Dr Sajoscha Sorrentino,, rID: 14979

X-ray shows homogenous radio-opaque areas in bilateral lung fields. These represent areas of consolidation Source: Case courtesy of Dr Aditya Shetty,, rID: 26828


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  1. Watkins RR, Lemonovich TL (2011). "Diagnosis and management of community-acquired pneumonia in adults". Am Fam Physician. 83 (11): 1299–306. PMID 21661712.
  2. Syrjala H, Broas M, Suramo I, et al. High resolution computed tomography for the diagnosis of community-acquired pneumonia. Clin Infect Dis 1998; 27:358-363 PMID 9709887
  3. "Guidelines for the Management of Adults with Hospital-acquired, Ventilator-associated, and Healthcare-associated Pneumonia". American Journal of Respiratory and Critical Care Medicine. 171 (4): 388–416. 2005. doi:10.1164/rccm.200405-644ST. ISSN 1073-449X.
  4. Koenig, S. M.; Truwit, J. D. (2006). "Ventilator-Associated Pneumonia: Diagnosis, Treatment, and Prevention". Clinical Microbiology Reviews. 19 (4): 637–657. doi:10.1128/CMR.00051-05. ISSN 0893-8512.

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