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J R Soc Med. 1988 November; 81(11): 626–628.
PMCID: PMC1291837

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.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Carew-McColl M. Radiological interpretation in an accident and emergency department. Br J Clin Pract. 1983 Nov-Dec;37(11-12):375–377. [PubMed]
  • Wardrope J, Chennells PM. Should all casualty radiographs be reviewed? Br Med J (Clin Res Ed) 1985 Jun 1;290(6482):1638–1640. [PMC free article] [PubMed]
  • Gleadhill DN, Thomson JY, Simms P. Can more efficient use be made of x ray examinations in the accident and emergency department? Br Med J (Clin Res Ed) 1987 Apr 11;294(6577):943–947. [PMC free article] [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press