Since the discovery of medical imaging there has been major milestones in the diagnosis and management of illnesses. X-ray imaging has been used widely. It is not only fast but also cheap and affordable for many.
X-ray imaging has been used to diagnose conditions such as tuberculosis pneumonia and fractures aid in medical and surgical management plans and also to guide the insertion of devices into body cavities and tumors (Wildenschild & Sheppard 2013). However x-rays have negative impacts as they emit ionizing radiation. Such radiation may affect the individuals DNA leading to an increased risk of developing cancer. High levels of radiation may also affect the patients tissues and cause hair loss reddening or cataracts. It is therefore important to balance the benefits and risks for the patient in every situation (Story et al. 2012). Mobile chest x-rays are often used in conditions when the patient cannot be moved such as in the Intensive Care Unit setting. They can also be referred to as portable x-rays (Ioos et al. 2011).Performing a mobile chest x-ray is more challenging because of several external factors to be put into consideration. This may include the size of the patient the condition of the patient and sometimes difficulties in positioning the patient. Despite all this it may be beneficial to perform a chest x-rays therefore proper considerations must be put in place for the x-ray to be effective and this also depends majorly on the techniques (Saugel et al. 2011).
Normal chest x-rays are obtained in the posterior anterior direction to reduce the degree of magnification of the heart. However when conducting a portable chest x-ray the anteroposterior direction is used. Such patients who are less mobile have their x-rays taken in supine position (Bourcier et al. 2014).The results of this patient will appear differently because of the anterior posterior imaging the supine position and the degree that they can breathe in. In the anterior posterior viewing the structures on the anterior side which include the clavicle sternum and the heart will appear larger and may have a significant effect. This are much smaller in the posterior anterior view by a difference of up to 15%. In addition in the anterior posterior view the scapula appears to be much more projected into the lung (Gardelli et al. 2012). The heart and the mediastinum will also appear wider in the supine position because of the pull of gravity on the organs (Wallet et al. 2013). The positions also changes the functioning of the blood vessels in the lungs leading to more blood flow in the upper lobes of the lungs. This in turn may make it harder to make a diagnosis of cephalization (Ganapathy Adhikari Spiegelman & Scales 2012). In films taken in this position it may be difficult to differentiate the normal parenchymal activity and pleural effusion. This is eventually results to difficulties in diagnosing a pneumothorax (Oba & Zaza 2010; Young Harrison Cuthbertson & Rowan 2013).
For the image to be clearer the film should be taken on breathing in. This may be difficult for critically ill patients or those who are from surgery. Some patients may also not be willing to cooperate with the radiographer. If the shot is taken on an incomplete inhalation evaluating the film may be difficult. Eventually diagnosing conditions such as lung edema and basilar atelectasis become near impossible (Lakhal et al. 2012). Incomplete inhalation may also result to changes in the size of the heart and the mediastinum. There is up to a 50% difference in the appearance of the mediastinum in a film taken anterior posterior when the patient exhales while in the supine position and that taken when the patient inhales and is standing and the film taken posterior anteriorly (Lemson van Die Hemelaar & van der Hoeven 2010).
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