title: The role of chest radiography in patients presenting with anterior chest pain to the Accident & Emergency Department.
abstract: 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.
authors.affiliation: Department of Thoracic Medicine, Westminster Hospital, London.
authors.forename: N J
authors.initials: NJ
authors.lastname: Russell
authors.forename: C F
authors.initials: CF
authors.lastname: Pantin
authors.forename: P A
authors.initials: PA
authors.lastname: Emerson
authors.forename: N J
authors.initials: NJ
authors.lastname: Crichton
mesh_terms: D002637:Chest Pain / Q000000981:diagnostic imaging* / Q000209:etiology; D003951:Diagnostic Errors; D004636:Emergency Service, Hospital / Q000592:standards*; D005188:False Negative Reactions; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging; D006801:Humans; D008131:London; D008171:Lung Diseases / Q000000981:diagnostic imaging; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D013902:Radiography, Thoracic