Utility of the lateral chest radiograph in the evaluation of patients with a positive tuberculin skin test result.
OBJECTIVE
In the United States, chest radiographs are performed on patients with positive tuberculin skin test (TST) results. It is not known whether, in addition to a single posteroanterior radiograph, a lateral chest radiograph is clinically indicated or cost-effective. We sought to determine the utility of the lateral chest radiograph in evaluating TST-positive adults.


METHODS
Cross-sectional study.


METHODS
Tertiary-care hospital.


METHODS
Adults with positive TST results.


METHODS
Findings on posteroanterior radiographs alone were compared to posteroanterior and lateral chest radiographs.


RESULTS
In 2 of 535 cases (0.4%), lateral chest radiographs revealed a calcified granuloma not visible on posteroanterior radiographs. This finding did not alter patient management. In all other cases, lateral radiographs only confirmed findings seen on posteroanterior chest radiographs.


CONCLUSIONS
Treatment altering findings were always visible on posteroanterior radiographs alone. These results suggest that lateral chest radiographs are not useful in evaluating adults with positive TST results.
Meyer
Marianne
M
Pulmonary Center, Boston University School of Medicine, Boston, MA 02118, USA.
Clarke
Peter
P
O'Regan
Anthony W
AW
D000328:Adult; D003430:Cross-Sectional Studies; D006801:Humans; D015588:Observer Variation; D013902:Radiography, Thoracic; D014374:Tuberculin Test; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis*