An assessment of the contribution of chest radiography in outpatients with acute chest complaints: a prospective study.

The contribution of chest radiography to diagnosis was assessed in 1,102 consecutive patients with chest complaints at the Emergency Ward and Ambulatory Screening Clinic of a large hospital. The goal of this prospective study was to identify selective indications for chest radiography in this population with relation to the patient's age, the symptoms, and the results of physical examination. Although in patients over 40 years old chest symptoms are a sufficient indication for chest radiography, 96% of the patients below age 40 had a normal physical examination of the chest, no hemoptysis, and no acute radiographic abnormalities. If chest radiographs in the below-40 group had been limited to patients to patients with abnormal physical examinations and/or hemoptysis, 58% of the patients in that group would have been spared the examination. Under these conditions, 2.3% of the acute radiographic abnormalities in the entire population of patients under 40 would have gone undetected.