High yield of chest radiography in walk-in clinic patients with chest symptoms

• Published in: Journal of general internal medicine : JGIM 1993-03, Vol.8 (3), p.115-119
• Main Authors: BUTCHER, B. L, NICHOL, K. L, PARENTI, C. M
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Cardiomegaly - diagnostic imaging; Cardiomegaly - epidemiology; Chest Pain - etiology; Cough - etiology; Dyspnea - etiology; Female; Heart Failure - diagnostic imaging; Heart Failure - epidemiology; Hospitals, Veterans; Humans; Lung Diseases - diagnostic imaging; Lung Diseases - epidemiology; Male; Medical sciences; Middle Aged; Minnesota - epidemiology; Outpatient Clinics, Hospital; Pneumology; Prospective Studies; Radiography, Thoracic - statistics & numerical data; Respiratory system : syndromes and miscellaneous diseases
• ISSN: 0884-8734; 1525-1497
• DOI: 10.1007/BF02599752

To assess the yield of chest radiography among a group of symptomatic adults presenting to a walk-in clinic. Outpatients presenting to a walk-in clinic for evaluation of cough, shortness of breath, or pleuritic chest pain were interviewed by nurses who recorded clinical data pertaining to the present illness and past medical history. Chest radiographs were then obtained prior to physician evaluation. A total of 221 patients were enrolled in the study; 97% were men and the mean age was 62 (+/- 10.3) years. New clinically important radiographic abnormalities, defined as those necessitating acute intervention and/or follow-up evaluation, were identified for 77 (34.8%) of the 221 patients studied. Abnormalities included 39 (17.6%) cases of infiltrates, 23 (10.4%) cases of nodules or mass lesions, and 19 (8.6%) cases of cardiomegaly or congestive heart failure. Evaluation of clinical data obtained during the triage interview revealed no statistically significant difference between those patients with and those without new radiographic abnormalities on their chest x-rays. Adult patients similar to those described in this study who present to a walk-in clinic with a chief complaint of cough, dyspnea, or pleuritic chest pain have a high likelihood of having new clinically important abnormalities found on their chest radiographs. Since patient characteristics did not predict which patients were more likely to have abnormal findings, the practice of obtaining chest radiographs for such individuals at the time of triage and prior to physician evaluation appears justified.