Chest X-Ray Procedure: Preparation, Steps and What to Expect
A chest x-ray is a quick, painless imaging test. You stand in front of an x-ray detector, hold your breath for a moment, and the technologist captures pictures of your lungs, heart and chest. It needs no special preparation, and the whole exam is usually finished within about 15 minutes. At Garden State Medical Group, radiology is on site, so if your clinician orders a chest x-ray you can have it done as part of your care in North Bergen or Secaucus. You can read more on our chest x-ray page.
This guide walks you through each step, from what to wear to how results reach you. It also covers radiation safety and, since many people ask, how to prepare for an ultrasound.
TL;DR
- A chest x-ray takes about 15 minutes from positioning to verified images, and it requires no fasting or special preparation.
- Wear a top without metal, or expect to change into a gown. Remove jewelry, glasses and anything metal near the chest.
- The radiation dose is very small, roughly what you absorb from background radiation in about a day. Tell the technologist if you are or may be pregnant.
- Your clinician reviews the images and explains the results, and may suggest further imaging if something needs a closer look.
- An ultrasound is different: some exams need fasting, others a full bladder, so follow the instructions you are given.
Table of Contents
- What a chest x-ray is and why it is ordered
- How to prepare for a chest x-ray
- The chest x-ray procedure, step by step
- Is a chest x-ray safe?
- Results: what a chest x-ray can and cannot show
- How to prepare for an ultrasound
- Preparing for any radiology appointment
- Who benefits most from knowing this
- Our perspective
- Getting your chest x-ray with Garden State Medical Group
- FAQ
- Sources
What a chest x-ray is and why it is ordered
A chest x-ray is a picture of your chest, including the lungs, heart, large arteries, ribs and diaphragm. MedlinePlus, the National Library of Medicine’s health encyclopedia, lists symptoms that often lead to one: a cough that will not go away, chest pain, coughing up blood, trouble breathing and fever. It is also used when a clinician is looking for signs of conditions such as tuberculosis or lung cancer.
It is the most commonly performed diagnostic x-ray exam, according to the Radiological Society of North America and the American College of Radiology. That is because it is fast, widely available and answers a lot of first questions about the heart and lungs.
The test is not only for new symptoms. The American Lung Association notes that it can help show how well a treatment is working and can check for complications after surgery. For patients managing a long-term heart or lung condition, a chest x-ray may be one part of ongoing monitoring.
How to prepare for a chest x-ray
For most people, preparation is simple. Radiologyinfo.org states that a chest x-ray needs no special preparation. You can eat, drink and take your usual medicines unless your clinician tells you otherwise.
What to wear
The aim is to keep metal and thick layers out of the picture. Metal can block the x-rays and leave shadows on the image, which may mean a repeat.
- Choose a comfortable top with no zippers, snaps, buttons or metal decoration near the chest or shoulders. A plain cotton t-shirt works well.
- If you wear a bra, a style without underwire or metal hooks is easiest. You may be asked to change into a gown regardless.
- Wear pants or a skirt you are comfortable in. Only the chest area is imaged, and a lead apron may be placed over areas not being x-rayed, as the Veterans Affairs health library describes.
- Leave necklaces and other jewelry at home if you can.
If you arrive in clothing with metal, you will be given a gown. That is routine and does not delay the exam much.
What to remove
You may be asked to remove jewelry, removable dental appliances, eyeglasses and any metal objects that could interfere with the images, per radiologyinfo.org. The VA library adds that you may be asked to take off a watch. Keep valuables in a bag or leave them at home.
What to tell the imaging team
The technologist may ask about your overall health and the medicines you take. Give them the following:
- Whether you are pregnant or think you might be. The American Lung Association says it is important to tell the technologist.
- Any recent surgery or injury. The test is not painful, but moving into different positions can be uncomfortable after surgery or an injury.
- Any implanted devices, such as a pacemaker, or a chest tube or lines you already have.
- Whether you have trouble standing, so staff can adjust the position.
Bring your photo ID, insurance card and the order from your clinician. If you have had earlier chest imaging elsewhere, tell the team so your clinician can compare. Our guide on how to prepare for a health screening has a checklist of what to bring to any appointment.
The chest x-ray procedure, step by step
Here is what happens in the room, in order.
- Check-in and questions. You confirm your identity and the exam ordered, and answer health questions.
- Changing. You remove jewelry and metal items and change into a gown if needed.
- Positioning. For the standard exam you stand in front of the x-ray detector. MedlinePlus describes being told to hold your breath when the picture is taken, and usually two images are taken: one from the front and one from the side. The side view helps show structures that overlap in the front view.
- Breath hold. The technologist steps behind a protective barrier or screen. You take a deep breath and hold it for a few seconds. A full breath lets the lungs fill with air, which makes them easier to read.
- Image check. The technologist looks at each image before it goes to the radiologist. In digital radiography, professional guidance from the American Society of Radiologic Technologists says each image is reviewed for correct patient information, positioning, exposure and image quality before it is sent for interpretation.
- Finish. You change back and go on with your day.
From positioning to verified images, the exam is usually done within 15 minutes. If you cannot stand, the images can be taken sitting or lying down, and the technologist will help you into place.
What a digital chest x-ray means for you
Most modern x-ray rooms use digital radiography. Instead of film, a digital detector captures the image and a computer displays it within moments. For you, the experience is the same: you stand, breathe in and hold still. The practical benefit is that the technologist can confirm the image is usable right away, and your clinician can review it quickly. Radiologyinfo.org notes that results can be available almost immediately for physician review.
What it feels like
You will feel nothing from the x-ray itself. The detector may feel cool, and standing still with your arms positioned can be tiring if you are unwell or have shoulder or back pain. Tell the technologist if you need to rest.
Is a chest x-ray safe?
Yes, for most people. A chest x-ray uses a very small dose of ionizing radiation. A peer-reviewed review in the medical literature puts the dose at about 0.01 to 0.02 mSv, which is roughly one day of natural background radiation in most places on Earth. The unit mSv (millisievert) is simply how medicine measures radiation dose to the body.
Radiologyinfo.org explains that there is always a slight chance of harm from radiation, but with the small amounts used in medical imaging the benefit of an accurate diagnosis far outweighs the risk. It also states that no radiation stays in your body after an x-ray exam. If you want a deeper explanation of dose numbers, read our article on what x-ray radiation risk means for patients.
If you are pregnant
Tell the technologist before the exam. The same review notes that a chest x-ray gives a very low exposure, and that abdominal shielding has not been shown to be necessary to substantially reduce fetal exposure, though it is still offered for the comfort of the patient. Your clinician and the imaging team will decide together whether the exam is right for you and how to proceed.
How imaging teams keep exposure low
Radiation safety in a clinic rests on three basic ideas, which OSHA’s hospital radiology guide names as minimizing time of exposure, maximizing distance from the source, and using shielding. Together they keep exposure as low as reasonably achievable. Staff step away from the beam and you get a protective apron where it is appropriate.
Imaging should also be ordered for a reason. The American Academy of Family Physicians, in a 2021 review of appropriate imaging, points to guidance against routine plain chest x-rays in people without symptoms before surgery or as a baseline during a hospital stay. A good clinician orders the test when it will change decisions about your care. If you are unsure why an x-ray was ordered, ask at your visit.
Results: what a chest x-ray can and cannot show
A radiologist, a physician who specializes in reading medical images, reviews your x-ray and sends a report to your clinician. The report looks at the lungs, heart size and outline, blood vessels, ribs and the diaphragm. Findings can include signs of pneumonia, fluid, an enlarged heart, collapsed lung or other changes.
An x-ray is a first look, and some things need a different test. Radiologyinfo.org says that small cancers may not show up and a pulmonary embolism, a blood clot in the lung, cannot be seen on a chest x-ray. If your symptoms continue or the picture is unclear, your clinician may suggest more views or other imaging. The VA health library says your doctor may discuss results at a follow-up appointment or by phone and may advise an MRI, a CT scan or further x-ray views to confirm a diagnosis.
A follow-up test does not mean something is wrong. It often means the clinician wants a clearer picture before deciding on treatment. If you have chest pain, see our guide to chest pain evaluation. If you have severe chest pain, trouble breathing or fainting, call 911 rather than waiting for a scheduled test.
How to prepare for an ultrasound
Many people searching for x-ray preparation also want to know about ultrasound, which uses sound waves rather than radiation. Preparation depends on the body area being scanned, so the instructions on your order come first.
According to radiologyinfo.org’s ultrasound preparation guide:
- Wear comfortable, loose-fitting clothing. You may need to remove clothing and jewelry in the area being examined and change into a gown.
- For some scans, you may be told not to eat or drink for up to 12 hours beforehand. The period is shorter for babies and young children.
- For others, you may be asked to drink up to six glasses of water about two hours before and not urinate, so your bladder is full at the start.
If you take medicines daily, ask whether to take them as usual during a fast. Do not guess, especially if you have diabetes. An echocardiogram, the ultrasound of the heart, has its own steps, which we describe in our echocardiogram procedure guide.
Preparing for any radiology appointment
A few habits make every imaging visit smoother:
- Confirm the exam name and the preparation when you book, and write it down.
- Arrive a little early for paperwork.
- Bring your insurance card, photo ID, and a list of your medicines.
- Wear simple, metal-free clothing.
- Ask when and how you will hear about results, and who will explain them.
To understand which kind of imaging fits which question, our articles on the role of radiology in medicine and when you should see a radiologist are a good start.
Who benefits most from knowing this
If you manage a long-term condition such as heart disease, a lung condition or diabetes, imaging is often part of a routine. Knowing what to expect helps you attend appointments calmly and on time. Older adults may find standing for the exam tiring, so mention mobility needs when you book. Families can also use the same guidance for older children, though younger children may need different positioning, which the imaging team will explain.
Our perspective
Imaging works best when it sits inside a care plan, not apart from it. A chest x-ray tells a story about your lungs and heart, and that story is most useful when the clinician who knows your history reads it with you.
That is why we believe in a multidisciplinary approach. Primary care, cardiopulmonary care and on-site radiology and diagnostic testing work as one practice, so the question your clinician asks and the test that answers it stay connected. Patients with chronic conditions, older adults and families can have their imaging, follow-up and education in one place.
We also think preparation should be calm and clear. Most people only need to wear simple clothes and tell us about their health and medicines. Our aim is for you to understand why a test is ordered, what it will show, and what comes next.
Garden State Medical Group
Getting your chest x-ray with Garden State Medical Group
If your clinician has ordered a chest x-ray, or you have symptoms you want checked, our team can help. We offer on-site radiology and diagnostic testing alongside primary care and cardiopulmonary care for adults and families in North Bergen and Secaucus, New Jersey.
To book, start from our chest x-ray page or the full list of diagnostics, or contact us through our website. If you want to know what your insurance covers, ask when you schedule.
FAQ
Do I have to fast before a chest x-ray?
No. A chest x-ray needs no special preparation, per radiologyinfo.org. Eat, drink and take your medicines as usual unless your clinician says otherwise. Fasting is more often a requirement for certain ultrasound exams.
What should I wear to a chest x-ray?
Wear a loose top without metal zippers, snaps or underwire, and leave jewelry at home. You may be asked to change into a gown. The goal is to keep metal out of the image so it does not need to be repeated.
How long does a chest x-ray take?
The whole exam, from positioning to checking the images, is usually done within 15 minutes. The x-ray itself takes only a moment. Most of the time is spent checking in, changing and positioning.
Is a chest x-ray safe if I have had several?
Each chest x-ray uses a very small dose, about 0.01 to 0.02 mSv according to a peer-reviewed review. Your clinician orders the test when it is useful for your care. Tell the technologist about recent imaging and about any possible pregnancy.
When will I get my results?
Images can be available almost immediately for your physician to review. A radiologist’s report and your clinician’s explanation may take longer, and may come at a follow-up visit or by phone, as the VA health library describes.
Sources
- Chest x-ray: MedlinePlus Medical Encyclopedia
- Chest X-ray (Radiography), RadiologyInfo.org
- Chest X-Ray, American Lung Association
- Having an X-ray, Veterans Affairs
- Best practices in digital radiography, ASRT
- Imaging the Chest: The Chest Radiograph, PMC
- Radiology, OSHA hospital eTool
- Diagnostic Imaging: Appropriate and Safe Use, AAFP
- How to Prepare for Your Ultrasound Exam, RadiologyInfo.org