Lateral View Chest X-ray

Lateral view chest X-ray is an X-ray done from the side of the chest.  This is usually done together with a view from the front of the chest, also called a frontal view.  Lateral view of the chest is not always done, particularly when the chest X-ray is done portably or is not ordered by the clinical doctor.

Why are two views of the chest done?

A two view chest called a PA and lateral views is the most complete assesment of the chest using X-ray.  Two views are done because one view may not show all the abnormalities.  One view may show an abnormality that can be better clarified on the lateral view.   A lateral view also lets us localize abnormalities better to a specific anatomic site.

What does the lateral view of the chest show?

A lateral view of the chest can show more abnormalities like pneumonia, nodules and masses compared with just a frontal view of the chest.  Sometimes pneumonia can hide behind the heart or mediastinum and the lateral view will best show it.  The lateral view can also let us see a structure in two ways letting us come to a more accurate diagnosis.

Nodules and masses which can be cancerous are also sometimes seen only on the lateral view.  Nodules and masses may be seen by the spine, along the diaphragms and about the mediastinum on the lateral view.  Some nodules and masses of the lung are better seen on the lateral view.

An abnormality in the lung can better be localized on the lateral view.  We can tell on the lateral view if the abnormality is in the front or the back of the chest.  We can tell if an abnormality is in the mediastinum or hila versus the lung next to those structures.

A lateral view is also better to look at the bones of the spine and sternum.  Lateral view also shows parts of the lungs and heart to better advantage.  Therefore, a complete evaluation of the chest will include close inspection of both the frontal and lateral views of the chest.  There are blind spots on the frontal view alone.

Summary

Lateral view of the chest when done with the frontal view offers a more complete evaluation of the chest.   We can sometimes see abnormalities on the lateral view only like pneumonia or cancer.  The lateral view also lets us offer a more accurate diagnosis in some cases.  The lateral view of the chest also lets us say where the abnormality is in the chest.