X-ray artifact. I am a bit confused.

I recently had 2 x-rays of my left shoulder for possible tendonitis with impingement. The x-rays have been reviewed by a radiologist with nothing of interest noted to my shoulder. The radiologist did report a left lung hilum artifact on the PA (posterior -> anterior) view so obviously part of my left lung was captured as well as my shoulder and a chest x-ray has been requested.

I am not one to really worry pre-emptively or frighten myself to death with online information but I am a bit puzzled by this. I was a nurse in critical care up to a few years ago (currently not working due to a separate unrelated illness). My chest x-ray knowledge is limited to basic things specific to critical care. In my 30 year career I have never heard the term artifact used in relation to a chest x-ray. The only terms I know are over or under exposure and slight rotation (as in chest).

I am very familiar with ECG (EKG) and cardiac rhythm monitor artefact. It is usually due to patient movement or poor electrode contact. I have tried searching on DDG for 'chest x-ray hilum artifact' and ''chest x-ray artifact' but it brings up links to hilar masses, lymphoma and bronchogenic carcinoma (lung cancer). As I said I am not clicking on stuff like that and I am not reaching out for ATS diagnosis. I was a two pack a day smoker for 35 years stopping nearly two years ago.

Artefact has quite a few descriptions but I have always thought of it as 'man-made'? I know the term is used a lot on the UFO threads. Modern x-rays are digital and viewed on a pc monitor so I started thinking of software glitches but would this be so localised and would a radiologist not be able to see this?

The x-ray below (not mine) shows the left and right hilar points. Anatomically the lung hilum is a triangular shaped indent on the inner side surface of the lung. The left and right bronchus runs through it as well as blood vessels, nerves and many lymph nodes.



I can't for the life of me think how you would differentiate an artifact in those tiny areas (obviously they are the experts).

Its probably a long shot but are any ATS members radiographers or doctors? I have been unwell this week so may have missed something on searching. I had the chest x-ray this morning and I have to wait 7-10 days now for the result.

Thanks in advance for any assistance.

a reply to: Morrad

Here's a good synopsis from a radiologist. Don't freak out...if they're calling it artifact, they're not worried about it. This can be perfectly normal.

Edit: Typically, if it's something worrisome they'll put a rush on the reading by a radiologist...it takes them minutes to actually read the films, so if they thought something was wrong, they'd have put your films at the front of the queue for a stat read.

www.quora.com...

a reply to: Morrad

Looks like a monkey wrench. Have you had any surgery lately?

a reply to: CrapAsUsual

X-rays have an issue with soft tissue such as muscle,
and other non-bony structures like a liver or kidney.

It's really designed for dense, extremely fibrous
and/or bony structures. Depending upon the
sensitivity of the "reader" and the digital signal
processing power of the attached computer system,
it is likely an xray will pickup denser structures that
MIGHT be be more on the side of connective tissue
than any tumor.

The only way to be sure is a 3D CT scan
(technically it's a multi-slice x-ray) or an
MRI which picks up glucose uptake which
may be present in cancerous tissue.

Those two types of imaging are your best best
just in case you have a type of fibrosis in the
lungs (i.e. scar tissue buildup) or an advanced
inflammatory response in any tissue near or
in the lungs indicating something is up!

It could be anything from absolutely NOTHING
(you might even just be dehydrated!) all the
way to a bacterial or even fungal infection
in nearby tissue!

Don't take my ill-educated word for it!

A cheap CT or MRI scan can be around
$750 to $1500 depending on the
area you live, so get it checked out!

The MRI is better with finding soft tissue
disease and injury but it's around $2600
if you pay cash!

or another possibilty...the radiologist read the wrong x-ray.....I am not a radiologist but have performed x-rays for many years and had to check them out to make sure the films were viewable...but I do not see anything that shows up on your x-ray as an artifact....not a radiologist as I stated but further testing like CT or MRI if you think they made a mistake....which I think they may have mixed up your x-ray with someone else.

or another possibilty...the radiologist read the wrong x-ray.....I am not a radiologist but have performed x-rays for many years and had to check them out to make sure the films were viewable...but I do not see anything that shows up on your x-ray as an artifact....not a radiologist as I stated but further testing like CT or MRI if you think they made a mistake....which I think they may have mixed up your x-ray with someone else.

a reply to: Morrad

My wife is a non-practicing MD, radiology, though I am in no way offering medical advice. Wait for the new xrays. I know it's hard not to worry, but they need the new xrays.

Maybe those areas have damaged tendons in them, tendons do show up some times depending on the strength they choose when doing the X-ray.

Wait and see I suppose. An artifact can be a lot of things.

Thanks for the replies. I will try not to think about it over the next week.

a reply to: tigertatzen

That makes sense regarding queue-jumping.

a reply to: StargateSG7

I live in the UK. CT would be the next diagnostic exam if there is concern about my x-ray from yesterday. Thanks for the other info.

a reply to: lutherg65

It is not my x-ray (just for demonstration purposes) but appreciate that radiographers review and sometimes have to repeat the x-ray. Funny you should mention name mix ups. I received someone else's medication (dispensed in my name) last week.

a reply to: Ksihkehe

Thank you and please thank your wife.