Advances in chest imaging in acute medicine

Chest radiography is the most commonly performed diagnostic imaging test, but in unselected acute medical admissions it offers low diagnostic yield and high case-finding costs. There has been a trend towards the use of targeted radiological investigation. Advances in computed tomography technology, with improvements in spatial and temporal resolution, have facilitated detailed cardio-pulmonary imaging within a single breath hold. Advances in ultrasound technology have improved the accurate delineation of small thoracic structures with the added advantages of portability, repeatability. Real-time, dynamic ultrasound imaging is particularly useful for ‘point-of-care’ testing. The targeted use of radiological investigations early in clinical assessment has the potential to reduce diagnostic time and costs, improve diagnostic yield and facilitate prompt treatment.