Routine chest radiography in the elderly

Routine chest radiography is common practice in geriatric admission units. The cumulative cost of this unproven procedure is very high, and the authors challenge the need to carry out the investigation in all cases. A prospective survey of 1000 consecutive admissions to an acute geriatric ward showed that 35-50% had little or no clinical indication for chest X-ray examination, and that omitting the investigation in these patients would not have resulted in 'missed' significant chest conditions. Considerable savings to the service would accrue if radiology was restricted to those patients with a positive indication for the investigation.