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Tuberculosis: When Not to Order Roentgenograms

George M. Lordi, MD; Lee B. Reichman, MD, MPH
JAMA. 1985;253(12):1780-1781. doi:10.1001/jama.1985.03350360106030.
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IN 1979, the National Center for Devices and Radiological Health of the Food and Drug Administration sponsored the formation of a Chest X-ray Panel to review the selection of patients for chest x-ray screening examinations. The panel's recommendations have recently been published.1 The panel's statements regarding pulmonary tuberculosis are of particular interest and should be emphasized.

Essentially, the panel concluded that (1) the yield of tuberculosis cases found by screening or repeated chest x-ray examinations was not sufficient to justify the monetary cost or added radiation exposure, (2) mandated chest x-ray examinations as a condition of initial or continued employment were not productive for tuberculosis detection, (3) repeated chest x-ray examinations of persons with significant tuberculin reactions (without current disease), including those not treated with isoniazid, were not of value, (4) repeated chest x-ray examinations of asymptomatic patients with tuberculosis who had completed treatment were of insufficient clinical value,


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