Indications for chest X-ray in a patient with asthma:
(1) possible pneumonia
(2) localizing signs (such as decreased breath sounds) on the chest exam
(3) uncertainty about asthma being the cause of respiratory distress
(4) suspicion for pneumothorax or pneumomediastinum (asymmetric breath sounds, subcutaneous emphysema, tracheal deviation, mediastinal crunch)
(5) chest pain
(6) cardiovascular instability
(7) possible aspirated foreign body
where:
• Decreased breath sounds may indicate bronchial obstruction (plugging, foreign body) with or without atelectasis.
• Pneumonia may be suspected if there are fever, bronchial breath sounds or hypoxemia that is not corrected by low-flow supplemental oxygen.
