Chest Radiographs and Their Reliability in the Diagnosis of Tuberculosis

Abstract

Radiology plays an important role in the diagnosis of pulmonary tuberculosis. Many medical practitioners
believe in and rely primarily on the chest x-ray for the diagnosis of pulmonary tuberculosis. This study
attempts to evaluate the reliability and validity of chest radiographs. This study was carried out in the
tuberculosis clinic of BPKIHS. 75 radiographs were chosen for the study and viewed by 25 physicians of
varying qualifications. Their findings were compared with the gold standard. The overall sensitivity and
specificity was 78% and 51% respectively. There was poor agreement between the best physician and the best
radiologist. This study has demonstrated an unsatisfactory sensitivity and specificity of chest x-rays in the
diagnosis of pulmonary tuberculosis. The over-diagnosis and over-treatment due to chest x-rays could lead
to an unmanageable burden on the resources of a poor country like Nepal. Private practitioners should be
made aware about the importance of bacteriological diagnosis of tuberculosis before initiating drug therapy.
Key Words: Chest radiograph, pulmonary tuberculosis, specificity, sensitivity.