• Saskia van Vugt, Lidewij Broekhuizen, Nicolaas Zuithoff, Pim de Jong, Christopher Butler, Kerenza Hood, Samuel Coenen, Herman Goossens, Paul Little, Jordi Almirall, Francesco Blasi, Slawomir Chlabicz, Mel Davies, Maciek Godycki-Cwirko, Helena Hupkova, Janko Kersnik, Arthur Mierzecki, Sigvard Mölstad, Michael Moore, Tom Schaberg, An De Sutter, Antoni Torres, Pia Touboul, Theo Verheij, and GRACE Project Group.
• University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, the Netherlands. s.f.vanvugt@umcutrecht.nl
• Ann Fam Med. 2012 Nov 1; 10 (6): 510-5.

PurposeImaging may produce unexpected or incidental findings with consequences for patients and ordering of future investigations. Chest radiography in patients with acute cough is among the most common reasons for imaging in primary care, but data on associated incidental findings are lacking. We set out to describe the type and prevalence of incidental chest radiography findings in primary care patients with acute cough.MethodsWe report on data from a cross-sectional study in 16 European primary care networks on 3,105 patients with acute cough, all of whom were undergoing chest radiography as part of a research study workup. Apart from assessment for specified signs of pneumonia and acute bronchitis, local radiologists were asked to evaluate any additional finding on the radiographs. For the 2,823 participants with good-quality chest radiographs, these findings were categorized according to clinical relevance based on previous research evidence and analyzed for type and prevalence by network, sex, age, and smoking status.ResultsIncidental findings were reported in 19% of all participants, and ranged from 0% to 25% by primary care network, with the network being an independent contributor (P <.001). Of all participants 3% had clinically relevant incidental findings. Suspected nodules and shadows were reported in 1.8%. Incidental findings were more common is older participants and smokers (P <. 001).ConclusionsClinically relevant incidental findings on chest radiographs in primary care adult patients with acute cough are uncommon, and prevalence varies by setting.

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