What Is the Importance of X-rays for the Immigration Medical Exam?

Only tuberculosis (TB) infected applicants applying for visas and immigration to the US have to undergo chest X-rays.

A blood test will be performed to determine whether or not an applicant is infected with TB. The x-ray is obtained to determine whether or not a TB-infected applicant is contagious.

Applicants determined not to be contagious may proceed with their immigration medical exams and arrange for treatment on their own.

Applicants with questionable X-ray findings must undergo further testing with the local health department.

Applicants determined to be contagious must undergo treatment under the supervision of a lung specialist and the health department before proceeding any further with their immigration medical exams.

The Process of Chest X-rays for Immigration Medical Exams

The process of X-rays for immigration medical exams is quite simple.

The applicant has to change into a gown. No metal objects are to be on the body, including watches, pins, jewelry, etc. Bras must not have metal underwires or clasps if they are worn during the x-ray examination.

The radiology technologist will ask the applicant to stand with the chest against an upright board. The applicant must stay still, and take a deep breath, and hold it while the X-ray continues.

Generally, only a front view of the chest is screened.

Once the radiologist or x-ray specialist confirms that the image quality is good, the radiologist generates a report that is sent directly to the immigration doctor’s office.

Also read: How Is Tuberculosis Linked to Immigrants

Ensuring Safety and Accuracy During Immigration Medical Exam Chest X-ray

While carrying out a chest X-ray for immigration, there is some radiation exposure. It applies to other imaging procedures as well.

Therefore, there are certain things that radiology technologist needs to know before getting the X-ray done:

• A female applicant must inform the technologist if she is pregnant or planning to conceive soon. The chest x-ray requirement cannot be waived for reasons of pregnancy. The applicant should discuss the risks to the unborn baby with her obstetrician before obtaining the x-ray and may want to consider postponing the x-ray (and the whole immigration process) until after the pregnancy is completed.
• The X-ray technologist must also know about metal or other implants (including breast implants) in any body part that needs imaging. Metals block the X-rays, making the film more difficult to interpret.
• If an applicant has had chest X-rays in the past, especially if they were abnormal, the applicant may be asked to obtain the older films in case a comparison study is needed.
• Some people, especially women, may have thick or prominent nipples, which can cause confusing findings on a chest X-ray. If the radiologist determines that such is the case, the x-ray will be re-taken with metal nipple markers in place (possibly at additional expense to the applicant). Lead shielding will be used to minimize radiation exposure to the applicant and/or to an applicant’s unborn baby during an X-ray.

Related: Tuberculosis (TB) Testing for Immigration Medical Exam

Importance of Civil Surgeon for Interpreting X-ray Results for Immigration Exams

Once the X-ray is completed, the radiologist interprets the results and generates a report for the civil surgeon.

The civil surgeon then reviews and further interprets the report and documents the results.

The civil surgeon, not the radiologist, is the subject matter expert and final interpretation authority.

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