The Chest Radiograph Following a Positive Tuberculin Skin Test
TB Fact Sheet 1d
A person whose tuberculin skin test (TST) result is positive should be given a chest radiograph to rule out active tuberculosis (TB) disease. A physician uses the chest radiograph results, as well as the medical history and physical examination, to determine the appropriate follow-up.
If the initial chest radiograph is negative for active TB disease, no follow-up films are recommended or indicated for an asymptomatic TST-positive person
Some employers still recommend routine follow-up chest radiographs at regular intervals; such radiographs are not indicated, nor are they recommended by city, state, or federal health agencies.1, 2, 3
After an initial film is negative for active TB, the New York City Department of Health and Mental Hygiene chest clinics do not perform follow-up chest radiographs on asymptomatic TST-positive persons. If completion of a follow-up film is a condition of employment, individuals or employers may contact the Director of Patient Care Services, Bureau of Tuberculosis Control, at 311. The Bureau will advise employers to bring their policies into accordance with city, state, and federal recommendations.
A single chest radiograph should be obtained on all TST-positive individuals, and films should be obtained on all patients with suspected or confirmed active TB as indicated.
Notes and References
- New York City Department of Health, Bureau of Tuberculosis Control. Clinical Policies and Protocols, 3rd ed., 1999. Call the number below to request copies of the relevant portions of this publication.
- New York State Department of Health, Tuberculosis Program, Bureau of Communicable Disease Control. Recommendations for tuberculosis surveillance in schools. State of New York - Department of Health Memorandum. Health Facilities Series: PH-1, 88-2. Jan. 5, 1988.
- U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health care facilities. MMWR 1994;43 (RR-13):40.
