Tuberculosis has been one of the most important problems for a long time. This disease can involve different organs among which lung is the most common one. Chest X-ray is the oldest and the most practical diagnostic method for pulmonary tuberculosis. Using chest X-ray can cause difficulties for the students of medicine and young physicians because of the different patterns of lung involvement during the disease therefore, familiarity with them is important. The present research was an observational study done in periodic cross-sectional way on patients with TB in Rasoul-e-Akram and Firoozgar Hospitals. Data collection was done via kind of form designed like a checklist. The aim of this study was to determine the frequency of parenchymal consolidation atelectasis and lymphadenopathy, pleural effusion and other abnormal findings in chest X-ray of 400 patients with pulmonary TB. 203 of patients were women (50.7%) and 197 of them were men(49.3%) with mean age of 56.01+18.47 years. The youngest was 10 years old and the oldest was 90. The location of infection was in the right lung in 66.6% of patients(265 ones), in the left lung in 15%(60 ones), in both sides in 18.3%(75 ones), in 61.8% of patients in upper lobe of the lung, 24.3% of patients(97 ones) in lower lobe and in 14% middle lobe was involved. The most common finding in chest X-ray was parenchymal consolidation(53.7%) and after that mixed pattern(18.7%). The finding of this study showed that chest X-ray is an important tool in the diagnosis of tuberculosis and parenchymal consolidation is the most common radiologic finding. The chronicity of symptoms(fever,cough), positivity of PPD and failure to respond to antibiotics in CAP are key points to differentiate TB from bacterial pneumonia.
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