CXR Case 009
78 year old female current smoker presents with wheeze, productive cough and breathlessness worsening over 6 days.
Describe and interpret this CXR
CHEST X-RAY INTERPRETATION
Non-infective exacerbation COPD
The lung fields are overinflated with flattened hemidiagragms consistent with airways disease and COPD.
No focal consolidation to suggest pneumonia.
CLINICAL CORRELATION
The flattened hemidiaphragms are a sign of overinflation from gas trapping from the emphysema.
Attempts to increase tidal volume are usually offset by a reduction in expiratory time – leading to dynamic hyperinflation.
CLINICAL PEARLS
Exacerbation of COPD – associated with sustained falls in FEV1.
Attempts to mitigate this with early physio and pulmonary rehabilitation programs are critical to avoid permanent loss of lung function.
TOP 150 CXR SERIES
Prof Fraser Brims Curtin Medical School, acute and respiratory medicine specialist, immediate care in sport doc, ex-Royal Navy, academic| Top 100 CXR | Google Scholar | ICIS Course ANZ
6 Comments
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isn’t there bilateral blunting of the costophrenic angles? thx!
I can see what you are thinking – I think there is often an impression of blunting of CPAs when there is overinflation.
good to know, thanks!
Is there a lytic lesion in the distal left clavicle as an incidental finding?
Is there cephalization of aortic arch compressing the trachea?
Isn’t there LVH?