CXR Case 009

78 year old female current smoker presents with wheeze, productive cough and breathlessness worsening over 6 days.

CXR CASE 009 LITFL

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 |

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