CXR Case 031
A 32 year old female presents with dry cough and dyspnoea
Describe and interpret this CXR
CHEST X-RAY INTERPRETATION
There is bilateral hilar adenopathy with a predominantly nodular infiltrate in the lung fields, sparing the bases.
This is sarcoidosis (Stage II on radiological classification).
Other than a biopsy and CT chest, routine tests to investigate sarcoidosis should include lung function including gas transfer, ECG, renal function, calcium, serum ACE levels.
*Note: Angiotensin-converting Enzyme (ACE) levels are not diagnostic of sarcoidosis and a normal serum ACE with sarcoidosis is equally possible.
*Serum ACE is only useful to track disease progression / response, if it is elevated.
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