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Had Chest X-ray. Is The Report Normal?

Posted on Tue, 26 Nov 2013

Question: I had a chest xray and it showed stable biapical pleural thickening as well as mildly hyperinflated lungs..my dr. never ordered a chest ct What does this mean.

Answered by Dr. Vivek Chail (1 hour later)

Brief Answer: Apical pleural thickening can be normal finding Detailed Answer: Hi, Thanks for writing in to us. I have read through your query in detail. Medical literature says that the term apical cap has been used extensively in radiology to describe a density seen on the chest radiograph located in the extreme apex of the lung. Although apical caps are similar in appearance, their clinical significance varies widely. Most are a common feature of advancing age, the result of nonspecific sub pleural scarring and apical pleural thickening. Such appearance can be seen in a symptomatic individuals and are usually of no clinical importance. The mildly hyper inflated lungs can alsonbe considered as a normal variation and shows increase in lung volume. This is also considered as normal. CT scan chest is done where there is strong clinical suspicion in the light of X XXXXXXX chest findings. You might not require a CT scan chest. Do write in when you had myocarditis and synovial sarcoma and the area involved and short treatment details. Hope your query is answered. Do write back in case of doubts. Regards, Dr.Vivek

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Vivek Chail (1 hour later)

had tacosubas myocarditis 3 yrs. ago, synovial sarcoma on femoral artery thigh17 yrs. ago. treatment for sarcoma involved 40 radiation treatments to area w/wide excision first. myocarditis had cardiac XXXXXXX and admitted 6 days hospital w/f/up w/cardiologist. Recent cardiologist visit indicated ejection fraction decreased by 28% in 3.5 weeks about 2 months ago. Having another echo in 3 weeks, recent ekg was unchanged from 3 yrs. prior. A little bit of pleural effusion was noticed on echo, nothing significant noted by physician.

Answered by Dr. Vivek Chail (12 hours later)

Brief Answer: Please find detailed answer below Detailed Answer: Hi, Thanks for writing in with an update. Since the history of synovial sarcoma is 17 years back and you were treated with wide excision and radiation 40 fractions, there is no likelihood of any thing related to it at present. The myocarditis needs regular follow up. The ejection fraction is an important parameter in heart function and needs regular echocardiography and you are already getting treated for that by your cardiologist. I would like to confirm if your echocardiography showed pleural effusion or pericardial efusion. However, little amount of pleural effusion (less than 150 ml) will not be seen on chest X XXXXXXX The apical pleural thickening even in above situation may be considered as a normal finding and not something to worry about. There is no need for CT scan chest for the purpose of evaluating apical pleural thickening. Hope your query is answered. Do write back in case of doubts. Regards, Dr.Vivek

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Vivek Chail (21 hours later)

Thank you so much Dr. XXXXXXX Sorry, yes it was pericardial effusion. Small amount shown on echo back in August. Having another echo 11/25..

Answered by Dr. Vivek Chail (12 hours later)

Brief Answer: Welcome Detailed Answer: Hi, You are welcome and thanks for writing in with an update. The echo is important to review the pericardial effusion and ejection fraction. Please do take your medications on time. Hope the echo results are better this time. Wishing you good health. Do write back if you need further information. Regards, Dr.Vivek

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Vivek Chail (17 hours later)

Thank you very much. You are very knowledgable and helpful. Need more physicians like you in Boston, Ma. Regards, XXXXXXX

Answered by Dr. Vivek Chail (6 hours later)

Brief Answer: Welcome Detailed Answer: Hi XXXXXXX You are welcome and thanks for putting in your queries. Hope the results of your echo are better. Please be aware of your health condition and take precautions. Wishing you good health. Do write back should you need further information in the future. I will be glad to reply to your queries. Regards, Dr.Vivek

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Vivek Chail (12 hours later)

Thanks so much. Will do.

Answered by Dr. Vivek Chail (17 hours later)

Brief Answer: Important information - Please claim top up refund Detailed Answer: Hi XXXXXXX Welcome and hope you are doing good. I have to answer to every query of yours as per WWW.WWWW.WW guidelines. May I request you to please wait for a while and write in only when you have a query so that you do not have to pay unnecessarily. Please ask for a top up refund if you desire because now I notice that your earlier two queries contain thank you messages and feedback response which I humbly acknowledge. It contained no medical query which I have answered. You may also choose to close the thread and get back to me when you have a new query by quoting your query ID 0000. Your query will be directed to me and I will be glad to reply to you. Thanks again for your feedback. Regards, Dr.Vivek

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar