What Does This X-ray Report Indicate?

Posted on Mon, 18 Sep 2017

Question: PA and Lateral chest radiographs. Findings: The heart is normal sized, with normal pulmonary vascularity. There is diffuse interstitial scarring, most pronounced within the mid and lower lung zones bilaterally, with no evidence of atelectasis, pulmonary consolidation, or pleural effusion. There is a small hiatal hernia. There is diffuse osteopenia, with moderate degenerative change within the mid/lower thoradic spine. Impression: 1. No acute cardiopulmonary pathology, with diffuse interstitial scarring, most pronounced within the mid and lower lung zones bilaterally. 2. Findings consistent small hiatal herna.

Answered by Dr. Indu Kumar (10 hours later)

Brief Answer:
Most commonly scarring is due to sequel of past infection.

Detailed Answer:
Hello,
Thanks for writing to Healthcaremagic,
I've gone through your query and understand your concern,

Findings suggests interstitial scarring in mid and lower zones of both sides of lungs.
Most commonly it is sequel of past infection and scar is formed during healing process of infection.
Patient may need clinical examination.
If patient is having respiratory problem then HRCT of thorax may be advised for further evaluation.Since patient's age is 85 years,there may be problem in breath holding during CT scan.

There is also small hiatus hernia.

Other findings like osteopenia and spine degenerative changes are age related findings.

In short,findings are not very serious. Findings may need clinical correlation.

Get well soon.

Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr. Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Indu Kumar (1 hour later)

Patient was having pain in chest on right side along with loss of weight - overall not feeling well since April timeframe. This x-ray was taken at the end of XXXXXXX Would you as a Radiologist have noted in the Impression section that a HRCT was advised for further evaluation?

Answered by Dr. Indu Kumar (10 minutes later)

Brief Answer:
HRCT(thorax) may be advised only after clinical evaluation.

Detailed Answer:
Hello,
Thanks for writing to Healthcaremagic,
I've gone through your query and understand your concern,

HRCT(thorax) may be advised only after clinical evaluation.
HRCT is not advised in impression part but it is ideal to evaluate interstitial lesions.

Get well soon.

Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr. Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Indu Kumar (6 hours later)

In your opinion - would lacking this information (HRCT - ideal to evaluate interstitial lesions) have cause to initiate a medical malpractice. The doctor finally ordered a CT scan in September (almost 3 months later) only to discover Stage IV non small cell lung cancer. My father passed away 5 months later.

Answered by Dr. Indu Kumar (11 hours later)

Brief Answer:
Lung cancer with this presentation is seen only in few cases.

Detailed Answer:
Hello,
Thanks for writing to Healthcaremagic,
I've gone through your query and understand your concern,
Sorry for replying late and sad to know about father's demise

Lung cancer with this presentation is seen only in few cases.
This may be the reason for advising late.

Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr. Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Indu Kumar (2 hours later)

Thank you for your answer. After viewing this x-ray would you have recommended further testing knowing someone was losing weight along with a cough?

Answered by Dr. Indu Kumar (2 hours later)

Brief Answer:
Complete investigations may be advised.

Detailed Answer:
Hello,
Thanks for writing to Healthcaremagic,
I've gone through your query and understand your concern,

In such cases, (besides proper physical check up),complete investigations may be advised.
Investigations include routine hemogram,random blood sugar,renal and liver function test,urine analysis,ultrasound of abdomen,ANA factor(to exclude any auto immune causes) etc.

Get well soon.

Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr. Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Nagamani Ng