CHEST X-RAY INTERPRETATION

Clinical Picture

• 42-year-old man presenting with 2 day history of coryza and non-productive cough.
• Stable renal transplant, no recent issues. No chest pain, no fever, no shortness of breath and no signs of sepsis. Daughter recently experienced similar symptoms.
• Looks well, normal vital signs, normal physical examination. 

Findings

• Technical factors
  • Rotation – Normal
  • Inspiration – Adequate
  • Picture – Adequate
  • Exposure – Adequate
• A-E Assessment
  • Airway – Trachea central
  • Breathing – Clear lung fields
  • Circulation – Normal heart size and border
  • Diaphragm – No abnormalities, no free air
  • Everything else – No abnormalities

Summary 

• This is a normal chest x-ray

Differential diagnosis

• Appreciating there was a limited amount of information available, there was no significant concern in the patient history to suggest a sinister cause of cough. Though Ray had a renal transplant, he had no issues with it and the history was highly suggestive of a viral cause. Whilst it may be reasonable to inform Ray’s normal team of the situation, the most likely cause of the cough in this case was a viral respiratory tract infection.

Management

• Reassurance
• Symptomatic treatment of a viral infection

Further reading

• Chest x-ray interpretation guide