Question

A 68 yr old male presents to the ED complaining of SOB for the last week that has increased over the last couple days. He states he has also has a non-productive cough. He denies any lower extremity swelling, hemoptysis or chest pain. He has has a temp at 99.0 today. Denies any chills. Denies any sick contacts.
1. What findings would you see on a patient's chest xray if they had: (6 points)
      a. COPD
      b. pulmonary edema
2. What is costophrenic angle blunting and what are 2 diagnosis that you can see it with? (4 points)

Answer 1

Answer:

1. a. COPD

* Hyperinflation of lungs - Lungs appears larger than normal

* Flatter diaphragm

*Heart appears longer than normal

*Presence of air pockets

*Enlarged pulmonary artery

b. Pulmonary edema

* Cephalization of pulmonary vessels.

*  Patchy showing with air bronchograms

* Increased cardiac size

   * Peribronchial cuffing

   * Septal lines

2. Costophrenic angle helps in the reading of chest x ray systematically. Usually this angle is acute and sharp. But some pulmonary and plureal diseases causes blunting of the angle. The two diagnosis that we can see with it are pleural effusion and chronic obstructive pulmonary disease.