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Respiratory Disorders  (Expert Forum)
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CXR hyperinflated lungs - CT negative
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CXR hyperinflated lungs - CT negative

by kina5544, Oct 22, 2005 12:00AM
47yr Male. Suffering from a number of mild intermitent neurological? symptoms for 18 months (possible MS) revealed along the way hyperinflated lungs "consitent with mild emphysema" via CXR.

Subsequent 8mm resolution CT scan (due to blood production) revealed nothing unusual about the lung at all except it being typical of hyperinflation (large and flattened diaphragm etc). LFT showed figures a few points below predicted in all areas - except lung capacity being at 109%.

As i understand it LFT results at only a few points below predicted would not be reflected in either a CXR or in patient symptoms. Also  BP and pulse at normal (120/70 & 65P rest) ..though right side BP 10 points higher on ave and an Ankle Bracheal Index of 1.2 (done at home).

1. Do i just have large lungs?? 2. Would 8mm resolution CT be sensitive in denying emphysema?

I do have occassional breathing IN problems(sensation)...but this maybe now subjective due to original emphysema diagnosis..but no other obvious symptoms of COPD. What would be a diff.diagnosis for hyperinflated lungs.

by National Jewish, Oct 30, 2005 12:00AM
You have written LFT by this I suspect you mean pulmonary function tests (PFTs).  Chest x-ray is not a reliable way to determine if a person has emphysema.  CT scan is better but the PFTs are the best way to know if the problem is emphysema.  Your PFTs and chest x-ray could reflect early emphysema.  This would depend on your smoking history.  It would also depend on what comprises "a few points below predicted in all areas."  This could also be seen with poorly controlled asthma.  Breathing problems such as asthma and emphysema are characterized primarily by difficulty breathing out, not in.  Asthma and emphysema, together, are probably the cause of greater than 95% of the cases of generalized hyperinflation, but not localized hyperinflation.
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