Respiratory failure chest x ray

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]

X-ray may be helpful in establishing the etiology of respiratory failure as it may detect underlying disease. Findings on x-ray suggestive of pre-existing COPD include hyperinflation and a flattened diaphragm. X-ray findings suggestive of interstitial lung disease include reticular nodular shadows. Findings on x-ray suggestive of acute respiratory distress include cardiomegaly, redistribution of vessels, peribronchial cuffing, pleural effusion, lines within the septum, and bat-wing distribution of perihilar infiltrates. Finally, thoracic cage abnormalities may be detected such as kyphosis, scoliosis, pectus excavatum, fractured ribs and ankylosing spondylitis, as well as diaphragmatic paralysis.

• X-ray may be helpful in the diagnosis of respiratory failure as it may detect underlying disease.^[1]
• Findings on an x-ray suggestive of pre-existing COPD include:
  • Hyperinflation
  • Flattened diaphragm
• Findings on x-ray suggestive of interstitial lung disease include:
  • Reticular nodular shadows
• Findings on x-ray suggestive of thoracic cage abnormalities include:
  • Kyphosis
  • Scoliosis
  • Pectus excavatum
  • Fractured ribs
  • Ankylosing spondylitis
• Findings on x-ray suggestive of acute respiratory distress include:
  • Cardiomegaly
  • Redistribution of vessels
  • Peribronchial cuffing
  • Pleural effusion
  • Septal lines
  • Perihilar infiltrates

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