Previous Chest X-ray (2017)
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Clinical information
- Previously presented with hypertension
- 57-year-old male
Previous Chest X-ray (2017)
- If available, always compare with the previous chest X-ray
- PA chest
- The heart is not enlarged
- All zones of the lungs are clear
Admission chest X-ray
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Clinical information - day 1
- Patient now aged 60
- Cough
- Shortness of breath
- O2 saturation of 50% on air and 85% on 15 litres of O2
Admission chest X-ray
- AP chest
- Dense peripheral shadowing mainly affects the mid and lower zones
- Patchy shadowing is seen elsewhere in both lungs
- Compare with the previous X-ray above
- Classification: Severe
Admission to ITU
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Clinical information - later on day 1
- Admitted to ITU
- ET tube, right internal jugular catheter and nasogastric tube inserted
- Chest X-ray requested to check tube position
Admission to ITU
- Lung shadowing has extended superiorly
- Tube position is satisfactory
- Classification: Severe
Initial clearing
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Clinical information - day 3
- Tube change
- Chest X-ray to check position
Initial clearing
- Shadowing has started to clear from the upper zones
- The ET tube is located more inferiorly in the trachea approximately 2 cm above the carina
- The new right internal jugular catheter is projected over the SVC just below the level of the carina
- Classification: Severe
Improvement
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Clinical information - day 5
- Patient stable
- Chest X-ray requested to assess progress
Improvement
- Shadowing now predominantly affects the lower zones
- Classification: Moderate
Further improvement
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Clinical information - day 7
- New fevers
Further improvement
- The shadowing continues to clear from the upper zones and has nearly cleared from the left lower zone
- Classification: Mild
Near complete resolution
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Clinical information - day 26
- Patient extubated (day 18) and moved to 'stepdown' ward
- Nasogastric tube still in situ
Near complete resolution
- Minimal atelectasis persists at the lung bases
- Classification: Mild
Complete radiological resolution
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Clinical information - day 33
- Nasogastric tube still required for feeding and medication
- Repeat swab negative for COVID-19
Complete radiological resolution
- All areas of the lungs now clear
- Lung expansion is normal - the diaphragm and mid-clavicular line meet at a point below the 5th rib
- Classification: Normal