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

  • 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

Later on day 1

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Clinical information

  • Admitted to ITU
  • ET tube, right internal jugular catheter and nasogastric tube inserted
  • Chest X-ray requested to check tube position

Later on day 1

  • Lung shadowing has extended superiorly
  • Tube position is satisfactory
  • Classification: Severe

Day 3

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Clinical information

  • Tube change
  • Chest X-ray to check position

Day 3

  • 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

Day 5

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Clinical information

  • Patient stable
  • Chest X-ray requested to assess progress

Day 5

  • Shadowing now predominantly affects the lower zones
  • Classification: Moderate

Day 7

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Clinical information

  • New fevers

Day 7

  • The shadowing continues to clear from the upper zones and has nearly cleared from the left lower zone
  • Classification: Minor

Day 26

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Clinical information

  • Patient extubated (day 18) and moved to 'stepdown' ward
  • Nasogastric tube still in situ

Day 26

  • Minimal atelectasis persists at the lung bases
  • Classification: Minor

Day 33

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Clinical information

  • Nasogastric tube still required for feeding and medication
  • Repeat swab negative for COVID-19

Day 33

  • Complete radiological recovery
  • 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

Page author: Salisbury NHS Foundation Trust UK (Read bio)

Last reviewed: May 2020