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Lung diseases

Lung Infection

05/12/2011

Question:

Hello,

Last Tuesday I suddenly developed a cough without any other symptoms. I saw my doctor on Thursday and he ordered a chest x-ray that showed streaking in both lungs. I have a very deep noisy cough but not able to cough anything up and have crackling noises on deep exhalation. I was put on Avelox, inhaler and musinex. I am no better and still have non-productive noisy cough with crackling sounds. Occaisonal pain in chest that is very mild after a coughing bought, no other symptoms except being tired. Was sick in February with bronchitis and in October had some respiratory thing that lasted into June. What does streaking indicate? I am an otherwise healthy 47 y/o female who is non-smoking since 1997

Answer:

I will apologize in advance since I cannot make specific recommendations without the full set of information available to your physician including exam. I will generally discuss the question you put to me: "What does streaking indicate?"  

As always, it is important to review and discuss any aspects of your healthcare or testing with your physician which you do not understand or have questions about. It is important in these discussions to voice your specific concerns and questions. 

"Streaking" on a chest x-ray is not a medical or scientific term. It is a descriptive term used by someone who interpreted the x-ray to describe what they believe they saw. I do not have much more information than that. Specifically there is no clear assessment of the density, location, associated findings if any or interpretations. It is implied that the appearance or prominence of markings on the chest x-ray is more than might be expected, but this is only speculation since I do not have access to the film. There is no listed comparison to old films which is often very useful if old films exist and can identify any changes in the appearance. 

Since no strong recommendations were made by your physician, I am assuming that the appearance is subtle at best or maybe even questionable - again this is pure speculation and needs to be reviewed with your physician. 

In general, prominence if present in the chest x-ray might represent an incredibly large array of processes with different implications depending on the specific appearance. If there is any uncertainty about chest x-ray findings, a repeat film or more detailed film of the chest or CT scan may be useful in some cases. As a general rule, abnormalities on a chest x-ray either real or suspected should be defined and/or followed to insure a reasonable resolution of any questions that may have been raised. 

Again, I invite you to discuss with your physician if any further imaging or action is indicated. 

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Response by:

Robert  Schilz, DO, PhD Robert Schilz, DO, PhD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University