Small Lung Volumes



Small Lung Volumes


Dharshan Vummidi, MD

Eric J. Stern, MD



DIFFERENTIAL DIAGNOSIS


Common



  • Lung Fibrosis


  • Pleural Disease


  • Lobectomy


  • Skeletal Deformities


  • Ascites


Less Common



  • Neuromuscular Disorders


Rare but Important



  • Pulmonary Hypoplasia


ESSENTIAL INFORMATION


Key Differential Diagnosis Issues



  • Normal lungs vs. fibrotic


  • Check for prior surgery


  • Check for ascites


  • Poor inspiratory effort vs. intrinsic disease


Helpful Clues for Common Diagnoses



  • Lung Fibrosis



    • Reticulation or honeycombing in peripheral caudal lungs for interstitial pneumonias


    • Apical scarring from prior tuberculosis (or similar)


  • Pleural Disease



    • Large pleural effusions frequently cause compressive atelectasis


    • Diffuse pleural thickening causes restrictive physiology


  • Lobectomy



    • Surgical clips


    • Partial rib resection


  • Skeletal Deformities



    • Congenital or acquired



      • Kyphosis


      • Scoliosis


      • Kyphoscoliosis


  • Ascites



    • Abdominal fluid limits excursion of diaphragm


    • Abdominal distension on radiography and CT


    • Free fluid on CT


Helpful Clues for Less Common Diagnoses



  • Neuromuscular Disorders



    • Respiratory muscle involvement


    • “Shrinking lungs” in systemic lupus erythematosus from muscle weakness


    • Muscular dystrophy


    • Polymyositis


    • Myasthenia gravis



      • Association with thymomas


    • Diaphragm weakness, paralysis, or hernia



      • Unilateral or bilateral

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Aug 8, 2016 | Posted by in CARDIOLOGY | Comments Off on Small Lung Volumes

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