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Lung diseases

Suspicious infiltrates

05/04/2009

Question:

My son is 17 years old and had his x-rays taken 3 days ago stating suspicious infiltrates, right upper lobe. The next day , his apico-lordotic view shows clear lungs. 3 years ago x-ray results is also clear lungs. I`m worried, I`m confused with the result. When he was born he had neo-natal pneumonia, is this related? What do I do next?

Answer:

It is difficult to be certain what these interpretations mean without seeing the actual films. 

Keep in mind that in a way x-rays are "shadow pictures" (made by shining a special energy source through a person and seeing how much of it gets through to the other side.)  Sometimes the images that are seen aren't entirely clear.  When radiologists use the term "suspicious," I usually interpret that to mean that they are seeing something in the area that they aren't quite sure of - it might be a  pneumonia, or it might just be another structure (some normal blood vessels are airways, for instance) that simply are casting some funny shadows.  Sometimes to clarify these concerns, a second picture is taken from a different angle - hoping to get the normal structures "out of the way" so that what's underneath them is a little clearer.  A lordotic view is an example of this type of "different angle."

Since the radiologist didn't see the worrisome shadow on the lordotic view just 24 hours after the first x-ray, probably the first x-ray didn't actually show a pneumonia after all.  (Pneumonia's don't go away that quickly, even with medicine.)

Your son's "clear" x-rays in his teen years are reassuring.  The neonatal pneumonia is long gone, and hasn't left any lasting marks. 

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Response by:

Elizabeth D Allen, MD Elizabeth D Allen, MD
Clinical Associate Professor of Pediatrics
College of Medicine
The Ohio State University