What is the role of chest radiography in the workup of cystic fibrosis (CF)?

Updated: Oct 22, 2019
  • Author: Girish D Sharma, MD, FCCP, FAAP; Chief Editor: Kenan Haver, MD  more...
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Answer

On chest radiography, initial changes are hyperinflation and peribronchial thickening. Progressive air trapping with bronchiectasis may be apparent in the upper lobes. With advancing pulmonary disease, the following findings may be noted:

  • Pulmonary nodules resulting from abscesses

  • Infiltrates with or without lobar atelectasis

  • Marked hyperinflation with flattened domes of the diaphragm

  • Thoracic kyphosis

  • Bowing of the sternum

Pulmonary artery dilatation and right ventricular hypertrophy associated with cor pulmonale is usually masked by marked hyperinflation. Several radiologic scoring systems are recognized. An example of chest radiography in cystic fibrosis is shown in the image below.

Chest radiograph of a patient with advanced cystic Chest radiograph of a patient with advanced cystic fibrosis. Note marked hyperinflation, peribronchial thickening, and bilateral infiltrates with evidence of bronchiectasis especially of the upper lobes.

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