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Crackling Sound In Lungs And Xray Showing Bibasilar Crackles And Mild Calcification Aorta. Should I Be Concerned?

Posted on Wed, 11 Dec 2013

Question: I have a question for my mom. We just went for a physical check for her. She is 74 years old and quite healthy and active otherwise. the doc said everything was normal but he heard some crackling sound on her lungs while check up so he sent for xray to check it. here is what the x-ray report said INDICATION: Bibasilar crackles COMPARISON: None TECHNIQUE: XR CHEST 2 VIEWS PA LATERAL Impression: IMPRESSION: Cardiomediastinal silhouette normal. Mild calcification aorta. Heart size normal. Minimal small nodular densities lung apices to exclude minimal fibronodular change. Lungs otherwise clear. Minimal blunting far posterior costophrenic angle bilaterally cannot exclude small pleural effusion. If patient has previous or outside films these may be useful for comparison. -------------------------------------------- She has very occasionally complained of shortness of breath like from last so many years. Doc did the ECg today too. Which was almost normal and just said sinus rhythm with occasional PVC . The Pulmonologist What do you think. Otherwise she seems quite ok as I said. Please advise.heard dry fine crackles. She never smoked or drank. Also, Her breast exams have been normal so far. Many thanks

Answered by Dr. Shashi Dangwal (33 hours later)

Brief Answer: Get a CECT chest and PFT done. Detailed Answer: Hello XXXX, Having gone through your query, i am of the opinion that the salient features in your mother`s case are: 1. Occasional shortness of breath. 2. Crackling sounds in the lung. 3. Few fibronodular opaciteis in lung apices. 4. Blunting of CP angles posteriorly. 5. Few cracling sound in the lungs. I am of the opinion that min fibronodular opacities in the lung apices may be a result of some infection esp TB in the past and may be of no significance. But in view of all the other findings, i suggest that you go in for a CECT chest and a PFT(pulmonary Function test). These tests may help in ruling out a condition called Interstitial Lung Disease. CECT chest will also throw more light on fibronodular opacities in the lung apices. I suggest you consult a pulmonologist in your vicinity who can examine her in detail and also interpret above mentioned tests and advise you accordingly.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shashi Dangwal (12 hours later)

Thanks so much for your answer Doctor. I am a worried daughter. How much of a chance it is with crackling sound in lungs to have the ILD? She doesn't have much of shortness of breath as she goes to walks and active. And what about the blunting of CP angles? Her ECG was ok and just occasional PVCs. But I have noticed her she has been clearing her throat without mucus. Any further comments. I will try to get the tests done but not sure how much of a chance it is for her to have this issue? Have you seen people with fine dry crackles yet not having any lung disease as serious as this. Please advise.. A very worried daughter

Answered by Dr. Shashi Dangwal (1 hour later)

Brief Answer: Get the invest done to rule out any ailments. Detailed Answer: Hello XXXX, I think you are unnecessarily worrying yourself up. In all likelyhood, your mother may not have any underlying lung problem and crackling may be an incidental finding. However since a doubt has been raised and there are some x ray findings, it is advisable to complete the investigations and reach a diagnosis so that necessary corrective measure can be taken. Even if it turns out to be ILD, hers may be in very early stages. Blunting of CP angles first needs to be confirmed which may be done either by CT Scan or a USG chest. So i suggest stop worrying unnecessarily and get the tests done earliest possible.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shashi Dangwal (17 minutes later)

Hi Doc You have been a wonderful in answering my queries. I should be writing you a good review as you deserve it. One last question is that with ILD, the shortness of breath is with exercise or lying down also?. Hers is not from exercise. Mainly takes some few deep breaths to catch.. and that is very rare. In any case, also what are the other causes of blunting besides plueral effusion. As you suggested, I would try getting the tests done. But I also do have one more kind request, can you please take my name out of the communication please. As due to privacy....would not like to be on public forums with my name on it. :-)But thanks for your wonderful assistance. You have been awesome and will keep you in loop for the future. Thanks

Answered by Dr. Shashi Dangwal (4 hours later)

Brief Answer: Thanks. Detailed Answer: Hello XXXX, Thanks for all the good things you have written. Breathlessness in ILD initially comes with exertion and in advanced stages may be present at rest or on lying down. In your mother`s case it may be a matter of habit or due to some underlying pathology which tests will tell us. There are some other causes of blunting of CP angles. Like in some cases flat, low lying diaphragms or pleural thickening as a result of some old infection(usually unilateral) just to name a few. However as i said a usg or a CT chest will tell us the exact cause. Lastly, regarding removing your name from this forum, i would`nt know how to do it as i only get to answer the questions and not able to access the whole soft ware. You may approach XXXXXXX team for the same. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar