From the Guidelines
The chest X-ray shows no acute problems with your heart or lungs, which is reassuring. The "low lung volumes" noted on the X-ray means you weren't taking a full, deep breath during the X-ray, a common finding that is typically not concerning by itself 1. To improve future X-rays, it is recommended to take a deep breath and hold it when instructed during the imaging. Low lung volumes can sometimes make it harder for radiologists to see certain details, but since no acute findings were noted, this isn't an immediate concern.
If you're experiencing symptoms like shortness of breath, chest pain, or persistent cough despite this normal X-ray, it is crucial to follow up with your healthcare provider as some conditions may require additional testing 1. The chest radiograph is a useful initial imaging study in chronic dyspnea, and it may reveal a wide variety of abnormalities that can guide further imaging choices. However, the diagnostic performance of chest radiography varies among the reviewed literature, and it may not be sensitive enough to exclude certain conditions, such as bronchiectasis or interstitial lung disease 1.
In the context of chronic cough, the American College of Chest Physicians recommends an initial chest radiograph, and studies have shown that abnormal radiography is positively associated with underlying primary pulmonary pathology other than asthma 1. Nevertheless, the sensitivity of chest radiography in this group is likely skewed toward early disease and airway abnormalities, which could potentially result in delayed diagnosis for a small percent of patients with chronic cough. Therefore, it is essential to prioritize clinical evaluation and consider additional testing if symptoms persist or worsen over time.
From the Research
Chest X-ray Findings
- The chest x-ray reads no acute cardiopulmonary findings, but low lung volumes are noted.
- According to 2, pulmonary function tests (PFTs) are used to diagnose and manage chronic respiratory diseases, and low lung volumes may indicate a restrictive ventilatory impairment.
- The European Respiratory Society and the American Thoracic Society (ERS/ATS) provide guidelines for interpreting PFTs, which include comparing results to a healthy reference population and identifying potential ventilatory impairments 2.
Possible Causes of Low Lung Volumes
- Low lung volumes can be caused by various factors, including restrictive lung diseases, such as interstitial lung disease or pulmonary fibrosis 3.
- Other possible causes of low lung volumes include conditions that affect the chest wall or respiratory muscles, such as neuromuscular disorders or skeletal abnormalities 3.
- The study by 4 found that patients with acute pulmonary embolism often present with dyspnea, tachypnea, or pleuritic pain, but low lung volumes are not specifically mentioned as a common finding.
Diagnostic Imaging
- The study by 5 discusses the use of diagnostic imaging in acute cardiopulmonary disease, including portable radiography and newer imaging modalities.
- According to 5, careful coordination between the radiologist and intensivist is necessary for the optimum use of diagnostic imaging in patients with acute cardiopulmonary disease.
- The chest x-ray finding of low lung volumes may require further evaluation with additional diagnostic tests, such as PFTs or computed tomography (CT) scans, to determine the underlying cause 2, 3.