What is the diagnosis for a patient with a cough, based on a chest X-ray (X-ray) showing no focal consolidation, but with multiple healed left-sided rib fractures?

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Last updated: April 17, 2025 • View editorial policy

From the Guidelines

Your chest X-ray shows no signs of pneumonia or other concerning lung issues that would explain your cough, and the next step would be to investigate common causes of cough such as upper airway secretions, asthma, or gastroesophageal reflux disease, as suggested by the American College of Chest Physicians evidence-based clinical practice guidelines 1. The radiologist noted some old, healed rib fractures on your left side, but these are not related to your current symptoms and don't require any treatment, and according to the Thorax journal, a diagnostic algorithm for chronic cough can be used in patients with normal chest radiographs 2.

From the Research

Patient Information

  • The chest X-ray results show that there is no focal consolidation, which means that there are no signs of pneumonia or other infections in the lungs 3.
  • However, it's essential to note that the right costophrenic sulcus is excluded from view, which may limit the accuracy of the diagnosis, and the patient has a history of cough, which is a common symptom of respiratory infections 4, 5.

Diagnostic Considerations

  • The role of chest X-rays in diagnosing pulmonary infections is to determine the presence, localization, and extent of the infection, as well as to detect predisposing factors and complications 3.
  • While chest X-rays are a useful diagnostic tool, they may not always be able to exclude infectious or inflammatory lung disease, especially in patients with no respiratory symptoms or signs 5, 6.
  • The diagnosis of pneumonia requires a combination of clinical judgment and diagnostic tests, including chest X-rays, and the decision to use a chest X-ray should be based on the individual patient's presentation and medical history 7.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.