Chest x-ray revealed a flattened diaphragm. Please help.

Question

Hi doctor,

My husband is 52 years old. He has never smoked and is currently training for a half marathon. He is very fit. For a couple of years, he is suffering from mild asthma and using Ventolin inhaler. For the past few months, he is suffering from chronic cough and that sounds like an asthmatic cough. This is not always relieved by the Ventolin. He had a spirometry test which came back normal. A few weeks ago he came down with pneumonia and had a chest x-ray which revealed a flattened diaphragm. He was treated with antibiotics, fully recovered from the pneumonia and had a second x-ray done a few days ago with the same result. The doctor has given him a referral to a pulmonologist, but the appointment is only after a month. I am very concerned about his x-ray results. I have attached all his reports for your reference. What are the likely diagnoses?

Answer 1

Hello,

Welcome to icliniq.com. Well, your husband's x-ray (attachment removed to protect patient identity) shows stable hyperinflation. It means his lungs are over distended (mildly) with air. This is the result of his asthma. More than asthma, chronic obstructive pulmonary disease (COPD) is a better diagnosis. In this condition, the amount of air he inhales is not completely exhaled out. So, with every breath some amount ofair gets trapped in the lung and gradually it over distends the lungs. An over distended lung needs more space to accommodate itself and hence it pushes the diaphragm downwards. This results in flattening of diaphragm. There is no need to worry, as his spirometry test has come normal. It indicates the problem is mild. He needs to do deep breathing exercise, incentive spirometry and avoid dust and smoke.