Q. Is it possible to detect interstitial lung disease on a 64 slice chest CT angiography?

Answered by
Dr. Vivek Chail
and medically reviewed by iCliniq medical review team.
Published on Nov 29, 2018

Hello doctor,

Can an interstitial lung disease be detected on a 64 slice chest CT angiography or a 128 slice 3 mm of the chest with no contrast? For the past four months, I have symptoms of chest tightness, fatigue, anxiety, broken sleep, and low back pain.

Dr. Vivek Chail

Radiodiagnosis Radiology
#

Hi,

Welcome to icliniq.com.

Interstitial lung disease can be visualized in 64 slices and 128 slice CT machines (attachment removed to protect patient identity). A particular HRCT chest protocol is to be followed. No contrast is needed.

Thank you doctor,

Please review my CT scan for any lung disease abnormalities. Do you see the need for a follow-up HRCT scan? I have sharp chest pains and pretty bad back pain right now. My chest can be tight as well for the most part and it feels like a tearing sensation in my muscles in my back and chest. My SPO stats during the day stay above 96. I do not have a cough nor wheezing or crackles in my lungs as per the doctor. Just feel fatigued for the most part with pain in my chest, back, lower abdomen area. I also seem to have what seems to be increased tactile fremitus. Not sure if it is just my nerves though.

Dr. Vivek Chail

Radiodiagnosis Radiology
#

Hi,

Welcome back to icliniq.com.

There is no need for an HRCT lung. The lungs are looking normal with no obvious focal or diffuse lesion. I was wondering if you ever had any problems with your right clavicle like a previous injury.

Thank you doctor,

No, that has never bothered me. Right now I am trying to figure out what is causing this sharp pain beneath my sternum, what is causing an increase in the vibration of my voice in my chest, and this incredible back pain. I have also lost about 14 pounds and cannot seem to gain it back. What test do you suggest I take next? I have had X-rays, EKG, stress EKG, two CT scans, spirometer results were within normal limits besides small airways which were 66 %. That was the only outlier. DLCO was 106 and DEV was well above 90 %. At rest my pain is fine but upon exertion, it escalates. The back pain is most severe in my lower back, however, the sharp uncomfortable pain in the chest is driving me crazy. Plus the vibration in my chest. I have been sleeping more than usual and can still feel tired in the day.

Dr. Vivek Chail

Radiodiagnosis Radiology
#

Hi,

Welcome back to icliniq.com.

Pain near the sternum can be from a condition called costochondritis and is inflammation of the junction between the anterior ribs and the cartilage areas. This condition is benign but the pain can be disturbing and for a long time. CT or X-ray cannot pick up the condition and diagnosis is made by elimination, other possible causes of pain in front of the ribs. A severe pain in the back might need to be evaluated by doing a screening MRI whole spine just to see if there is any nerve being pinched or any pressure on the spinal cord. This is not evaluated on a CT scan. The more disturbing pain needs to be first investigated in detail.

Hi doctor,

Thank you for replying back to me. Will you please look at the attached documents and let me know if anything is of concern to you? Also, these symptoms I have been experiencing have been for the past 17 weeks. One symptom that seems to bother me is foamy/ cloudy urine. If I urinate directly into the water it foams up, if I urinate next to the bowl it looks like I have white particles in my urine. I have been tested for infection and nothing came up. They gave me a device to try and catch the particles but they seem to slip right through. My primary care also tested my urine for protein and he said my levels were fine. Any idea why I would have foamy urine for 17 weeks? If I urinate sitting down it does not foam but still will have some slight white particles in it.

For costochondritis, do you suggest that I treat that injury? Would pleurisy and other lung or heart-related problems have been diagnosed via CT scan? My xiphoid process is sore to the touch as well wondering if you have any idea why that might be. Thank you for your help as I have been anxious and depressed these past 17 weeks with my condition. I am a former smoker and a night of binge smoking lead to all of this. I was not a heavy smoker, more social, maybe half a pack a month. That was off and on for 15 years. Could that night of binge smoking cause injury to my health that has led to the tightness in the chest, rapid heartbeat, and these other underlying symptoms?

Dr. Vivek Chail

Radiodiagnosis Radiology
#

Hi,

Welcome back to icliniq.com.

Foamy urine can happen due to many causes, protein in urine and an infection are the common causes. There can be less common causes like dehydration and retrograde ejaculation. You might like to review the possible cause with your doctors.

Costochondritis is a benign inflammation of the anterior ribs and cartilage areas. It is a disturbing symptom and the pain if severe may be controlled with medicines. The pain can persist for 2 to 6 months and rarely longer. This does not need any definitive treatment and recovery is spontaneous over weeks to months.

Did you see anything abnormal with my lab results or spirometer? Does the 66% of raw is small airways alarm you? As far as my xiphoid process is concerned, what could be causing that to be sore? How can I address the increased vibration of my voice and chest? Could anxiety or depression be causing these symptoms? Does my thyroid score look low? Just wondering if you have any steps I should take in testing.... could gerd be a problem and maybe that's what is keeping me from gaining weight again?

Dr. Vivek Chail

Radiodiagnosis Radiology
# Hi,
Thanks for writing in.

The raw and airway resistance is in the normal range.

Your hemoglobin is on the lower side of normal but in the normal range. You might like to get an anemia testing and peripheral blood smear done if not done before.

The TSH is also near the lower limit of normal. This is not a concern.

I am not sure though, but you might be having decreased intake of nutritious foods due to GERD and anxiety and this might be the cause for a low normal hemoglobin.

The pain in the xiphoid process area can be from costochondritis or anxiety.

Regards,
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