What causes pulmonary fibrosis in an elderly?

Hello,

Welcome to icliniq.com.

Single chest X-ray cannot diagnose lung fibrosis and further tests are required to rule out other causes. As you said, the chest X-ray was normal before a few months and now shows scattered fibrosis. It is advised to repeat the X-ray after a few days. Once the X-ray is reported as fibrosis, there is suspicion of a chronic irreversible disease known as IPF which is idiopathic pulmonary fibrosis. After this, I would like to clarify that having no significant past medical history of any risk factors, it is advisable to rule out common reversible infective causes like TB (tuberculosis) or pneumonia.

Radiation exposure, as you listed above, is not significant to cause fibrosis of the lungs. But it can be a contributing factor. Chest X-ray is not much sensitive to rule out lung fibrosis and the next important investigation advised is HRCT (high-resolution computed tomography) scan to rule out IPF or other ILD (immature lung disease). In your case, the advancing age of the patient is the most important risk factor to be the cause of scattered lung fibrosis. Looking at the spirometry, it is absolutely normal which cannot rule out IPF and further tests like DLCO (diffusing capacity of the lung for carbon monoxide) with body plethysmography are advised.

So in summary, as I said, a single chest X-ray cannot diagnose lung fibrosis. Further investigations like HRCT scan, DLCO with body plethysmography, and in some cases lung biopsy must find out the exact cause of lung fibrosis.