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A pathology that can surely create strange lung markings would be bronchitis. It is a very common disease and sometimes, the history of a sickness is not enough to help doctors determine what is wrong with a patient. This is when X-rays are needed.

As we have already covered, if a suspicious lesion on the lungs is seen during a simple Chest X-ray examination, that does not necessarily equate to a lesion of lung cancerThere are many other alternative possibilities and these irregularities could just be signs of a lung infection on X-ray. One of the classic types of lung infections that could be bothering you could be bronchitis. Many patients with this type of disease will have a lingering cough that does not seem to disappear and it is why doctors will order a chest X-ray to look for possible clues. Here, we will explore some of the telltale signs of bronchitis that you need to be aware of and if this disease will make irregular presentations an X-ray. 

What is Bronchitis? 

You may have heard of the disease "bronchitis" before but there is much more to it than just a chronic cough. There are two types of bronchitis; acute and chronic bronchitis.

Acute bronchitis is also referred to as a chest cough and it is the fifth most common reason why someone will visit with their family doctor. It is almost always a type of infection caused by a virus but bacteria are also capable of causing bronchitis. It is a disease that should self-resolve in a few days after the initial period of illness and an X-ray will almost never be ordered. [1]

Having a simple cough is one thing, but if the problems persist and you start to have the coughing year after year, doctors need to begin to suspect chronic bronchitis. This is a disease that causes the lining of the respiratory tract to narrow due to a chronic infection with a high degree of mucus production. A chronic cough is a way to try to help clear the mucus, and you will need to have this cough for at least 3 months a year for at least 2 consecutive years to meet the medical definition of chronic bronchitis. [2] It will also typically be associated with other types of chronic lung infections like chronic pulmonary obstructive disorder (COPD) and asthma. If you have a history of cigarette smoking, you increase your chances of having chronic bronchitis as well. [3]

The goal of treating this type of disease is to limit the number of symptoms that a patient will have to deal with. 

Antibiotics will be necessary to help reduce the risk of opportunistic infections but it is nearly impossible to reverse the worsening of this disease. 

Steroids and aerosols may provide some temporary relief in order to help reduce the swelling and inflammation to help the patient breath better. [4] 

This will also be the time when an X-ray will be necessary to get a better look at what is happening. 

How Will Signs of Bronchitis Present on a Chest X-ray? 

When it comes what will be seen on the imaging studies, signs of bronchitis are not very specific. There may be small lesions or markings in the lung boundaries but they are not always present in each case. What will be more noticeable, however, will be the irregularities of the lung borders on the chart. There will be obvious bronchial wall thickening and increased bronchovascular markings, enlarged vessels, and cardiomegaly. This is fancy medical lingo for saying that the vessels supplying blood to the lungs will appear to be whiter on the image and the heart will be much larger than it should be. 

Chest X-rays will be a valuable addition to make the final diagnosis of chronic bronchitis. In one study designed to compare the diagnostic accuracy of chronic bronchitis in Japan against the United States, 105 cases of chronic bronchitis were analyzed. The study observed that only 5 cases were found to have been diagnosed inaccurately based on the presentations on the chest X-ray and laboratory tests. This proves that a chest x-ray will be able to make a final diagnosis of chronic bronchitis almost without fail. [4]

As you may remember, there is also a subtype of bronchitis referred to as acute bronchitis and it will have a chest X-ray presentation that will be much more different than what we have seen with chronic bronchitis. 

You will not see the same physiological changes in the X-ray in acute bronchitis cases. Doctors will need to differentiate X-rays from cases of pneumonia. There will be no suspicious lesions on the lungsno effusions or obvious changes in the lung fields, no cardiomegaly unless there are underlying heart problems and no increased vascular markings. [5] This is why X-rays may not even be taken in the first place if doctors suspect acute bronchitis just based on the symptoms and complaints of a patient. 

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