How is hyperexpansion determined on a chest radiograph?
Greater than 7 anterior ribs visible above the diaphragm in the mid-clavicular line
Flattening of the diaphragm
What does hyperexpansion tell you about underlying lung disease?
There is obstructive airways/pulmonary disease
What could be the cause of the chest wall pain and tenderness?
There are multiple partially healed rib fractures
How is the history of steroid treatment relevant?
Steroid use has led to generalised loss of bone mineral density resulting in weakness of bone, with fractures secondary to minor trauma - coughing
How is osteoporosis formally diagnosed?
X-ray can show reduction of bone mineral density, but cannot formally diagnose osteoporosis
A DEXA (Dual Energy X-ray Absorptiometry) scan is required