Pediatric Expiratory Chest

  • Etiology: CXR is obtained in expiration instead of inspiration
  • Imaging CXR:
    — CXR in inspiration shows well expanded lungs, normal heart size, normal appearing pulmonary vasculature
    — CXR in expiration shows poorly expanded lungs, cardiomegaly, prominent pulmonary vasculature
  • DDX: Congestive heart failure
  • Complications: False positive diagnoses
  • Treatment:
  • Clinical: If it is suspected that an expiratory CXR has been obtained the CXR should be repeated in inspiration

Radiology Cases of Expiratory Chest

Difference between pediatric inspiratory and expiratory CXR
Inspiratory CXR (above) shows well expanded lungs, normal heart size, and normal appearing pulmonary vasculature. Expiratory CXR in the same patient (below) shows poorly expanded lungs, cardiomegaly, and prominent pulmonary vasculature.
Inspiratory and expiratory CXR
Inspiratory CXR (above) shows well expanded lungs, normal heart size, and normal appearing pulmonary vasculature. Expiratory CXR in the same patient (below) shows poorly expanded lungs, cardiomegaly, and prominent pulmonary vasculature.
Normal inspiratory and expiratory CXR
Initial CXR AP (left) shows the heart to be enlarged and the pulmonary vascularity to be congested and there are low lung volumes. Repeat CXR AP obtained 5 minutes later in inspiration (right) shows the heart to be normal in size and the pulmonary vascularity is not congested and there are normal lung volumes.