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British Lung Foundation
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Newbie needing help understanding chest X-ray

Hi, I'm new on this site, first time posting here, and would like help in trying to make sense of a resent chest X-ray.

I've had a persistent cough for the last 5 years, at times it gets better but it never goes away, it started when I had pleurisy 5 years ago. I get shortness of breath when Under stress or overdo things.

I have Sjogrens with SLE overlap and take prescribed medication for these, and finally seem to be on tract for these.

A recent CT scan came back clear, the chest X-ray showed hemidiaphragm elevation on the right, and reduction in lung volumes which was extra pulmonary so a diaphragm paresis remains a possibility.

Can anyone help me understand what this means. When I was with the doctor I felt overwhelmed and didn't know what to ask.

Thanks for reading this and I hope someone can help.



6 Replies

Hi am no expert by any means but if was me .. I would think the talking about lungs

Naturally one lung is bigger than other USALY if you look in mirror can see both lungs working in unison as the connected to each side of stomach musical hip's

This lots of things can cause unequal pressure SO might want to ask them to clarify what they mean as plumery is just a term and not condition.

I dont think is diaphragm paresis as that is serious and think you would still be in hospital.

I think hemidiaphragm is just your body compensating for different lung size volumes guess trying to keep things equal balanced.


Paresis is muscular weakness, which would suggest your diaphragm is not working as well as it might. You could ask for referral to a physio to give you safe exercises to improve your diaphragm strength. Or check with your doctor first and see if it's okay for you to join a singing group (more fun than going to a gym).


Hi Jean, I read your post. It appears that you have had a problem with your breathing. Your lungs are not as effective as they once were and it is very difficult for you to do deep breathing. Deep breathing is important to all of us and as we take a deep breath, it is with the rise of our diaphragm that helps us get air into the bottom of our lungs. With the possibility of diaphragm paresis, indicates where one side of your diaphragm muscle is not as efficient as the other side. Did the doctor mention anything to you about a sniff test? It is a fluoroscopic guided test to evaluate the function of your diaphragm. If I were you, I would stay in touch with your doctor. Keep all your appointments and ask questions next time you go. Ask him to put it in Layman terms. He should do that anyway. Just ask him....sometimes we have to remind them that we are the patient, not one of his colleagues; otherwise we would know what he was talking about. Welcome to our forum.

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Hi Girliegirl, thanks for your welcome and reply. I have a follow up appointment with a specialist next week and hopefully will get more testing done. I will make sure that I have full understanding of what I have, and what I will need to do to get well.

It's frustrating when I'm talking and I run out of breath in the middle of words, or even when I'm just walking and there is a slight incline on the path.

Again thanks for your insight and advice, I can only hope that I will walk out of the specialists office with better information.


Hi Jean

I have longstanding SLE with presumed Sjogrens overlap with respiratory/airway issues too! A significant part of my problem is respiratory/diaphragmatic weakness. I did some specialised tests in Birmingham which were sitting/lying spirometry, a sniff test and also tests for maximum inspiratory and expiratory strength. The tests were all significantly reduced on repeated occasions but no-one seems particularly concerned other than to keep an eye on it. I don't even do those tests any more. I did my own research and found that diaphragmatic weakness occurs in as many as 25% of lupus patients but my Rheumy has never told me that!

I find it difficult to take a good deep breath and also to cough well enough to clear my chest but, as I understand it, one sided diaphragm issues are quite manageable.

Hope this helps a bit. Clare x

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Hi Clareb67, thanks for you reply. I've had Sjogrens for several years, but only recently been diagnosed with SLE overlap. The shortness of breath has been a short while. I was sick with plurasy about 5 years ago and since then I've had constant chest infections and coughs, have taken multiple courses of antibiotics, which have helped, but only for short periods of time before the cough/infections would return. My voice has changed over this time and I now run out of breath just talking, let alone doing anything strenuous. If I'm upset etc, I find it very difficult to even talk.

I have an appointment with a respetory specialist next week, so hopefully I will get all the testing to find out exactly what is going on in this old body.

I will ask my Rhumatologist about diaphragmatic weekness, see if what I have is lupus related. Were you given any medication? I have only just started taking plaqinel, I was told it could take up to 3 months to work.

Thanks for your kind words,



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