Lung Metastases Imaging: Practice Essentials, Radiography, Computed Tomography
Lung Sounds: What Do They Mean?
When you go for a sick visit or your annual checkup at your doctor's office, they will likely listen to your chest through a stethoscope. Part of what they're listening for is the sounds your lungs make as you breathe in and out. Listening to your lung sounds gives your doctor a clue about how well your lungs are working.
Your doctor will use a stethoscope to listen to your lung sounds. The medical term for this is auscultation. (Photo Credit: DigitalVision/Getty Images)
There are three types of normal lung sounds that are different depending on where in your chest your doctor is listening. The three normal lung sounds are bronchial, bronchovesicular, and vesicular.
Bronchial lung sounds
Your doctor can hear these most clearly when you breathe out. They'll listen high in your chest and over your windpipe for loud, rough, and high-pitched lung sounds. These sounds are normal in your bronchial area, but may be abnormal in other areas of your lungs.
Bronchovesicular lung sounds
Your doctor can hear these sounds when you breathe in and out. They'll listen in the middle part of your chest for sounds are lower-pitched than bronchial lung sounds but higher-pitched than vesicular lung sounds.
Vesicular lung sounds
Your doctor can hear these sounds best when you breathe in. They'll listen in your mid-back for soft, smooth, low-pitched sounds. These tell your doctor that nothing (like mucus) is blocking your airways, and there's no swelling or narrowing that's stopping you from taking a full breath.
Adventitious lung sounds
Adventitious sounds are ones that your doctor hears in addition to the normal sounds. These noises can help your doctor identify problems in your lungs. For instance, lung conditions like bronchitis or pneumonia can cause adventitious lung sounds. The five most common abnormal lung sounds are:
Read on to learn more about these common types of adventitious lung sounds and a few less common ones.
A wheeze (or sibilant rhonchus) is a continuous, high-pitched lung sound. Wheezing may be easier to hear when you breathe out, but sometimes you can hear it when you're breathing in and out. You may even be able to hear wheezing without a stethoscope. Wheezing indicates you have a narrowed airway that limits the flow of air in and out of your lungs.
Wheezing causes
The most common causes of wheezing include:
You can also start wheezing if you smoke or as a side effect of some medications (such as aspirin if you have asthma).
Rales, or crackles, are discontinuous, interrupted, or explosive lung sounds. They may sound like pulling velcro open. The sounds can be short and high-pitched, or they may last a bit longer and be lower-pitched. Your doctor is more likely to hear crackles when you're breathing in, but they may happen when you breathe out, too. Rales happen when your airway snaps open as you breathe in.
Rales causes
Common causes of short, high-pitched rales (fine crackles) include:
Longer, low-pitched rales (coarse crackles) are caused by the same conditions as fine crackles but suggest a more advanced state of the condition.
Stridor is a continuous, rough, high-pitched whistle or squeaking lung sound. Your doctor is more likely to hear it when you breathe in. Like wheezing, stridor suggests you have blocked airflow, but it happens more in your upper airway or throat than in your chest.
Stridor causes
Causes of stridor include:
Rhonchi (also called sonorous rhonchi) are loud, continuous, low-pitched, snoring, or gurgling lung sounds. Your doctor may be able to hear them best when you're breathing out, but they may also hear them when you breathe in and out. The sound might move around to different parts of your chest when you cough as mucus moves around. These sounds happen because your larger airways are narrowed by mucus, and they flutter as air flows through.
Rhonchi causes
Wheezing and rhonchi have a similar cause (narrowed airways usually due to fluid buildup), so the causes are mostly the same. For instance, rhonchi is often caused by:
Pleural rub is a rough, scratching, or grating lung sound. Your doctor will hear it when you breathe in and out. It's usually louder than other lung sounds since it's happening in your chest wall. You get pleural rub when the linings of your lungs (pleura) swell and rub against each other.
Pleural friction rub causes
Possible causes of pleural rub include:
Whooping is a loud, high-pitched gasp lung sound. You may make this noise when you gasp for air after a coughing fit. You will be able to hear this when you breathe in as you fill your lungs after expelling all your air when coughing.
Whooping causes
The most common cause of whooping lung sounds is an infection with a bacteria called Bordetella pertussis, commonly called whooping cough.
Hamman's sign is a crunchy or scratchy lung sound that happens in time with your heartbeat. This sound indicates that you have air trapped in the space between your lungs (a medical condition called pneumomediastinum). The sound is caused by shifting of the trapped air from the movement of your heart as it beats.
Hamman's sign causes
The most common causes of pneumomediastinum include:
Infants with breathing problems may make persistent noises, such as:
Your doctor can get important information about the health of your lungs by listening closely as you breathe. The easiest and most common way to do this is to hold a stethoscope to the skin on your back and chest. This is called auscultation.
As your doctor listens, they'll ask you to take deep breaths through your mouth. They also may ask you to speak certain phrases and see how they sound through your chest or back. Some examples of this include:
Bronchophony
Your doctor will ask you to say "ninety-nine." Normally, your lungs will muffle the words. If the words sound clear through the stethoscope, it may be a sign that your lungs are filled with blood, fluid, or mucus.
Whispered pectoriloquy
This involves whispering "ninety-nine" or "one, two, three." Healthy lungs will dampen the sound and make the words faint, but they'll be louder if your lungs are filled with fluid.
Egophony
If you have fluid in your lungs, your doctor uses this test to check for a collapsed lung. As you say an "e" sound, your doctor will listen to see if it's muffled and sounds like "e" or if it's louder and sounds like "a," which means fluid is changing the sound.
If you notice you have abnormal or changes in your breathing sounds, you should go get checked out by your doctor.
And if you have any of the following symptoms, call 911 and get to the ER right away:
As part of your physical exam, your doctor will listen to your lung sounds through a stethoscope. Part of what they are listening for is adventitious lung sounds, which are sounds your lungs make in addition to your normal breathing sounds. The five major adventitious lung sounds are wheezing, rales, stridor, rhonchi, and pleural rub. Various conditions cause different sounds, although there can be overlap. Lung sounds are one clue your doctor uses to help them figure out what is causing you to have breathing problems.
What lung sounds does pneumonia have?
This depends on whether you have viral or bacterial pneumonia. Bacterial pneumonia tends to be more severe than viral pneumonia. People with bacterial pneumonia can have wheezing, rales, rhonchi, and pleural rub. People with viral pneumonia may only have a dry cough.
What do congested lungs sound like?
Congestion in your lungs is usually due to mucus or swelling. If you have congestion, you may have wheezing, rales, rhonchi, and pleural rub.
What Causes Pediatric Musculoskeletal Disorders?
Musculoskeletal (MSK) disorders affect the muscles, bones, joints, and tissues. In children, they may be due to infection, cancer, inflammatory arthritis, or progressive muscle disorders.
MSK disorders in children may cause pain and impair a person's movement. A child's musculoskeletal system differs from an adult's, so MSK disorders often present differently in children and adults.
This article discusses some of the most common categories of musculoskeletal disorders, but not all of them. It explains the symptoms of MSK disorders in children, some causes, types, and diagnosis. It also discusses when a person should contact a doctor if they notice symptoms of an MSK disorder in a child.
The symptoms of MSK disorders in children can vary, depending on the underlying cause and type of the disorder.
According to Versus Arthritis, symptoms that may indicate a serious MSK disorder in a child include:
MSK disorders have various causes. Some conditions are congenital and present at birth, while others develop over time. Infection and tumors can also cause MSK issues. The following sections describe these causes in more detail.
Children are at especially high risk of infections. Many common infections are mild and treatable at home. However, others, such as those relating to MSK disorders, require attention from a healthcare professional.
TypesThe most common MSK infections in children include osteomyelitis, an infection of the bone, and septic arthritis, an infection of the joints.
The bacteria Staphylococcus aureus most often causes osteomyelitis and septic arthritis. The bacteria may spread after entering through a wound or as a complication of another illness, such as chickenpox or an ear infection.
Osteomyelitis affects the bone marrow or bones. It is rare and affects around 1 in 5,000 children. It more commonly affects children under 5 years, and boys are twice as likely as girls to develop the infection.
Osteomyelitis in children may lead to complications, such as fractures, differences in limb length, and problems with range of motion. A doctor can typically treat the infection with antibiotics.
Septic arthritis affects 3 to 4 in 100,000 children in the United States. The infection most often occurs in boys and children under 5.
Without treatment, septic arthritis may permanently damage the joints. A doctor can treat the condition by draining fluid from the joint with a needle and prescribing antibiotics.
Read more about the causes of septic arthritis.
Malignant musculoskeletal tumors are rare in children. Signs of these types of cancer in children include unexplained bone pain and swelling and unexplained soft tissue lumps that are growing larger.
TypesMusculoskeletal cancers in children include bone tumors, which are most often:
Malignant bone tumors account for 6% of all childhood cancers.
Bone cancer usually affects children during adolescence and tends to develop in bones that are growing rapidly. These include the bones around the knee and in the upper arm.
Soft tissue sarcomas account for around 7% of childhood cancers. The tumors can form in any soft tissue of the body, including the muscles, nerves, joints, and tendons.
Treatment for bone cancer and soft tissue sarcomas usually includes surgery, radiation therapy, and chemotherapy.
Progressive muscle conditions worsen over time. Muscular dystrophy (MD) refers to a group of more than 30 progressive muscle disorders. MD usually begins in childhood and requires lifelong treatment.
MD typically leads to muscle degeneration and weakness over time. This can affect various bodily movements and functions, including heart and lung function, which can shorten a person's lifespan.
TypesThere are many types of MD. The most common types include:
When a child presents with symptoms, such as joint or bone pain, doctors may first perform a physical examination and ask about a person's family medical history.
A physical examination may include palpation, which involves a doctor gently feeling areas of the body with their hands. A doctor may also check for visual signs of infections, such as an inability to bear weight on the limb with the infection or the child's ability to rotate the limb.
A doctor may then order several tests to help determine the cause. These may include:
A person needs to contact a doctor if a child has symptoms of an MSK disorder.
Some MSK disorders, such as septic arthritis, can result in severe complications without treatment. Others, such as bone and soft tissue cancer and MD, require medical care to reduce the severity of symptoms and, in some cases, to prolong a person's life.
Several pediatric musculoskeletal (MSK) disorders exist. These include infectious types, such as osteomyelitis and septic arthritis, cancers, such as bone and soft tissue sarcomas, inflammatory arthritis, and progressive muscle disorders.
Many types of MSK disorders are rare in children but can be severe.
A person needs to contact a doctor if their child has symptoms of an MSK disorder. The disorders typically require medical attention and may lead to severe complications without treatment.
Imfinzi Side Effects: What You Should Know
Imfinzi (durvalumab) is a brand-name infusion prescribed for certain types of cancers, including certain lung cancers. As with other drugs, Imfinzi can cause side effects, such as fatigue, rash, cough, hair loss, and shortness of breath.
Imfinzi (durvalumab) is a brand-name prescription immunotherapy medication. It's approved by the Food and Drug Administration (FDA) to treat certain types of lung cancer, as well as some other types of cancer.
Specifically, Imfinzi can be used in certain situations to treat:
Like other medications, Imfinzi can cause side effects. Read on to learn about potential common, mild, and serious side effects. For a general overview of Imfinzi, including details about its uses, see this article.
Imfinzi can cause certain side effects, some of which are more common than others. These side effects are usually temporary, lasting a few days or weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
The side effects can vary depending on the condition Imfinzi is being used to treat and whether Imfinzi is used alone or in combination with other drugs. Some of the more common side effects of the drug across all people treated with it include:
Mild side effects can occur with Imfinzi. This list doesn't include all possible side effects of the drug. For more information, you can refer to Imfinzi's prescribing information.
Mild side effects that people being treated with Imfinzi have reported include:
These side effects may be temporary, lasting a few days or weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks the side effects the drug causes. If you develop a side effect during Imfinzi treatment and want to tell the FDA about it, visit MedWatch.
Imfinzi may cause serious side effects, but this isn't common. The list below may not include all possible serious side effects of the drug. For more information, refer to Imfinzi's prescribing information.
If you develop serious side effects as a result of your treatment with Imfinzi, call your doctor right away. If the side effects seem life threatening or you think you're having a medical emergency, immediately call 911 or your local emergency number.
Serious side effects that have been reported can include:
For more information about each of these serious side effects, see "Side effect specifics" below.
Imfinzi may cause several side effects. Here are some frequently asked questions and answers about the drug's side effects.
Is joint pain a side effect of Imfinzi?Yes, joint pain was a common side effect in clinical trials of Imfinzi.
Imfinizi may also cause muscle pain, bone pain, or inflammation (damage and swelling) in your body, which can affect your joints and cause pain.
If you have joint pain during your treatment with Imfinzi, talk with your doctor. They may be able to recommend treatments to help you feel better. Or, they may suggest a different medication for your condition.
Will I need to be observed for side effects after Imfinzi infusions?Imfinzi is given as an IV infusion by a healthcare professional, but you probably won't need to stay for observation after receiving a dose.
Imfinzi may cause infusion reactions, such as dizziness or fainting, but these usually occur while you receive the drug. A healthcare professional will monitor you during the infusion to treat any reactions you develop.
Some drugs given by infusion can cause infusion-related reactions hours or even days after the infusion. However, this hasn't been reported with Imfinzi.
If you have any concerns about infusion reactions from Imfinzi, talk with your doctor.
Does Imfinzi have long-term side effects?Imfinzi may cause long-term side effects, such as immune systemic reactions, including inflammation and thyroid problems.
Most side effects go away after a few weeks of treatment or after stopping Imfinzi. However, some people may experience side effects after stopping treatment until the drug clears from the body. Some people may require, additional medication to treat the long-term side effects.
If you're concerned about how long you may have certain side effects of Imfinzi, talk with your doctor.
Learn more about some of the side effects that Imfinzi may cause.
Hair lossHair loss may occur with Imfinzi treatment. This was one of the more common side effects reported in clinical trials of the drug.
Hair loss may also be a symptom of low levels of thyroid hormones, which is another potential side effect of Imfinzi.
In addition, hair loss is a common side effect of chemotherapy drugs. Imfinzi isn't a type of chemotherapy, but it's sometimes used with chemotherapy medications to treat cancer.
What you can doTalk with your doctor if you're concerned about or experiencing hair loss during treatment with Imfinzi. They can help determine the cause.
If your hair loss is related to hormone problems, your doctor may recommend medication to help regulate your hormone levels. Or, they may suggest that you try a different drug to treat your cancer.
Infusion reactionsImfinzi is given as an IV infusion, which is an injection of medication into a vein over a period of time. In clinical trials of Imfinzi, there were reports of reactions that occurred during infusions. This included severe infusion reactions in rare cases.
Infusion reactions can also be life threatening. Symptoms of severe infusion reactions can include:
What you can doIf you experience an infusion reaction while receiving a dose of Imfinzi, your healthcare professional will typically slow down or stop the infusion. Depending on the severity of your reaction, they may give you medications or other treatments to ease the side effects.
Your doctor may also want you to receive your next infusion more slowly than the previous one. Giving the infusion over a longer period of time may lower your risk for having another infusion reaction.
If your infusion reaction is severe, your doctor may have you stop treatment with Imfinzi and try a different medication for your cancer.
Immune system reactionsRarely, Imfinzi may cause serious allergic reactions that affect the immune system. Immune system reactions are when the immune system mistakenly attacks the body's healthy cells. This can lead to inflammation (damage and swelling) in any part of the body. Sometimes, the immune system reactions can be severe or life threatening.
Symptoms can vary depending on which part of your body is affected. These reactions weren't common in clinical trials.
The following are some serious immune system side effects that Imfinzi may cause:
During your Imfinzi treatment, your doctor will monitor you for inflammation or immune system reactions by ordering lab tests. These may include blood and urine tests.
If you have symptoms of an immune system reaction during your treatment with Imfinzi, talk with your doctor right away. Depending on which part of your body is affected, they may recommend treatment to help ease the inflammation. Your doctor may also decide to pause your Imfinzi treatment. Or, they may have you stop using Imfinzi and try a different treatment for your cancer.
Serious infectionsSerious infections, such as pneumonia, may occur during Imfinzi treatment, but this isn't common.
In clinical trials, people receiving Imfinzi were more likely to develop a serious infection, including pneumonia, than people receiving a placebo. (A placebo is a treatment without an active drug.)
Symptoms of pneumonia and other serious infections can include:
Symptoms of cystitis can include:
While receiving Imfinzi treatment, talk with your doctor if you notice any symptoms of an infection. They can order tests to determine what type of infection you have. Your doctor can also recommend treatment to help ease your symptoms and clear up the infection.
In addition, you can take the following steps to help lower your risk for infection:
Be sure to talk with your doctor about your health history before you start Imfinzi treatment. This drug may not be the right treatment for you if you have certain medical conditions or other factors that affect your health. The conditions and factors to consider include the following:
Allergic reaction. You should not receive Imfinzi if you've ever had an allergic reaction to it or any of its ingredients. Talk with your doctor about which other treatments are better choices for you.
Autoimmune disease. Imfinzi can cause your immune system to attack healthy cells, so the drug could worsen existing autoimmune diseases. (Lupus and Crohn's disease are examples of autoimmune diseases.) Before you start Imfinzi treatment, tell your doctor about any autoimmune diseases you may have. They can determine whether Imfinzi is the best medication for your cancer.
Breathing problems. Receiving Imfinzi may cause damage to your lungs. If you have or have ever had any breathing problems, using this drug may worsen the condition. Before you start Imfinzi treatment, tell your doctor if you have a history of any breathing problems. They can determine whether Imfinzi or a different drug is the right option for you.
Previous radiation treatment. Non-small cell lung cancer is sometimes treated with radiation. Having radiation before receiving Imfinzi may increase your risk for serious inflammation of the lungs. If you've received radiation to the chest area, tell your doctor before you have Imfinzi treatment. They may want you to delay using the medication until the effects of the radiation have worn off.
Stem cell or organ transplant. Imfinzi can cause your immune system to attack healthy cells. This includes cells in organs such as your lungs, kidneys, liver, and heart. This could be especially dangerous if you've had a stem cell transplant or organ transplant. Before you start treatment with Imfinzi, be sure to tell your doctor if you've received a transplant.
Current infection. Some infections need time to clear up before it's safe to start Imfinzi treatment. If you have a current infection and are receiving treatment for it, tell your doctor before you receive Imfinzi. They can advise you on when to start your treatment.
Alcohol consumption with ImfinziThere are no known interactions between Imfinzi and alcohol. However, drinking alcohol could worsen certain side effects of Imfinzi, such as nausea or fatigue.
If you drink alcohol, be sure to talk with your doctor before using Imfinzi. They can determine how much is safe for you to consume during your treatment.
Pregnancy and breastfeeding while using ImfinziIt is not safe to receive Imfinzi while pregnant. Studies of pregnant animals given Imfinzi found that the drug could cause pregnancy loss or stillborn offspring. Animal studies don't always predict what will happen in people. However, it's recommended that Imfinzi is not used during pregnancy.
If you're pregnant or planning to become pregnant, talk with your doctor. They can recommend a treatment other than Imfinzi.
Keep in mind that if you're receiving Imfinzi and are able to become pregnant, you should use birth control during treatment. You should keep using it for 3 months or more after your last dose of the medication.
Also, there's no information on the safety of Imfinzi treatment while breastfeeding. It's recommended that you do not breastfeed during Imfinzi treatment and for at least 3 months after your final dose of the drug. You should talk with your doctor if you're thinking about breastfeeding. They can advise you on whether Imfinzi is right for you.
Side effects can occur while you're receiving Imfinzi treatment, but they're usually mild. Most mild side effects of the drug go away with time and don't require medical attention.
It's important to note that Imfinzi may be used with chemotherapy or biologics. Some side effects of chemotherapy or biologic drugs and Imfinzi overlap, but the medications can also cause different side effects. Your doctor or pharmacist can help explain similarities and differences in side effects you may expect from each drug.
You should call your doctor if you have any symptoms of an infusion reaction, immune system reaction, infection, or allergic reaction. These side effects could be serious and require medical attention.
If you'd like to learn more about Imfinzi, talk with your doctor or pharmacist. They can help answer any questions you have about the side effects of the drug.
For more information, read our articles on lung cancer. Biliary tract cancer, hepatocellular carcinoma, and endometrial cancer.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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