How is it diagnosed?

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How is it diagnosed? 2017-04-27T04:44:09+00:00

 

How is bronchiectasis diagnosed?

Bronchiectasis relies on both a clinical and radiological diagnosis.

 Comprehensive medical history taken by GP or respiratory physician including:

History of childhood infection or childhood respiratory symptoms

Family history of bronchiectasis, especially cystic fibrosis

Smoking history

Presence of symptoms to suggest a systemic inflammatory disorder (joint problems, skin rash, muscle pain)

Duration and severity of symptoms

Frequency of infective exacerbations

Clinical examination:

Peripheral examination for signs of chronic lung disease e.g nail changes (clubbing) occur in some forms of bronchiectasis

Cough quality, strength and sputum production

Signs to suggest a systemic inflammatory disorder (joints, skin, muscles, eyes)

Listening to the chest. Bronchiectasis is characterised by focal or generalised noises (crepitations, crackles, wheeze,) heard with the stethoscope

HRCT

A high resolution CT scan establishes the diagnosis of bronchiectasis

Findings – bronchial wall dilation (internal lumen diameter greater than the diameter of its adjacent pulmonary artery), failure of the bronchi to taper and visualisation of bronchi in the outer 1-2cm of the lung fields

Generally undertaken when patient is clinically stable

c-HRCT remains the diagnostic gold standard.

As children are at greater risk from radiation-induced cancers later in life, the c-HRCT protocol must ensure the lowest possible radiation exposure to obtain adequate assessment.

As the key radiographic criteria of broncho-arterial ratio in people without lung disease is age-dependent, child specific criteria are recommended (TSANZ Bronchiectasis Guidelines).