Abnormal Streaked Hilar Shadow

CLINICAL DIAGNOSTIC MANUAL

An abnormal streaked hilar shadow on a chest X-ray refers to the presence of unusual lines or striations in the hilar region of the lung. This pattern can be caused by various conditions affecting the blood vessels, bronchi, and pulmonary interstitium. These conditions range from infections to heart failure and interstitial lung diseases. Accurate identification of the underlying cause is essential for proper patient management.

Pathology	Clinical Symptoms and Signs	Suspected Diagnosis	Confirmatory Diagnosis
Left ventricular failure	Dyspnoea, orthopnoea, fatigue, peripheral oedema, crackles on auscultation	History of heart disease, symptoms of congestion	Chest X-ray, chest CT, echocardiogram, arterial blood gas analysis
Bronchopneumonia	Fever, productive cough, dyspnoea, chest pain	History of respiratory infection, acute symptoms	Chest X-ray, chest CT, sputum culture, blood cultures
Pneumocystis carinii pneumonia	Progressive dyspnoea, dry cough, fever, fatigue	History of immunosuppression, respiratory symptoms	Chest X-ray, chest CT, bronchoalveolar lavage, specific antigen tests
Other causes	Vary depending on aetiology, may include dyspnoea, cough, fatigue, weight loss	Clinical history and relevant background	Chest X-ray, chest CT, lung biopsy, pulmonary function tests, serological tests