Decreased Bilateral Chest Expansion

MANUAL OF CLINICAL DIAGNOSIS

Decreased bilateral chest expansion refers to a symmetrical reduction in the ability of the thorax to expand properly during breathing. This condition may indicate diseases affecting both the lungs and the respiratory muscles.

The causes can range from chronic lung conditions to neuromuscular diseases, and early identification is crucial for appropriate patient management and the prevention of respiratory complications.

Pathology	Clinical Symptoms and Signs	Suspected Diagnosis	Confirmatory Diagnosis
Obesity Causing Hypoventilation Syndrome	Decreased chest expansion, daytime sleepiness, dyspnoea, hypoventilation, snoring	History of obesity, respiratory symptoms	Arterial blood gas analysis, polysomnography
Emphysema	Decreased chest expansion, dyspnoea, chronic cough, wheezing, weight loss	Smoking history, physical examination	Chest X-ray, computed tomography (CT), spirometry
Pulmonary Fibrosis	Decreased chest expansion, progressive dyspnoea, dry cough, crackles	Clinical history, physical examination	Chest X-ray, high-resolution CT (HRCT), lung biopsy
Muscular Dystrophy	Decreased chest expansion, generalised muscle weakness, difficulty breathing	Family history, physical examination	Electromyography (EMG), genetic studies
Motor Neuron Disease	Decreased chest expansion, muscle weakness, fasciculations, dysarthria	Clinical history, neurological examination	EMG, magnetic resonance imaging (MRI), cerebrospinal fluid analysis
Multiple Sclerosis	Decreased chest expansion, weakness, spasticity, respiratory dysfunction	Clinical history, neurological examination	Brain and spinal MRI, lumbar puncture, evoked potentials
Guillain-Barré Syndrome	Decreased chest expansion, ascending muscle weakness, areflexia	History of previous infection, neurological examination	EMG, lumbar puncture, nerve conduction studies