MANUAL OF CLINICAL DIAGNOSIS
Fine inspiratory crackles are abnormal lung sounds heard during auscultation when the patient inhales. These sounds, also known as crackles or rales, are high-pitched and often compared to the sound of crumpling cellophane or hair being rubbed near the ear. Fine crackles indicate the presence of fluid in the alveoli or the late opening of small airways and collapsed alveoli. This finding can be associated with various pulmonary pathologies and is crucial for the clinical evaluation and differential diagnosis of respiratory diseases.
Pathology | Clinical Symptoms and Signs | Suspected Diagnosis | Confirmatory Diagnosis |
Secondary to Normal Secretions | Cough, expectoration, crackles that disappear after coughing | Medical history, physical examination | Resolution after expectoration, no further testing required |
Pulmonary Oedema | Dyspnoea, orthopnoea, crackles at lung bases, wheezing, peripheral oedema | Medical history, physical examination, crackles at bases | Chest X-ray, echocardiogram, arterial blood gas analysis |
Pulmonary Oedema Secondary to Trauma | Chest pain, dyspnoea, history of trauma, crackles | History of trauma, physical examination | Chest X-ray, chest computed tomography (CT) |
Pulmonary Fibrosis | Progressive dyspnoea, dry cough, basal crackles, clubbing | Medical history, physical examination, basal crackles | Chest X-ray, high-resolution CT (HRCT), lung biopsy |
Interstitial Lung Disease | Dyspnoea, dry cough, crackles, fatigue | Medical history, physical examination, crackles | Chest X-ray, HRCT, lung biopsy |
Chronic Bronchitis | Productive cough, dyspnoea, wheezing, scattered crackles | Smoking history, physical examination | Spirometry, chest X-ray |
Emphysema | Dyspnoea, chronic cough, barrel chest, decreased breath sounds, occasional crackles | Smoking history, physical examination | Chest X-ray, chest CT, spirometry |
Consolidation Secondary to Infection | Fever, productive cough, chest pain, crackles | Medical history of respiratory infection, physical examination | Chest X-ray, chest CT, sputum culture |
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