We are excited to start the month off with a new #RadiologyRounds

A young adult man in his 20s presents with dyspnea on exertion, productive cough, intermittent wheezing and general fatigue. A chest x-ray was obtained as part of his work-up.

You can identify hyperinflation, interstitial changes and bronchial wall thickening on this image with concern for associated bronchiectasis

You should have Sarcoidosis, Cystic Fibrosis (CF), Hypersensitivity Pneumonitis (HP) and Lymphangioleiomyomatosis (LAM) on the differential

A CT chest is obtained given his abnormal chest x-ray and representative images are shown below

Given upper lobe bronchiectasis you are concerned for cystic fibrosis. A sweat chloride test is obtained and was elevated suggesting CF and further genetic testing was sent to confirm the diagnosis.