19th January 2024

A 35-year-old female presents to respiratory clinic with a 3-month history of progressive shortness of breath on exertion and cough.

A 35-year-old female presents to respiratory clinic with a 3-month history of progressive shortness of breath on exertion and cough. She denies any fever, chest pain, haemoptysis, or weight loss. She recently saw her GP for chronic back pain and was diagnosed with a condition that she does not remember the name of. She drinks alcohol occasionally and smokes 3-5 cigarettes per day for the past 5 years. She denies any night sweats, haemoptysis, or weight loss. Examination of the chest revealed scattered bibasal crepitations. Blood test results taken a few months ago were as follows:

Hb 125 g/L (130-180)

MCV 93.5fL (80-96)

WCC 7.0 x 10⁹/L (4.0-11.0)

CRP 40 mg/L (<10)

Sodium 140 (133–146 mmol/L)

Potassium 3.8 (3.5–5.3 mmol/L)

Creatinine 80 (45–84 μmol/ L)

EGFR >90

LFTs normal

Rheumatoid factor 5 (0-20 u/mL)

Anti-CCP negative

A chest x-ray and some lung function tests were requested. What is the most likely finding on the chest x-ray?