Wheeze differential diagnosis: Difference between revisions

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__NOTOC__
{{Wheeze}}
{{Wheeze}}
{{CMG}}; {{JFS}}


==Differentiating Wheeze from other Diseases==
{{CMG}}; {{AE}} {{KZ}}, {{IQ}}, {{Anmol}}
===Overview==
The [[differential diagnosis]] of wheezing is wide, and the cause of wheezing in a given patient is determined by considering the characteristics of the wheezes and the historical and clinical findings made by the examining physician.


===Complete Differential Diagnosis of the Causes of Wheeze===
==Differential diagnosis of Wheezing==
'''(In alphabetical order)'''
'''For the differential diagnosis of wheeze and cough, click [[Cough and wheeze|here]].'''<br>
*Abnormal arytenoid movement
'''For the differential diagnosis of wheeze and fever, click [[Cough and fever|here]].'''<br>
*[[Allergic bronchopulmonary aspergillosis]] ABPA
'''For the differential diagnosis of wheeze and slurred speech, click [[Wheeze and slurred speech|here]].'''<br>
*[[Alpha 1-Antitrypsin Deficiency]]
*Amyloid deposition
*[[Anaphylaxis]]
*[[Angioedema]]
*[[Aspergillosis]] including [[aspergilloma]] and ABPA
*[[Aspiration]](foreign particles or foods)
*[[Asthma]] including status asthmaticus
*Benign airway [[tumors]] including:
**Bronchial adenomata syndrome
**Unknown ([[hamartoma]], [[clear cell]], [[teratoma]])
**Epithelial ([[papilloma]], [[polyps]])
**Mesodermal ([[fibroma]], [[lipoma]], [[leiomyoma]], [[chondroma]], granular cell tumor, sclerosing [[hemangioma]])
**Other (myofibroblastic tumor, xanthoma, [[amyloid]], mucosa-associated lymphoid tumor)
*[[Bronchiectasis]]
*[[Bronchiolitis]] (a common childhood disease)
*[[Bronchiolitis obliterans]]
*[[Bronchitis]] (usually viral, bacterial only in patients with tracheostomy or endotracheal intubation)
**[[influenza]] A and B
**[[parainfluenza]]
**[[coronavirus]] (types 1-3)
**[[rhinovirus]]
**[[respiratory syncytial virus]]
**human metapneumovirus
**Other:
***[[Mycoplasma pneumoniae]]
***[[Chlamydophila pneumoniae]]
***[[Pertussis]]
*[[Bronchopulmonary dysplasia]]
*[[Byssinosis]] - cotton duct
*[[Carcinoid syndrome]]
*Cardiac asthma (including cardiogenic pulmonary edema)
*[[Cardiomegaly]] (severe cardiomegaly)
*Chemical poisoning (more than 50 substances have been linked to wheezing)
*[[Chondromalacia]]
*[[Chronic obstructive pulmonary disease]]: Chronic bronchitis and Emphysema
*Cold induced [[wheezing]] (Paediatrics)
*[[Ciliary dyskinesia]]-bronchiectasis
*[[Congenital abnormalities]] affecting the bronchial tree
*Cricoarytenoid arthritis
*[[Cystic fibrosis]]
*Descending aortic [[aneurysm]]
*Dialyzer hypersensitivity syndrome 
*Esophageal foreign body
*Exercise-induced [[asthma]]
*Extrinsic allergic [[alveolitis]]
*Food allergies: numerous including: 
**[[Peanut]] Allergy
*[[Gastroesophageal Reflux Disease]] (with aspiration)
*[[Graft-versus-host disease]]
*[[Hay fever]]
*[[Heart failure]] (see cardiogenic pulmonary edema and cardiac asthma)
*[[Hemorrhage]], pulmonary
*Hypertrophied [[tonsils]]
*[[Immunodeficiency]]
*[[Infection]] ([[pneumonia]])
*[[Interstitial lung disease]]
*Intrathoracic [[goiter]]
*[[Klebsiella]] rhinoscleroma
*[[Laryngeal edema]]
*[[Laryngocele]]
*Laryngostenosis
*[[Laryngotracheobronchitis]]
*[[Lymphadenopathy]] with large lymphnodes compressing the tracheal tree.
*Lymphangitic carcinomatosis
*[[Malignancy]] (bronchogenic)
**[[Squamous cell carcinoma]] with variants: papillary, clear cell, small cell, basaloid
**[[Small cell carcinoma]]
**[[Adenocarcinoma]]
***Acinar
***Papillary
***Bronchioloalveolar carcinoma
****Non-mucinous (Clara cell/type II pneumocyte type)
****Mucinous (Goblet cell type) 
****Mixed mucinous and non-mucinous (Clara cell/type II pneumocyte/goblet cell type) or indeterminate 
***Solid adenocarcinoma with mucin formation
***Mixed
***Variants: well-differentiated fetal adenocarcinoma, mucinous ("colloid"), mucinous cystadenocarcinoma, signet ring, clear cell
**Large cell carcinoma with variants: large cell neuroendocrine carcinoma, combined large cell neuroendocrine carcinoma, basaloid carcinoma, lymphoepithelioma-like carcinoma, clear cell carcinoma, large cell carcinoma with rhaboid phenotype
**Adenosquamous carcinoma
**Carcinomas with pleomorphic, sarcomatoid, or sarcomatous elements
***Carcinomas with spindle and/or giant cells
***Pleomorphic carcinoma
***Spindle cell carcinoma
***Giant cell carcinoma
***Carcinosarcoma
***Blastoma (Pulmonary blastoma)
**Carcinoid tumor
***Typical carcinoid
***Atypical carcinoid
**Carcinomas of salivary gland type
***Mucoepidermoid carcinoma
***Adenoid cystic carcinoma
**Unclassified carcinoma
**[[Mastocytosis]]
**[[Mendelson's syndrome]] (aspiration pneumonitis)
*Medication-induced bronchoconstriction
**[[ACE inhibitors]] ( cough or rarely Angioneurotic edema and wheeze)
**[[Sotalol]]
**[[Adenosine]]
**[[Beta blockers]]: Common; usually occurs in patients with asthma or COPD; 1-selective agents, [[labetalol]], [[esmolol]], and [[pindolol]] are better tolerated than nonselective agents.
**[[Dipyridamole]] (IV form only)
**[[Protamine]]
**[[NSAIDs]] includign aspirin
**[[Marijuana]] (chronic use)
*[[Milk allergy]]
*Mobile supraglottic soft tissue
*[[Obesity]]
*[[Parasitic infections]]
**[[Ascariasis]]
**[[Hookworm]]
**Paragonimiases - lung infection
**[[Strongyloidiasis]]
**[[Toxocariasis]]
*Paroxysmal vocal cord motion
*Postextubation [[granuloma]]
*Postlobectomy bronchial torsion
*Postnasal drip syndrome
*Postradiation [[stenosis]]
*[[Primary ciliary dyskinesia]]
*[[Psychogenic]] wheezing
*[[Pulmonary edema]] (cardiogenic or non-cardiogenic)
*[[Pulmonary embolism]]
*[[Pulmonary eosinophilia]]
*[[Relapsing polychondritis]]
*Retained [[foreign body]] (trachea or esophagus)
*[[Retropharyngeal abscess]]
*Right sided [[aortic arch]]
*[[Sinusitis]] ( chronic sinusitis )
*Supraglottitis
*[[Tracheal stenosis]]
*[[Tracheobronchitis]]
*[[Tracheobronchomegaly]]
*Tracheobronchopathia osteoplastica : a rare, benign condition and is characterized by the presence of bony and cartilaginous nodules in the tracheal and bronchial mucosa.
*[[Tracheomalacia]]
*[[Tuberculosis]], Pulmonary 
*Vascular compression and rings ( Aberrant subclavian artery abnormality )
*Vocal cord dysfunction
*Vocal cord hematoma
*Vocal cord paralysis (bilateral paralysis)
*[[Wegener's granulomatosis]]


===Complete Differential Diagnosis of the Causes of Wheeze===
<small><small>
'''(By organ system)'''
{| class="wikitable"
{|style="width:75%; height:100px" border="1"
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="3" + |Etiology on the basis of anatomy
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="3" + |Diseases
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | Cardiac asthma ( pulmonary edema), [[Cardiomegaly]], Descending aortic [[aneurysm]], [[Pulmonary edema]]
! align="center" style="background:#4479BA; color: #FFFFFF;" colspan="7" + |Clinical manifestations
[[Pulmonary embolism]], Right sided aortic arch, Vascular compression/ rings, [[Heart failure]]
! align="center" style="background:#4479BA; color: #FFFFFF;" colspan="5" + |Diagnosis
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="3" + |Other features
|-
|-
|-bgcolor="LightSteelBlue"
! align="center" style="background:#4479BA; color: #FFFFFF;" colspan="5" + |Symptoms
| '''Chemical / poisoning'''
! align="center" style="background:#4479BA; color: #FFFFFF;" colspan="2" + |Physical exam
|bgcolor="Beige"| Dialyzer hypersensitivity syndrome, [[Food allergies]], [[Peanut Allergy]], Chemical poisoning
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="2" + |Labs
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="2" + |Pulmonary function testing
! align="center" style="background:#4479BA; color: #FFFFFF;" colspan="3" + |Imaging
|-
|-
|-bgcolor="LightSteelBlue"
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Onset
| '''Dermatologic'''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cough
|bgcolor="Beige"| No underlying causes
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Slurred speech
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cyanosis
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Auscultation
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Chest imaging
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Other
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard
|-
|-
|-bgcolor="LightSteelBlue"
| align="center" style="background:#DCDCDC;" rowspan="6" + |'''Extrathoracic upper airway diseases'''
| '''Drug Side Effect'''
| align="center" style="background:#DCDCDC;" + |'''Laryngeal edema'''
|bgcolor="Beige"| Medication-induced bronchoconstriction, [[ACE inhibitors]], [[Sotalol]]
 
,[[Adenosine]], [[Beta blockers]], [[Dipyridamole]], [[Protamine]], [[NSAIDs]], [[Aspirin]], [[Marijuana]]  
'''(Anaphylaxis)'''<ref name="pmid16461139">{{cite journal |vauthors=Sampson HA, Muñoz-Furlong A, Campbell RL, Adkinson NF, Bock SA, Branum A, Brown SG, Camargo CA, Cydulka R, Galli SJ, Gidudu J, Gruchalla RS, Harlor AD, Hepner DL, Lewis LM, Lieberman PL, Metcalfe DD, O'Connor R, Muraro A, Rudman A, Schmitt C, Scherrer D, Simons FE, Thomas S, Wood JP, Decker WW |title=Second symposium on the definition and management of anaphylaxis: summary report--Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium |journal=J. Allergy Clin. Immunol. |volume=117 |issue=2 |pages=391–7 |date=February 2006 |pmid=16461139 |doi=10.1016/j.jaci.2005.12.1303 |url=}}</ref><ref name="pmid15753908">{{cite journal |vauthors=Sampson HA, Muñoz-Furlong A, Bock SA, Schmitt C, Bass R, Chowdhury BA, Decker WW, Furlong TJ, Galli SJ, Golden DB, Gruchalla RS, Harlor AD, Hepner DL, Howarth M, Kaplan AP, Levy JH, Lewis LM, Lieberman PL, Metcalfe DD, Murphy R, Pollart SM, Pumphrey RS, Rosenwasser LJ, Simons FE, Wood JP, Camargo CA |title=Symposium on the definition and management of anaphylaxis: summary report |journal=J. Allergy Clin. Immunol. |volume=115 |issue=3 |pages=584–91 |date=March 2005 |pmid=15753908 |doi=10.1016/j.jaci.2005.01.009 |url=}}</ref><ref name="pmid12209078">{{cite journal |vauthors=Kemp SF, Lockey RF |title=Anaphylaxis: a review of causes and mechanisms |journal=J. Allergy Clin. Immunol. |volume=110 |issue=3 |pages=341–8 |date=September 2002 |pmid=12209078 |doi= |url=}}</ref><ref name="pmid20205694">{{cite journal |vauthors=Ewan PW, Dugué P, Mirakian R, Dixon TA, Harper JN, Nasser SM |title=BSACI guidelines for the investigation of suspected anaphylaxis during general anaesthesia |journal=Clin. Exp. Allergy |volume=40 |issue=1 |pages=15–31 |date=January 2010 |pmid=20205694 |doi=10.1111/j.1365-2222.2009.03404.x |url=}}</ref><ref name="pmid20176258">{{cite journal |vauthors=Simons FE |title=Anaphylaxis |journal=J. Allergy Clin. Immunol. |volume=125 |issue=2 Suppl 2 |pages=S161–81 |date=February 2010 |pmid=20176258 |doi=10.1016/j.jaci.2009.12.981 |url=}}</ref>
| align="center" style="background:#F5F5F5;" + |Acute
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | –
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| style="background:#F5F5F5;" + |
* [[Hoarseness]]
* [[Stridor]]
| style="background:#F5F5F5;" + |
* High levels of [[serum]] [[tryptase]]
* Increased levels of [[plasma]] [[histamine]]
* [[Skin allergy test]]
| style="background:#F5F5F5;" + |
* Not specific
| style="background:#F5F5F5;" + |
* Not required
| style="background:#F5F5F5;" + |
* Not required
| style="background:#F5F5F5;" + |
Acute onset with one of them:
* [[Respiratory]] compromise
* Reduced [[blood pressure]] ([[Blood pressure|BP]])
Two or more after the exposure to a likely [[allergen]]
* [[Respiratory]] compromise
* Reduced [[Blood pressure|BP]]
* [[Gastrointestinal tract|Gastrointestinal]] <nowiki/>symptoms
* [[Skin and soft-tissue infections|Skin–mucosa]]<nowiki/>l involvement
 
[[Blood pressure|BP]] reduced after exposure of a known [[allergen]]
* Adult [[Blood pressure|BP]] [[Systole (medicine)|systolic]] <90 mmHg
* Children: Low [[Systolic blood pressure|systolic BP]] 
| style="background:#F5F5F5;" + |
* [[Nasal discharge]], [[altered mental status]], redness and [[hives]] of the [[skin]]
* Common [[Allergen|allergens]]: Food, insect sting, biologic materials, natural rubber latex, etc
|-
| align="center" style="background:#DCDCDC;" + |'''Cricoarytenoid arthritis'''<ref name="pmid8519073">{{cite journal |vauthors=Kelly CA |title=Rheumatoid arthritis: other rheumatoid lung problems |journal=Baillieres Clin Rheumatol |volume=7 |issue=1 |pages=17–29 |date=February 1993 |pmid=8519073 |doi= |url=}}</ref><ref name="pmid3820205">{{cite journal |vauthors=Geterud A, Ejnell H, Månsson I, Sandberg N, Bake B, Bjelle A |title=Severe airway obstruction caused by laryngeal rheumatoid arthritis |journal=J. Rheumatol. |volume=13 |issue=5 |pages=948–51 |date=October 1986 |pmid=3820205 |doi= |url=}}</ref>
| align="center" style="background:#F5F5F5;" + |Acute
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |–
| style="background:#F5F5F5;" + |
* [[Hoarseness]]
* [[Stridor]]
| style="background:#F5F5F5;" + |
* Test for [[rheumatoid arthritis]]
| style="background:#F5F5F5;" + |
* [[Lung volumes|Forced inspiratory flow]]<nowiki/>decreased
* [[Lung volumes|Forced expiratory flow]]<nowiki/>decreased
| style="background:#F5F5F5;" + |
* Clear chest
| style="background:#F5F5F5;" + |
* Hyperdense intra–articular sclerotic [[Cricoid cartilage|cricoid]] and [[arytenoid cartilage]]<nowiki/>s in [[Computed tomography|CT]]<ref name="pmid22884484">{{cite journal |vauthors=Greco A, Fusconi M, Macri GF, Marinelli C, Polettini E, Benincasa AT, de Vincentiis M |title=Cricoarytenoid joint involvement in rheumatoid arthritis: radiologic evaluation |journal=Am J Otolaryngol |volume=33 |issue=6 |pages=753–5 |date= 2012 |pmid=22884484 |doi=10.1016/j.amjoto.2012.06.004 |url= |author=}}</ref>
| style="background:#F5F5F5;" + |
* [[Laryngoscopy|Direct laryngoscopy]]
| style="background:#F5F5F5;" + |
* [[Cartilage]] <nowiki/>erosion can lead on joint luxation and immobilization of the [[cord]]<ref name="pmid22884484" />
|-
| align="center" style="background:#DCDCDC;" + |'''Vocal fold edema/hematoma/paralysis'''<ref name="pmid17011423">{{cite journal |vauthors=Ishman SL, Halum SL, Patel NJ, Kerschner JE, Merati AL |title=Management of vocal paralysis: a comparison of adult and pediatric practices |journal=Otolaryngol Head Neck Surg |volume=135 |issue=4 |pages=590–4 |date=October 2006 |pmid=17011423 |doi=10.1016/j.otohns.2006.04.014 |url= |author=}}</ref>
| align="center" style="background:#F5F5F5;" + |Acute
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |–
| style="background:#F5F5F5;" + |
* [[Hoarseness]]
* Short breathing
| style="background:#F5F5F5;" + |
* Not specific
| style="background:#F5F5F5;" + |
* Variable
| style="background:#F5F5F5;" + |
* Clear chest
| style="background:#F5F5F5;" + |
* Not required
| style="background:#F5F5F5;" + |
* [[Laryngoscopy]]
| style="background:#F5F5F5;" + |
* Associated with [[Archives of Otolaryngology - Head & Neck Surgery|neck surgery]]
|-
| align="center" style="background:#DCDCDC;" + |'''Paradoxical vocal fold motion'''<ref name="pmid21051397">{{cite journal |vauthors=Morris MJ, Christopher KL |title=Diagnostic criteria for the classification of vocal cord dysfunction |journal=Chest |volume=138 |issue=5 |pages=1213–23 |date=November 2010 |pmid=21051397 |doi=10.1378/chest.09-2944 |url=}}</ref><ref name="pmid24125138">{{cite journal |vauthors=Tilles SA, Ayars AG, Picciano JF, Altman K |title=Exercise-induced vocal cord dysfunction and exercise-induced laryngomalacia in children and adolescents: the same clinical syndrome? |journal=Ann. Allergy Asthma Immunol. |volume=111 |issue=5 |pages=342–346.e1 |date=November 2013 |pmid=24125138 |doi=10.1016/j.anai.2013.07.025 |url=}}</ref>
| align="center" style="background:#F5F5F5;" + |Acute
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | –
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |–
| style="background:#F5F5F5;" + |
* Inspiratory [[stridor]]
| style="background:#F5F5F5;" + |
* [[Hypercapnia]] in [[arterial blood gases]] <nowiki/>when [[distress]] is severe
| style="background:#F5F5F5;" + |
* [[Lung function tests|Forced inspiratory flow]] <nowiki/>decrease but normal between episodes<ref name="pmid22434681">{{cite journal |vauthors=Forrest LA, Husein T, Husein O |title=Paradoxical vocal cord motion: classification and treatment |journal=Laryngoscope |volume=122 |issue=4 |pages=844–53 |date=April 2012 |pmid=22434681 |doi=10.1002/lary.23176 |url= |author=}}</ref>
| style="background:#F5F5F5;" + |
* Clear chest
| style="background:#F5F5F5;" + |
* [[Computed tomography|CT]] and color flow doppler <nowiki/>to rule out other diseases<ref name="pmid9207723">{{cite journal |vauthors=Nastasi KJ, Howard DA, Raby RB, Lew DB, Blaiss MS |title=Airway fluoroscopic diagnosis of vocal cord dysfunction syndrome |journal=Ann. Allergy Asthma Immunol. |volume=78 |issue=6 |pages=586–8 |date=June 1997 |pmid=9207723 |doi=10.1016/S1081-1206(10)63220-6 |url= |author=}}</ref>
| style="background:#F5F5F5;" + |
* Abnormal [[adduction]] of [[vocal fold]] visualized in [[laryngoscopy]]
| style="background:#F5F5F5;" + |
* [[Throat]] tightness, choking sensation
* Associated with [[exercise]], [[asthma]], post–extubation, etc.<ref name="pmid23097011">{{cite journal |vauthors=Chiang T, Marcinow AM, deSilva BW, Ence BN, Lindsey SE, Forrest LA |title=Exercise-induced paradoxical vocal fold motion disorder: diagnosis and management |journal=Laryngoscope |volume=123 |issue=3 |pages=727–31 |date=March 2013 |pmid=23097011 |doi=10.1002/lary.23654 |url= |author=}}</ref>
|-
| align="center" style="background:#DCDCDC;" + |'''Laryngeal stenosis'''<ref name="pmid27508129">{{cite journal |vauthors=Nair S, Nilakantan A, Sood A, Gupta A, Gupta A |title=Challenges in the Management of Laryngeal Stenosis |journal=Indian J Otolaryngol Head Neck Surg |volume=68 |issue=3 |pages=294–9 |date=September 2016 |pmid=27508129 |pmc=4961642 |doi=10.1007/s12070-015-0936-2 |url= |author=}}</ref>
| align="center" style="background:#F5F5F5;" + |Acute, Chronic
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| style="background:#F5F5F5;" + |
* [[Glottic]] or [[Glottis|supraglottic]]: Inspiratory [[stridor]]
* [[Glottis]] <nowiki/>through [[trachea]]: biphasic [[stridor]]
| style="background:#F5F5F5;" + |
* Not specific
| style="background:#F5F5F5;" + |
* [[Vital capacity|FV]] loop variable
| style="background:#F5F5F5;" + |
* Clear chest
| style="background:#F5F5F5;" + |
* Stenosis visualized in [[neck]] [[x-ray|x–ray]]
| style="background:#F5F5F5;" + |
* Palpation of [[Arytenoid cartilage|arytenoid]] <nowiki/>for passive mobility and [[Laryngoscope|laryngoscopy]]<ref name="pmid7208045">{{cite journal |vauthors=Bogdasarian RS, Olson NR |title=Posterior glottic laryngeal stenosis |journal=Otolaryngol. Head Neck Surg. |volume=88 |issue=6 |pages=765–72 |date= 1980 |pmid=7208045 |doi= |url= |author=}}</ref>
| style="background:#F5F5F5;" + |
* History of neck trauma or [[intubation]]
|-
| align="center" style="background:#DCDCDC;" + |'''Laryngocele'''<ref name="pmid1053096">{{cite journal |vauthors=Crelin ES |title=Development of the upper respiratory system |journal=Clin Symp |volume=28 |issue=3 |pages=1–30 |date=1976 |pmid=1053096 |doi= |url=}}</ref><ref name="pmid11374255">{{cite journal |vauthors=Pennings RJ, van den Hoogen FJ, Marres HA |title=Giant laryngoceles: a cause of upper airway obstruction |journal=Eur Arch Otorhinolaryngol |volume=258 |issue=3 |pages=137–40 |date=March 2001 |pmid=11374255 |doi= |url=}}</ref><ref name="pmid8614888">{{cite journal |vauthors=Sniezek JC, Johnson RE, Ramirez SG, Hayes DK |title=Laryngoceles and saccular cysts |journal=South. Med. J. |volume=89 |issue=4 |pages=427–30 |date=April 1996 |pmid=8614888 |doi= |url=}}</ref><ref name="pmid8166980">{{cite journal |vauthors=Chu L, Gussack GS, Orr JB, Hood D |title=Neonatal laryngoceles. A cause for airway obstruction |journal=Arch. Otolaryngol. Head Neck Surg. |volume=120 |issue=4 |pages=454–8 |date=April 1994 |pmid=8166980 |doi= |url=}}</ref><ref name="pmid1554451">{{cite journal |vauthors=Civantos FJ, Holinger LD |title=Laryngoceles and saccular cysts in infants and children |journal=Arch. Otolaryngol. Head Neck Surg. |volume=118 |issue=3 |pages=296–300 |date=March 1992 |pmid=1554451 |doi= |url=}}</ref>
| align="center" style="background:#F5F5F5;" + |Chronic
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | –
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + |–
| style="background:#F5F5F5;" + |
* Inspiratory [[stridor]]
* [[Hoarseness]]
| style="background:#F5F5F5;" + |
* Not specific
| style="background:#F5F5F5;" + |
* Normal function
| style="background:#F5F5F5;" + |
* Clear chest
| style="background:#F5F5F5;" + |
* [[Cyst]] with liquid or air content on [[ultrasound]], [[radiography]] or [[Computed tomography|CT]]
| style="background:#F5F5F5;" + |
* Smooth swelling visualized in [[laryngoscopy]]<ref name="pmid8166980">{{cite journal |vauthors=Chu L, Gussack GS, Orr JB, Hood D |title=Neonatal laryngoceles. A cause for airway obstruction |journal=Arch. Otolaryngol. Head Neck Surg. |volume=120 |issue=4 |pages=454–8 |date=April 1994 |pmid=8166980 |doi= |url= |author=}}</ref>
| style="background:#F5F5F5;" + |
* [[Dysphagia]], laryngeal discomfort
* Usually [[asymptomatic]]
|-
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="3" + |Etiology on the basis of anatomy
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="3" + |Diseases
! align="center" style="background:#4479BA; color: #FFFFFF;" colspan="7" + |Clinical manifestations
! align="center" style="background:#4479BA; color: #FFFFFF;" colspan="5" + |Diagnosis
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="3" + |Other features
|-
! align="center" style="background:#4479BA; color: #FFFFFF;" colspan="5" + |Symptoms
! align="center" style="background:#4479BA; color: #FFFFFF;" colspan="2" + |Physical exam
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="2" + |Labs
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="2" + |Pulmonary function testing
! align="center" style="background:#4479BA; color: #FFFFFF;" colspan="3" + |Imaging
|-
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Onset
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cough
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Slurred speech
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cyanosis
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Auscultation
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Chest imaging
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Other
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard
|-
| align="center" style="background:#DCDCDC;" rowspan="7" + |'''Extrathoracic upper airway diseases'''
| align="center" style="background:#DCDCDC;" + |'''Epiglottitis (supraglottitis)'''<ref name="pmid18510881">{{cite journal |vauthors=Glynn F, Fenton JE |title=Diagnosis and management of supraglottitis (epiglottitis) |journal=Curr Infect Dis Rep |volume=10 |issue=3 |pages=200–4 |date=May 2008 |pmid=18510881 |doi= |url=}}</ref><ref name="pmid7497775">{{cite journal |vauthors=Mayo-Smith MF, Spinale JW, Donskey CJ, Yukawa M, Li RH, Schiffman FJ |title=Acute epiglottitis. An 18-year experience in Rhode Island |journal=Chest |volume=108 |issue=6 |pages=1640–7 |date=December 1995 |pmid=7497775 |doi= |url=}}</ref><ref name="pmid7933397">{{cite journal |vauthors=Frantz TD, Rasgon BM, Quesenberry CP |title=Acute epiglottitis in adults. Analysis of 129 cases |journal=JAMA |volume=272 |issue=17 |pages=1358–60 |date=November 1994 |pmid=7933397 |doi= |url=}}</ref><ref name="pmid17892608">{{cite journal |vauthors=Guldfred LA, Lyhne D, Becker BC |title=Acute epiglottitis: epidemiology, clinical presentation, management and outcome |journal=J Laryngol Otol |volume=122 |issue=8 |pages=818–23 |date=August 2008 |pmid=17892608 |doi=10.1017/S0022215107000473 |url=}}</ref><ref name="pmid9432069">{{cite journal |vauthors=Hébert PC, Ducic Y, Boisvert D, Lamothe A |title=Adult epiglottitis in a Canadian setting |journal=Laryngoscope |volume=108 |issue=1 Pt 1 |pages=64–9 |date=January 1998 |pmid=9432069 |doi= |url=}}</ref>
| align="center" style="background:#F5F5F5;" + |Acute
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | –
| style="background:#F5F5F5;" + |
* [[Hoarseness]]
* [[Stridor]]
| style="background:#F5F5F5;" + |
* [[Leukocytosis]]
* Epiglottal [[Culture collection|culture]]
| style="background:#F5F5F5;" + |
* Normal function
| style="background:#F5F5F5;" + |
* Clear chest
| style="background:#F5F5F5;" + |
* More than 8 mm of size epiglottal and distend [[hypopharynx]]  in neck [[x-ray|x–ray]]
| style="background:#F5F5F5;" + |
* An edematous [[epiglottis]] is visualized on [[laryngoscopy]]<ref name="pmid18510881">{{cite journal |vauthors=Glynn F, Fenton JE |title=Diagnosis and management of supraglottitis (epiglottitis) |journal=Curr Infect Dis Rep |volume=10 |issue=3 |pages=200–4 |date=May 2008 |pmid=18510881 |doi= |url= |author=}}</ref>
| style="background:#F5F5F5;" + |
* Tripod posture
* [[Drooling]]
* Tenderness of the anterior part of the neck
|-
| align="center" style="background:#DCDCDC;" + |'''Goiter'''<ref name="pmid3885887">{{cite journal |vauthors=Katlic MR, Wang CA, Grillo HC |title=Substernal goiter |journal=Ann. Thorac. Surg. |volume=39 |issue=4 |pages=391–9 |date=April 1985 |pmid=3885887 |doi= |url=}}</ref><ref name="pmid6648812">{{cite journal |vauthors=Allo MD, Thompson NW |title=Rationale for the operative management of substernal goiters |journal=Surgery |volume=94 |issue=6 |pages=969–77 |date=December 1983 |pmid=6648812 |doi= |url=}}</ref><ref name="pmid3970328">{{cite journal |vauthors=Katlic MR, Grillo HC, Wang CA |title=Substernal goiter. Analysis of 80 patients from Massachusetts General Hospital |journal=Am. J. Surg. |volume=149 |issue=2 |pages=283–7 |date=February 1985 |pmid=3970328 |doi= |url=}}</ref><ref name="pmid2802045">{{cite journal |vauthors=Shaha AR, Burnett C, Alfonso A, Jaffe BM |title=Goiters and airway problems |journal=Am. J. Surg. |volume=158 |issue=4 |pages=378–80; discussion 380–1 |date=October 1989 |pmid=2802045 |doi= |url=}}</ref><ref name="pmid7661484">{{cite journal |vauthors=Torre G, Borgonovo G, Amato A, Arezzo A, Ansaldo G, De Negri A, Ughè M, Mattioli F |title=Surgical management of substernal goiter: analysis of 237 patients |journal=Am Surg |volume=61 |issue=9 |pages=826–31 |date=September 1995 |pmid=7661484 |doi= |url=}}</ref><ref name="pmid6831895">{{cite journal |vauthors=Torres A, Arroyo J, Kastanos N, Estopá R, Rabaseda J, Agustí-Vidal A |title=Acute respiratory failure and tracheal obstruction in patients with intrathoracic goiter |journal=Crit. Care Med. |volume=11 |issue=4 |pages=265–6 |date=April 1983 |pmid=6831895 |doi= |url=}}</ref><ref name="pmid4777540">{{cite journal |vauthors=Shambaugh GE, Seed R, Korn A |title=Airway obstruction in substernal goiter. Clinical and therapeutic implications |journal=J Chronic Dis |volume=26 |issue=11 |pages=737–43 |date=November 1973 |pmid=4777540 |doi= |url=}}</ref><ref name="pmid22147633">{{cite journal |vauthors=Banks CA, Ayers CM, Hornig JD, Lentsch EJ, Day TA, Nguyen SA, Gillespie MB |title=Thyroid disease and compressive symptoms |journal=Laryngoscope |volume=122 |issue=1 |pages=13–6 |date=January 2012 |pmid=22147633 |doi=10.1002/lary.22366 |url=}}</ref>
| align="center" style="background:#F5F5F5;" + |Chronic
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | –
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + |–
| style="background:#F5F5F5;" + |
* [[Stridor]]
| style="background:#F5F5F5;" + |
* [[Thyroid function tests]]: [[TSH]], [[Triiodothyronine|T3]], and [[Thyroxine|T4]]
* [[Thyroid peroxidase|Thyroid peroxide antibodies]] :[[Thyroid peroxidase|TPO]]
| style="background:#F5F5F5;" + |
* Airflow limitation of the volume loop depending on the size and localization<ref name="pmid1130755">{{cite journal |vauthors=Al-Bazzaz F, Grillo H, Kazemi H |title=Response to exercise in upper airway obstruction |journal=Am. Rev. Respir. Dis. |volume=111 |issue=5 |pages=631–40 |date=May 1975 |pmid=1130755 |doi=10.1164/arrd.1975.111.5.631 |url= |author=}}</ref>
| style="background:#F5F5F5;" + |
* Substernal [[goiter]] causes a deviation of the [[trachea]]
| style="background:#F5F5F5;" + |
* [[Computed tomography|CT]] can be performed to visualize the [[cervical]] and substernal [[goiter]] and its extention<ref name="pmid6600532">{{cite journal |vauthors=Bashist B, Ellis K, Gold RP |title=Computed tomography of intrathoracic goiters |journal=AJR Am J Roentgenol |volume=140 |issue=3 |pages=455–60 |date=March 1983 |pmid=6600532 |doi=10.2214/ajr.140.3.455 |url= |author=}}</ref> 
| style="background:#F5F5F5;" + |
* [[Physical examination]]
| style="background:#F5F5F5;" + |
* [[Iodine deficiency]] is the most common cause<ref name="pmid10700715">{{cite journal |vauthors=Knudsen N, Perrild H, Christiansen E, Rasmussen S, Dige-Petersen H, Jørgensen T |title=Thyroid structure and size and two-year follow-up of solitary cold thyroid nodules in an unselected population with borderline iodine deficiency |journal=Eur. J. Endocrinol. |volume=142 |issue=3 |pages=224–30 |date=March 2000 |pmid=10700715 |doi= |url= |author=}}</ref>
|-
| align="center" style="background:#DCDCDC;" + |'''Postnasal drip syndrome'''<ref name="pmid6861547">{{cite journal |vauthors=Pratter MR, Hingston DM, Irwin RS |title=Diagnosis of bronchial asthma by clinical evaluation. An unreliable method |journal=Chest |volume=84 |issue=1 |pages=42–7 |date=July 1983 |pmid=6861547 |doi= |url=}}</ref><ref name="pmid3057962">{{cite journal |vauthors=Curley FJ, Irwin RS, Pratter MR, Stivers DH, Doern GV, Vernaglia PA, Larkin AB, Baker SP |title=Cough and the common cold |journal=Am. Rev. Respir. Dis. |volume=138 |issue=2 |pages=305–11 |date=August 1988 |pmid=3057962 |doi=10.1164/ajrccm/138.2.305 |url=}}</ref><ref name="pmid6697790">{{cite journal |vauthors=Irwin RS, Pratter MR, Holland PS, Corwin RW, Hughes JP |title=Postnasal drip causes cough and is associated with reversible upper airway obstruction |journal=Chest |volume=85 |issue=3 |pages=346–52 |date=March 1984 |pmid=6697790 |doi= |url=}}</ref>
| align="center" style="background:#F5F5F5;" + |Acute
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | –
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + |–
| style="background:#F5F5F5;" + |
* [[Stridor]]
| style="background:#F5F5F5;" + |
* Elevated [[eosinophils]]
 
* Increase of [[IgE]]
 
* Positive intradermic test<ref name="pmid25910556">{{cite journal |vauthors=Yu L, Xu X, Lv H, Qiu Z |title=Advances in upper airway cough syndrome |journal=Kaohsiung J. Med. Sci. |volume=31 |issue=5 |pages=223–8 |date=May 2015 |pmid=25910556 |doi=10.1016/j.kjms.2015.01.005 |url= |author=}}</ref>
| style="background:#F5F5F5;" + |
* Normal response to [[bronchoprovocation]]
* Variable FV loop 
| style="background:#F5F5F5;" + |
* Clear chest
| style="background:#F5F5F5;" + |
* Sinus [[Computed tomography|CT]] may be helpful
| style="background:#F5F5F5;" + |
* Clinical diagnosis
| style="background:#F5F5F5;" + |
* [[Nasal congestion]]
* [[Rhinorrhea]]
|-
| align="center" style="background:#DCDCDC;" + |'''Relapsing polychondritis''' <ref name="pmid20692543">{{cite journal |vauthors=Rafeq S, Trentham D, Ernst A |title=Pulmonary manifestations of relapsing polychondritis |journal=Clin. Chest Med. |volume=31 |issue=3 |pages=513–8 |date=September 2010 |pmid=20692543 |doi=10.1016/j.ccm.2010.04.004 |url=}}</ref><ref name="pmid19017885">{{cite journal |vauthors=Ernst A, Rafeq S, Boiselle P, Sung A, Reddy C, Michaud G, Majid A, Herth FJF, Trentham D |title=Relapsing polychondritis and airway involvement |journal=Chest |volume=135 |issue=4 |pages=1024–1030 |date=April 2009 |pmid=19017885 |doi=10.1378/chest.08-1180 |url=}}</ref><ref name="pmid2012438">{{cite journal |vauthors=Eng J, Sabanathan S |title=Airway complications in relapsing polychondritis |journal=Ann. Thorac. Surg. |volume=51 |issue=4 |pages=686–92 |date=April 1991 |pmid=2012438 |doi= |url=}}</ref><ref name="pmid9653428">{{cite journal |vauthors=Tillie-Leblond I, Wallaert B, Leblond D, Salez F, Perez T, Remy-Jardin M, Vanhille P, Brouillard M, Marquette C, Tonnel AB |title=Respiratory involvement in relapsing polychondritis. Clinical, functional, endoscopic, and radiographic evaluations |journal=Medicine (Baltimore) |volume=77 |issue=3 |pages=168–76 |date=May 1998 |pmid=9653428 |doi= |url=}}</ref><ref name="pmid14994981">{{cite journal |vauthors=Riha RL, Douglas NJ |title=Obstructive sleep apnoea/hypopnoea as the initial presentation of relapsing polychondritis |journal=Int. J. Clin. Pract. |volume=58 |issue=1 |pages=97–9 |date=January 2004 |pmid=14994981 |doi= |url=}}</ref><ref name="pmid775252">{{cite journal |vauthors=McAdam LP, O'Hanlan MA, Bluestone R, Pearson CM |title=Relapsing polychondritis: prospective study of 23 patients and a review of the literature |journal=Medicine (Baltimore) |volume=55 |issue=3 |pages=193–215 |date=May 1976 |pmid=775252 |doi= |url=}}</ref><ref name="pmid449538">{{cite journal |vauthors=Damiani JM, Levine HL |title=Relapsing polychondritis--report of ten cases |journal=Laryngoscope |volume=89 |issue=6 Pt 1 |pages=929–46 |date=June 1979 |pmid=449538 |doi= |url=}}</ref>
| align="center" style="background:#F5F5F5;" + |Acute
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + |–
| style="background:#F5F5F5;" + |
* [[Hoarseness]]
* [[Aphonia]]
* Inspiratory [[stridor]]
| style="background:#F5F5F5;" + |
* [[Leukocytosis]] or [[thrombocytosis]]
* Positive [[antinuclear antibodies]] ( [[Antinuclear antibodies|ANA]]) and  [[Anti-neutrophil cytoplasmic antibody|ANCA]] 
| style="background:#F5F5F5;" + |
* Variable flow volume loop
| style="background:#F5F5F5;" + |
* Tracheal narrowing
 
* Cartilaginous calcification, bronchial wall thickness, and tracheal narrowing is observed on CT 
* MRI can distinguish [[fibrosis]] from inflammation 
| style="background:#F5F5F5;" + |
* Cartilaginous calicification, [[Bronchial|bronchial wall]] thickness, and tracheal narrowing observed in  [[Computed tomography|CT]] <ref name="pmid11756115">{{cite journal |vauthors=Behar JV, Choi YW, Hartman TA, Allen NB, McAdams HP |title=Relapsing polychondritis affecting the lower respiratory tract |journal=AJR Am J Roentgenol |volume=178 |issue=1 |pages=173–7 |date=January 2002 |pmid=11756115 |doi=10.2214/ajr.178.1.1780173 |url= |author=}}</ref>
* [[Magnetic resonance imaging|MRI]] can distinguish [[fibrosis]] from inflammation 
| style="background:#F5F5F5;" + |
Mc Adam criteria:<ref name="pmid775252">{{cite journal |vauthors=McAdam LP, O'Hanlan MA, Bluestone R, Pearson CM |title=Relapsing polychondritis: prospective study of 23 patients and a review of the literature |journal=Medicine (Baltimore) |volume=55 |issue=3 |pages=193–215 |date=May 1976 |pmid=775252 |doi= |url= |author=}}</ref>
*  [[Ear]] bilateral [[chondritis]] 
*  Seronegative inflammatory [[polyarthritis]]
*  [[Respiratory tract]] chondritis
* Coclear or [[Vestibular system|vestibular]] dysfunction
* [[Ocular]] [[inflamation]]
| style="background:#F5F5F5;" + |
* Involvement of cartilage of ears, ribs, nose, and eyes
|-
| align="center" style="background:#DCDCDC;" + |'''Retropharyngeal abscess'''<ref name="pmid18312875">{{cite journal |vauthors=Page NC, Bauer EM, Lieu JE |title=Clinical features and treatment of retropharyngeal abscess in children |journal=Otolaryngol Head Neck Surg |volume=138 |issue=3 |pages=300–6 |date=March 2008 |pmid=18312875 |doi=10.1016/j.otohns.2007.11.033 |url=}}</ref><ref name="pmid12777558">{{cite journal |vauthors=Craig FW, Schunk JE |title=Retropharyngeal abscess in children: clinical presentation, utility of imaging, and current management |journal=Pediatrics |volume=111 |issue=6 Pt 1 |pages=1394–8 |date=June 2003 |pmid=12777558 |doi= |url=}}</ref><ref name="pmid12479720">{{cite journal |vauthors=Cmejrek RC, Coticchia JM, Arnold JE |title=Presentation, diagnosis, and management of deep-neck abscesses in infants |journal=Arch. Otolaryngol. Head Neck Surg. |volume=128 |issue=12 |pages=1361–4 |date=December 2002 |pmid=12479720 |doi= |url=}}</ref>
| align="center" style="background:#F5F5F5;" + |Subacute
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | –
| style="background:#F5F5F5;" + |
* [[Stridor]]
* [[Tachypnea]]
| style="background:#F5F5F5;" + |
* [[Leukocytosis]]
* [[Aerobic bacteria|Aerobic]] and [[Anaerobic bacteria|anaerobic]] [[Blood culture|blood cultures]] may be helpful<ref name="pmid28722903">{{cite journal |vauthors=Knorr TL, Sinha V |title= |journal= |volume= |issue= |pages= |date= |pmid=28722903 |doi= |url= |author=}}</ref>
| style="background:#F5F5F5;" + |
* Normal function
| style="background:#F5F5F5;" + |
* Lateral [[Chest X-ray|chest x–ray]] to determine the extension of the [[abscess]]
| style="background:#F5F5F5;" + |
* Increased vertebral space in lateral neck [[x-ray|x–ray]]
* Cervical [[lordosis]] and gas collection in [[retropharyngeal space]] in neck [[Computed tomography|CT]] with intravenous contrast
| style="background:#F5F5F5;" + |
* Neck [[Computed tomography|CT]] or presence of pus during the surgical procedure<ref name="pmid7991254">{{cite journal |vauthors=Lazor JB, Cunningham MJ, Eavey RD, Weber AL |title=Comparison of computed tomography and surgical findings in deep neck infections |journal=Otolaryngol Head Neck Surg |volume=111 |issue=6 |pages=746–50 |date=December 1994 |pmid=7991254 |doi=10.1177/019459989411100608 |url= |author=}}</ref>
| style="background:#F5F5F5;" + |
* [[Pain-Eze Paracetamol Infant Drops|Pain]] with neck extension
* [[Dysphagia]]
* Head in sniffing position
|-
| align="center" style="background:#DCDCDC;" + |'''Tonsillar hypertrophy'''<ref name="pmid20131382">{{cite journal |vauthors=Kaditis AG, Kalampouka E, Hatzinikolaou S, Lianou L, Papaefthimiou M, Gartagani-Panagiotopoulou P, Zintzaras E, Chrousos G |title=Associations of tonsillar hypertrophy and snoring with history of wheezing in childhood |journal=Pediatr. Pulmonol. |volume=45 |issue=3 |pages=275–80 |date=March 2010 |pmid=20131382 |doi=10.1002/ppul.21174 |url=}}</ref>
| align="center" style="background:#F5F5F5;" + |Acute, chronic
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + | + hyponasal speech
| align="center" style="background:#F5F5F5;" + |–
| style="background:#F5F5F5;" + |
* [[Stridor]]
| style="background:#F5F5F5;" + |
* Not specific
| style="background:#F5F5F5;" + |
* Flow loop shows inspiratory slowing
| style="background:#F5F5F5;" + |
* Clear chest
| style="background:#F5F5F5;" + |
* Not required
| style="background:#F5F5F5;" + |
* Direct visualization of enlarged [[tonsils]] in [[oropharyngeal]] exam<ref name="pmid22973368">{{cite journal |vauthors=Jazi SM, Barati B, Kheradmand A |title=Treatment of adenotonsillar hypertrophy: A prospective randomized trial comparing azithromycin vs. fluticasone |journal=J Res Med Sci |volume=16 |issue=12 |pages=1590–7 |date=December 2011 |pmid=22973368 |pmc=3434901 |doi= |url=}}</ref>
| style="background:#F5F5F5;" + |
* More in children and adolescents
|-
| align="center" style="background:#DCDCDC;" + |'''Tumor of pharynx/larynx/upper trachea'''<ref name="pmid23328541">{{cite journal |vauthors=Bradley PT, Bradley PJ |title=Branchial cleft cyst carcinoma: fact or fiction? |journal=Curr Opin Otolaryngol Head Neck Surg |volume=21 |issue=2 |pages=118–23 |date=April 2013 |pmid=23328541 |doi=10.1097/MOO.0b013e32835cebde |url=}}</ref><ref name="pmid6537892">{{cite journal |vauthors=Silverman S, Gorsky M, Lozada F |title=Oral leukoplakia and malignant transformation. A follow-up study of 257 patients |journal=Cancer |volume=53 |issue=3 |pages=563–8 |date=February 1984 |pmid=6537892 |doi= |url=}}</ref>
| align="center" style="background:#F5F5F5;" + |Chronic
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + |–
| style="background:#F5F5F5;" + |
* [[Stridor]]
* [[Hoarseness]]
| style="background:#F5F5F5;" + |
* Not specific
| style="background:#F5F5F5;" + |
* Flow loop shows inspiratory slowing
| style="background:#F5F5F5;" + |
* Not required
| style="background:#F5F5F5;" + |
* [[Computed tomography|CT]] provide information about the grade of invasion
* [[Magnetic resonance imaging|MRI]] can make a difference between tumors in the mucosa or bone marrow<ref name="urlCDC - Head and Neck Cancers">{{cite web |url=https://www.cdc.gov/cancer/headneck/index.htm |title=CDC - Head and Neck Cancers |format= |work= |accessdate=}}</ref>
| style="background:#F5F5F5;" + |
* Fine needle aspiration [[biopsy]]
| style="background:#F5F5F5;" + |
* Risk factor: [[Tobacco]] and [[Human papillomavirus|HPV]] infections
|-
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="3" + |Etiology on the basis of anatomy
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="3" + |Diseases
! align="center" style="background:#4479BA; color: #FFFFFF;" colspan="7" + |Clinical manifestations
! align="center" style="background:#4479BA; color: #FFFFFF;" colspan="5" + |Diagnosis
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="3" + |Other features
|-
! align="center" style="background:#4479BA; color: #FFFFFF;" colspan="5" + |Symptoms
! align="center" style="background:#4479BA; color: #FFFFFF;" colspan="2" + |Physical exam
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="2" + |Labs
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="2" + |Pulmonary function testing
! align="center" style="background:#4479BA; color: #FFFFFF;" colspan="3" + |Imaging
|-
|-
|-bgcolor="LightSteelBlue"
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Onset
| '''Ear Nose Throat'''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cough
|bgcolor="Beige"| [[Aspiration]](foreign particles or foods), Bilateral vocal cord paralysis, Hypertrophied [[tonsils]], Intrathoracic [[goiter]], [[Laryngeal edema]], [[Laryngocele]], Laryngostenosis, [[Laryngotracheobronchitis]], Mobile supraglottic soft tissue, Paroxysmal vocal cord motion, Postextubation [[granuloma]], Postlobectomy bronchial torsion, Postnasal drip syndrome, Postradiation [[stenosis]], [[Retropharyngeal abscess]], Supraglottitis, Vocal cord dysfunction, Vocal cord hematoma, [[Sinusitis]]
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea
|-
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever
|-bgcolor="LightSteelBlue"
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Slurred speech
| '''Endocrine'''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cyanosis
|bgcolor="Beige"| Intrathoracic [[goiter]], Obesity,
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Auscultation
|-
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Chest imaging
|-bgcolor="LightSteelBlue"
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Other
| '''Environmental'''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard
|bgcolor="Beige"| [[asthma]], [[Byssinosis]], [[Hay fever]]
|-
|-
|-bgcolor="LightSteelBlue"
| align="center" style="background:#DCDCDC;" rowspan="6" + |'''Central airway diseases'''
| '''Gastroenterologic'''
'''(Intrathoracic upper airway obstruction)'''
|bgcolor="Beige"| [[Gastroesophageal Reflux Disease]]
| align="center" style="background:#DCDCDC;" + |'''Mediastinal mass/lymphadenopathy'''<ref name="pmid22173664">{{cite journal |vauthors=Kawahara K, Miyawaki M, Anami K, Moroga T, Yamamoto S, Tokuishi K, Yamashita S, Kumamoto T |title=A patient with mediastinal mature teratoma presenting with paraneoplastic limbic encephalitis |journal=J Thorac Oncol |volume=7 |issue=1 |pages=258–9 |date=January 2012 |pmid=22173664 |doi=10.1097/JTO.0b013e318236eade |url=}}</ref><ref name="pmid20975383">{{cite journal |vauthors=Stover DG, Eisenberg R, Johnson DH |title=Anti-N-methyl-D-aspartate receptor encephalitis in a young woman with a mature mediastinal teratoma |journal=J Thorac Oncol |volume=5 |issue=11 |pages=1872–3 |date=November 2010 |pmid=20975383 |doi=10.1097/JTO.0b013e3181eba81d |url=}}</ref>
| align="center" style="background:#F5F5F5;" + |Chronic
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + |–
| style="background:#F5F5F5;" + |
* [[Stridor]]
* [[Hoarseness]]
| style="background:#F5F5F5;" + |
* Anti–acetylcholine receptor antibodies present in [[thymic]] [[Tumor|tumors]] 
* High levels of [[Alpha-fetoprotein|AFP]] and [[Human chorionic gonadotropin|beta–hCG]] present in [[Germ cell tumor|germ cell tumors]]
* Increased [[lactate dehydrogenase]] in [[Seminoma|seminomas]]
| style="background:#F5F5F5;" + |
* [[Lung volumes|Expiratory flow rate]] decreased<ref name="pmid7652680">{{cite journal |vauthors=Shamberger RC, Holzman RS, Griscom NT, Tarbell NJ, Weinstein HJ, Wohl ME |title=Prospective evaluation by computed tomography and pulmonary function tests of children with mediastinal masses |journal=Surgery |volume=118 |issue=3 |pages=468–71 |date=September 1995 |pmid=7652680 |doi= |url=}}</ref>
| style="background:#F5F5F5;" + |
* Size, location, and density of the mass can be observed
| style="background:#F5F5F5;" + |
* In [[Computed tomography|chest CT]], location, size, tissue characteristic, and relationship with other structures of the mass is observed
* Information of posterior mediastinal mass can be provided in chest or [[spine]] [[Magnetic resonance imaging|MRI]] <ref name="pmid23225215">{{cite journal |vauthors=Juanpere S, Cañete N, Ortuño P, Martínez S, Sanchez G, Bernado L |title=A diagnostic approach to the mediastinal masses |journal=Insights Imaging |volume=4 |issue=1 |pages=29–52 |date=February 2013 |pmid=23225215 |pmc=3579993 |doi=10.1007/s13244-012-0201-0 |url=}}</ref>
| style="background:#F5F5F5;" + |
* [[Computed tomography|Chest CT]]
| style="background:#F5F5F5;" + |
* [[Hemoptysis]]
* [[Superior vena cava syndrome]]
* [[Surgical resection]]  
|-
|-
|-bgcolor="LightSteelBlue"
| align="center" style="background:#DCDCDC;" + |'''Respiratory papillomatosis'''<ref name="pmid18496162">{{cite journal |vauthors=Derkay CS, Wiatrak B |title=Recurrent respiratory papillomatosis: a review |journal=Laryngoscope |volume=118 |issue=7 |pages=1236–47 |date=July 2008 |pmid=18496162 |doi=10.1097/MLG.0b013e31816a7135 |url=}}</ref><ref name="pmid23013073">{{cite journal |vauthors=Yuan H, Myers S, Wang J, Zhou D, Woo JA, Kallakury B, Ju A, Bazylewicz M, Carter YM, Albanese C, Grant N, Shad A, Dritschilo A, Liu X, Schlegel R |title=Use of reprogrammed cells to identify therapy for respiratory papillomatosis |journal=N. Engl. J. Med. |volume=367 |issue=13 |pages=1220–7 |date=September 2012 |pmid=23013073 |pmc=4030597 |doi=10.1056/NEJMoa1203055 |url=}}</ref>
| '''Genetic'''
| align="center" style="background:#F5F5F5;" + |Chronic
|bgcolor="Beige"| [[Cystic fibrosis]], [[Milk allergy]], Obesity, [[Primary ciliary dyskinesia]], Vascular compression/ rings, [[Alpha 1-Antitrypsin Deficiency]], [[Ciliary dyskinesia]]-bronchiectasis,
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |–
| style="background:#F5F5F5;" + |
* [[Hoarseness]]
* [[Stridor]]
| style="background:#F5F5F5;" + |
* Not specific
| style="background:#F5F5F5;" + |
* Not specific
| style="background:#F5F5F5;" + |
* Solid or cavitated [[Pulmonary nodule|pulmonary nodules]]
| style="background:#F5F5F5;" + |
* [[Nodules]] which involves mucosal surface observed in [[Computed tomography|CT]]<ref name="urlLaryngotracheobronchial papillomatosis: findings on computed tomography scans of the chest">{{cite web |url=http://www.scielo.br/scielo.php?pid=s1806-37132008001200016&script=sci_arttext&tlng=en |title=Laryngotracheobronchial papillomatosis: findings on computed tomography scans of the chest |format= |work= |accessdate=}}</ref>
| style="background:#F5F5F5;" + |
* [[Polypoidy|Polypoid lesions]] observed on [[bronchoscopy]]
| style="background:#F5F5F5;" + |
* Etiology: [[Human papillomavirus|HPV 6 and 11]]
* [[Biopsy]] to determine the type of virus
|-
|-
|-bgcolor="LightSteelBlue"
| align="center" style="background:#DCDCDC;" + |'''Tracheobronchomalacia'''<ref name="pmid16771908">{{cite journal |vauthors=Murgu SD, Colt HG |title=Tracheobronchomalacia and excessive dynamic airway collapse |journal=Respirology |volume=11 |issue=4 |pages=388–406 |date=July 2006 |pmid=16771908 |doi=10.1111/j.1440-1843.2006.00862.x |url=}}</ref>
| '''Hematologic'''
| align="center" style="background:#F5F5F5;" + |Chronic
|bgcolor="Beige"| [[Lymphadenopathy]]
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + | –
| align="center" style="background:#F5F5F5;" + |–
| style="background:#F5F5F5;" + |
* [[Stridor]]
* Forced expiration
| style="background:#F5F5F5;" + |
* Not specifc
| style="background:#F5F5F5;" + |
* Low [[Lung volumes|expiratory]] flow in flow volume loop
| style="background:#F5F5F5;" + |
* Airway compression from  other structures
| style="background:#F5F5F5;" + |
* Airway collpse observed in images at the end of [[inspiration]] in dynamic [[Computed tomography|CT]]<ref name="pmid11351189">{{cite journal |vauthors=Aquino SL, Shepard JA, Ginns LC, Moore RH, Halpern E, Grillo HC, McLoud TC |title=Acquired tracheomalacia: detection by expiratory CT scan |journal=J Comput Assist Tomogr |volume=25 |issue=3 |pages=394–9 |date= 2001 |pmid=11351189 |doi= |url=}}</ref>
| style="background:#F5F5F5;" + |
* Airway collapse observed on [[bronchoscopy]]<ref name="pmid24960030">{{cite journal |vauthors=Majid A, Gaurav K, Sanchez JM, Berger RL, Folch E, Fernandez-Bussy S, Ernst A, Gangadharan SP |title=Evaluation of tracheobronchomalacia by dynamic flexible bronchoscopy. A pilot study |journal=Ann Am Thorac Soc |volume=11 |issue=6 |pages=951–5 |date=July 2014 |pmid=24960030 |doi=10.1513/AnnalsATS.201312-435BC |url=}}</ref>
| style="background:#F5F5F5;" + |
* [[Sputum]] retention
* [[Barking cough]]  
|-
|-
|-bgcolor="LightSteelBlue"
| align="center" style="background:#DCDCDC;" + |'''Tracheal stenosis'''<ref name="pmid15187010">{{cite journal |vauthors=Ernst A, Feller-Kopman D, Becker HD, Mehta AC |title=Central airway obstruction |journal=Am. J. Respir. Crit. Care Med. |volume=169 |issue=12 |pages=1278–97 |date=June 2004 |pmid=15187010 |doi=10.1164/rccm.200210-1181SO |url=}}</ref><ref name="pmid11866017">{{cite journal |vauthors=Bolliger CT, Mathur PN, Beamis JF, Becker HD, Cavaliere S, Colt H, Diaz-Jimenez JP, Dumon JF, Edell E, Kovitz KL, Macha HN, Mehta AC, Marel M, Noppen M, Strausz J, Sutedja TG |title=ERS/ATS statement on interventional pulmonology. European Respiratory Society/American Thoracic Society |journal=Eur. Respir. J. |volume=19 |issue=2 |pages=356–73 |date=February 2002 |pmid=11866017 |doi= |url=}}</ref><ref name="pmid12740291">{{cite journal |vauthors=Ernst A, Silvestri GA, Johnstone D |title=Interventional pulmonary procedures: Guidelines from the American College of Chest Physicians |journal=Chest |volume=123 |issue=5 |pages=1693–717 |date=May 2003 |pmid=12740291 |doi= |url=}}</ref><ref name="pmid10649204">{{cite journal |vauthors=Stephens KE, Wood DE |title=Bronchoscopic management of central airway obstruction |journal=J. Thorac. Cardiovasc. Surg. |volume=119 |issue=2 |pages=289–96 |date=February 2000 |pmid=10649204 |doi=10.1016/S0022-5223(00)70184-X |url=}}</ref>
| '''Iatrogenic'''
| align="center" style="background:#F5F5F5;" + |Acute
|bgcolor="Beige"| [[Aspiration]](foreign particles or foods), Esophageal foreign body, [[Mendelson's syndrome]] (aspiration pneumonitis),
| align="center" style="background:#F5F5F5;" + | –
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | –
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + | +
| style="background:#F5F5F5;" + |
* [[Stridor]]
* Monophonic expiratory
| style="background:#F5F5F5;" + |
* Not specific
| style="background:#F5F5F5;" + |
* [[Lung volumes|FV]] loop variable
| style="background:#F5F5F5;" + |
* Narrowing of the [[trachea]]
| style="background:#F5F5F5;" + |
* Extension of the narrowing observed in [[Computed tomography|CT]] or [[Magnetic resonance imaging|MRI]]
| style="background:#F5F5F5;" + |
* Narrowing of the [[trachea]] observed in [[bronchoscopy]]<ref name="pmid9720679">{{cite journal |vauthors=Altman KW, Wetmore RF, Mahboubi S |title=Comparison of endoscopy and radiographic fluoroscopy in the evaluation of pediatric congenital airway abnormalities |journal=Int. J. Pediatr. Otorhinolaryngol. |volume=44 |issue=1 |pages=43–6 |date=June 1998 |pmid=9720679 |doi= |url=}}</ref>
| style="background:#F5F5F5;" + |
* Long segment stenosis incompatible with survival<ref name="pmid16481247">{{cite journal |vauthors=Chiu PP, Rusan M, Williams WG, Caldarone CA, Kim PC |title=Long-term outcomes of clinically significant vascular rings associated with congenital tracheal stenosis |journal=J. Pediatr. Surg. |volume=41 |issue=2 |pages=335–41 |date=February 2006 |pmid=16481247 |doi=10.1016/j.jpedsurg.2005.11.034 |url=}}</ref>
|-
|-
|-bgcolor="LightSteelBlue"
| align="center" style="background:#DCDCDC;" + |'''Tracheal and bronchial tumors'''<ref name="pmid24295654">{{cite journal |vauthors=Brand-Saberi BE, Schäfer T |title=Trachea: anatomy and physiology |journal=Thorac Surg Clin |volume=24 |issue=1 |pages=1–5 |date=February 2014 |pmid=24295654 |doi=10.1016/j.thorsurg.2013.09.004 |url=}}</ref><ref name="pmid25978628">{{cite journal |vauthors=Sherani K, Vakil A, Dodhia C, Fein A |title=Malignant tracheal tumors: a review of current diagnostic and management strategies |journal=Curr Opin Pulm Med |volume=21 |issue=4 |pages=322–6 |date=July 2015 |pmid=25978628 |doi=10.1097/MCP.0000000000000181 |url=}}</ref><ref name="pmid24034267">{{cite journal |vauthors=Wu CC, Shepard JA |title=Tracheal and airway neoplasms |journal=Semin Roentgenol |volume=48 |issue=4 |pages=354–64 |date=October 2013 |pmid=24034267 |doi=10.1053/j.ro.2013.03.018 |url=}}</ref>
| '''Infectious Disease'''
| align="center" style="background:#F5F5F5;" + |Chronic
|bgcolor="Beige"| [[Allergic bronchopulmonary aspergillosis]], Cold induced [[wheezing]], [[Bronchitis]], [[Bronchiolitis]], [[pneumonia]], [[Lymphadenopathy]], [[Retropharyngeal abscess]], [[Tuberculosis]], [[Ascariasis]], [[Hookworm]], Paragonimiases - lung infection, [[Strongyloidiasis]], [[Toxocariasis]], [[Aspergillosis]]
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + |–
| style="background:#F5F5F5;" + |
* [[Hoarseness]]
| style="background:#F5F5F5;" + |
* Not specific
| style="background:#F5F5F5;" + |
* FV loop variable
| style="background:#F5F5F5;" + |
* Narrowing of the [[trachea]]  
| style="background:#F5F5F5;" + |
* Foca lesions, [[Polypoid cervical growth|polypoid]], and narrowing observed in [[Computed tomography|CT]]<ref name="pmid28066620" />
| style="background:#F5F5F5;" + |
* [[Biopsy]] obtained by [[bronchoscopy]]<ref name="pmid28066620">{{cite journal |vauthors=Stevic R, Milenkovic B |title=Tracheobronchial tumors |journal=J Thorac Dis |volume=8 |issue=11 |pages=3401–3413 |date=November 2016 |pmid=28066620 |pmc=5179373 |doi=10.21037/jtd.2016.11.24 |url=}}</ref>
| style="background:#F5F5F5;" + |
* [[Squamous cell carcinoma]]
* Adenoid cystic carcinoma
* [[Benign tumors]]
|-
|-
|-bgcolor="LightSteelBlue"
| align="center" style="background:#DCDCDC;" + |'''Vascular ring or aneurysm'''<ref name="pmid25604054">{{cite journal |vauthors=Licari A, Manca E, Rispoli GA, Mannarino S, Pelizzo G, Marseglia GL |title=Congenital vascular rings: a clinical challenge for the pediatrician |journal=Pediatr. Pulmonol. |volume=50 |issue=5 |pages=511–24 |date=May 2015 |pmid=25604054 |doi=10.1002/ppul.23152 |url=}}</ref><ref name="pmid17034866">{{cite journal |vauthors=Shah RK, Mora BN, Bacha E, Sena LM, Buonomo C, Del Nido P, Rahbar R |title=The presentation and management of vascular rings: an otolaryngology perspective |journal=Int. J. Pediatr. Otorhinolaryngol. |volume=71 |issue=1 |pages=57–62 |date=January 2007 |pmid=17034866 |doi=10.1016/j.ijporl.2006.08.025 |url=}}</ref><ref name="pmid16585275">{{cite journal |vauthors=Humphrey C, Duncan K, Fletcher S |title=Decade of experience with vascular rings at a single institution |journal=Pediatrics |volume=117 |issue=5 |pages=e903–8 |date=May 2006 |pmid=16585275 |doi=10.1542/peds.2005-1674 |url=}}</ref><ref name="pmid11515879">{{cite journal |vauthors=Woods RK, Sharp RJ, Holcomb GW, Snyder CL, Lofland GK, Ashcraft KW, Holder TM |title=Vascular anomalies and tracheoesophageal compression: a single institution's 25-year experience |journal=Ann. Thorac. Surg. |volume=72 |issue=2 |pages=434–8; discussion 438–9 |date=August 2001 |pmid=11515879 |doi= |url=}}</ref><ref name="pmid15942575">{{cite journal |vauthors=Backer CL, Mavroudis C, Rigsby CK, Holinger LD |title=Trends in vascular ring surgery |journal=J. Thorac. Cardiovasc. Surg. |volume=129 |issue=6 |pages=1339–47 |date=June 2005 |pmid=15942575 |doi=10.1016/j.jtcvs.2004.10.044 |url=}}</ref><ref name="pmid15666159">{{cite journal |vauthors=Turner A, Gavel G, Coutts J |title=Vascular rings--presentation, investigation and outcome |journal=Eur. J. Pediatr. |volume=164 |issue=5 |pages=266–70 |date=May 2005 |pmid=15666159 |doi=10.1007/s00431-004-1607-6 |url=}}</ref>
| '''Musculoskeletal / Ortho'''
| align="center" style="background:#F5F5F5;" + |Chronic
|bgcolor="Beige"| Cricoarytenoid arthritis,  
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + |–
| style="background:#F5F5F5;" + |
* [[Hoarseness]]
| style="background:#F5F5F5;" + |
* [[D-dimer|D–dimer]],
* Blood [[urea]],
* Blood [[nitrogen]], and
* [[CBC]] may be helpful
| style="background:#F5F5F5;" + |
* Not required
| style="background:#F5F5F5;" + |
* [[Aorta|Aortic knob]] enlarged
* Displacement to the [[trachea]] <ref name="pmid11715324">{{cite journal |vauthors=Miller WT |title=Thoracic aortic aneurysms: plain film findings |journal=Semin Roentgenol |volume=36 |issue=4 |pages=288–94 |date=October 2001 |pmid=11715324 |doi= |url=}}</ref>
| style="background:#F5F5F5;" + |
* [[ECG]] to rule out [[myocardial infarction]]
| style="background:#F5F5F5;" + |
* [[Computed tomography|CT]] or [[Angiography|angiography MR]] to determine the aortic diameter or any change
| style="background:#F5F5F5;" + |
* Usually [[asymptomatic]]
* Chest or abdominal pain appears when other structures are compressed
|-
|-
|-bgcolor="LightSteelBlue"
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="3" + |Etiology on the basis of anatomy
| '''Neurologic'''
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="3" + |Diseases
|bgcolor="Beige"| No underlying causes
! align="center" style="background:#4479BA; color: #FFFFFF;" colspan="7" + |Clinical manifestations
! align="center" style="background:#4479BA; color: #FFFFFF;" colspan="5" + |Diagnosis
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="3" + |Other features
|-
|-
|-bgcolor="LightSteelBlue"
! align="center" style="background:#4479BA; color: #FFFFFF;" colspan="5" + |Symptoms
| '''Nutritional / Metabolic'''
! align="center" style="background:#4479BA; color: #FFFFFF;" colspan="2" + |Physical exam
|bgcolor="Beige"| Obesity
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="2" + |Labs
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="2" + |Pulmonary function testing
! align="center" style="background:#4479BA; color: #FFFFFF;" colspan="3" + |Imaging
|-
|-
|-bgcolor="LightSteelBlue"
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Onset
| '''Obstetric/Gynecologic'''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cough
|bgcolor="Beige"| No underlying causes
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Slurred speech
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cyanosis
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Auscultation
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Chest imaging
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Other
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard
|-
|-
|-bgcolor="LightSteelBlue"
! align="center" style="background:#DCDCDC;" rowspan="5" + |Lower airway obstruction
| '''Oncologic'''
| align="center" style="background:#DCDCDC;" + |'''Bronchiectasis'''<ref name="pmid16650970">{{cite journal |vauthors=King PT, Holdsworth SR, Freezer NJ, Villanueva E, Holmes PW |title=Characterisation of the onset and presenting clinical features of adult bronchiectasis |journal=Respir Med |volume=100 |issue=12 |pages=2183–9 |date=December 2006 |pmid=16650970 |doi=10.1016/j.rmed.2006.03.012 |url=}}</ref><ref name="pmid20627931">{{cite journal |vauthors=Pasteur MC, Bilton D, Hill AT |title=British Thoracic Society guideline for non-CF bronchiectasis |journal=Thorax |volume=65 Suppl 1 |issue= |pages=i1–58 |date=July 2010 |pmid=20627931 |doi=10.1136/thx.2010.136119 |url=}}</ref>
|bgcolor="Beige"| [[Carcinoid syndrome]], [[Lymphadenopathy]], Lymphangitic carcinomatosis, [[Malignancy]] (bronchogenic tumors), Bronchial adenomata syndrome, [[Mastocytosis]]  
| align="center" style="background:#F5F5F5;" + |Chronic
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + |–
| style="background:#F5F5F5;" + |
* [[Crackles]]
* [[Shortness of breath]]
| style="background:#F5F5F5;" + |
* [[Neutrophilia]]
* Levels of [[Immunoglobulin M|IgM]], [[Immunoglobulin G|IgG]] and [[Immunoglobulin A|IgA]]
* [[Sputum culture]] for [[fungi]], [[bacteria]] and [[mycobacteria]]<ref name="pmid28889110">{{cite journal |vauthors=Polverino E, Goeminne PC, McDonnell MJ, Aliberti S, Marshall SE, Loebinger MR, Murris M, Cantón R, Torres A, Dimakou K, De Soyza A, Hill AT, Haworth CS, Vendrell M, Ringshausen FC, Subotic D, Wilson R, Vilaró J, Stallberg B, Welte T, Rohde G, Blasi F, Elborn S, Almagro M, Timothy A, Ruddy T, Tonia T, Rigau D, Chalmers JD |title=European Respiratory Society guidelines for the management of adult bronchiectasis |journal=Eur. Respir. J. |volume=50 |issue=3 |pages= |date=September 2017 |pmid=28889110 |doi=10.1183/13993003.00629-2017 |url=}}</ref>
| style="background:#F5F5F5;" + |
** [[FEV1/FVC ratio|FEV1/FVC]] < 70%
** Normal [[FVC]]
** Low levels of [[FEV1]]
| style="background:#F5F5F5;" + |
* Linar [[atelectasis]]
* Dilated [[airways]]
| style="background:#F5F5F5;" + |
* Tram lines or end–on ring shadows in chest [[Computed tomography|CT]] <ref name="pmid26024063">{{cite journal |vauthors=Milliron B, Henry TS, Veeraraghavan S, Little BP |title=Bronchiectasis: Mechanisms and Imaging Clues of Associated Common and Uncommon Diseases |journal=Radiographics |volume=35 |issue=4 |pages=1011–30 |date= 2015 |pmid=26024063 |doi=10.1148/rg.2015140214 |url=}}</ref>
| style="background:#F5F5F5;" + |
* Chest [[Computed tomography|CT]]
| style="background:#F5F5F5;" + |
* [[Hemoptysis]]
* Chest [[pleuritic pain]]
* [[Clubbing]]
|-
|-
|-bgcolor="LightSteelBlue"
| align="center" style="background:#DCDCDC;" + |'''Bronchiolitis'''<ref name="pmid11512084">{{cite journal |vauthors=Hall CB, Long CE, Schnabel KC |title=Respiratory syncytial virus infections in previously healthy working adults |journal=Clin. Infect. Dis. |volume=33 |issue=6 |pages=792–6 |date=September 2001 |pmid=11512084 |doi=10.1086/322657 |url=}}</ref><ref name="pmid3706232">{{cite journal |vauthors=Glezen WP, Taber LH, Frank AL, Kasel JA |title=Risk of primary infection and reinfection with respiratory syncytial virus |journal=Am. J. Dis. Child. |volume=140 |issue=6 |pages=543–6 |date=June 1986 |pmid=3706232 |doi= |url=}}</ref><ref name="pmid10885982">{{cite journal |vauthors=Falsey AR, Walsh EE |title=Respiratory syncytial virus infection in adults |journal=Clin. Microbiol. Rev. |volume=13 |issue=3 |pages=371–84 |date=July 2000 |pmid=10885982 |pmc=88938 |doi= |url=}}</ref><ref name="pmid16007526">{{cite journal |vauthors=O'Shea MK, Ryan MA, Hawksworth AW, Alsip BJ, Gray GC |title=Symptomatic respiratory syncytial virus infection in previously healthy young adults living in a crowded military environment |journal=Clin. Infect. Dis. |volume=41 |issue=3 |pages=311–7 |date=August 2005 |pmid=16007526 |doi=10.1086/431591 |url=}}</ref><ref name="pmid7836643">{{cite journal |vauthors=Wald TG, Miller BA, Shult P, Drinka P, Langer L, Gravenstein S |title=Can respiratory syncytial virus and influenza A be distinguished clinically in institutionalized older persons? |journal=J Am Geriatr Soc |volume=43 |issue=2 |pages=170–4 |date=February 1995 |pmid=7836643 |doi= |url=}}</ref>
| '''Opthalmologic'''
| align="center" style="background:#F5F5F5;" + |Acute
|bgcolor="Beige"| No underlying causes
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | –
| align="center" style="background:#F5F5F5;" + | +
| style="background:#F5F5F5;" + |
* [[Crackles]]
* Increased [[respiratory rate]]
| style="background:#F5F5F5;" + |For bacterial infection in neonates:
* [[CBC]]
* [[Urinalysis]]
* [[Urine culture]]
| style="background:#F5F5F5;" + |
** Normal function or obstructive changes ([[FEV1/FVC ratio|FEV1/FVC]] < 70%)
** Air trapping in [[Lung volumes]]
** Reduced [[DLCO|diffusing capacity of carbon monoxide]] ( [[DLCO]]) <ref name="pmid20371529" />
| style="background:#F5F5F5;" + |
* Hyperinflation
* Mosaic attenuation
* Increased bronchial wall<ref name="pmid20371529">{{cite journal |vauthors=Devakonda A, Raoof S, Sung A, Travis WD, Naidich D |title=Bronchiolar disorders: a clinical-radiological diagnostic algorithm |journal=Chest |volume=137 |issue=4 |pages=938–51 |date=April 2010 |pmid=20371529 |doi=10.1378/chest.09-0800 |url=}}</ref>
| style="background:#F5F5F5;" + |
* [[Bronchoscopy]] to rule out other diseases
| style="background:#F5F5F5;" + |
* Clinical diagnosis
| style="background:#F5F5F5;" + |
* Etiology: [[Respiratory syncytial virus]]'', ''[[rhinovirus]]
|-
|-
|-bgcolor="LightSteelBlue"
| align="center" style="background:#DCDCDC;" + |'''Carcinoid syndrome'''<ref name="pmid12140134">{{cite journal |vauthors=Skuladottir H, Hirsch FR, Hansen HH, Olsen JH |title=Pulmonary neuroendocrine tumors: incidence and prognosis of histological subtypes. A population-based study in Denmark |journal=Lung Cancer |volume=37 |issue=2 |pages=127–35 |date=August 2002 |pmid=12140134 |doi= |url=}}</ref><ref name="pmid23486331">{{cite journal |vauthors=Moore W, Freiberg E, Bishawi M, Halbreiner MS, Matthews R, Baram D, Bilfinger TV |title=FDG-PET imaging in patients with pulmonary carcinoid tumor |journal=Clin Nucl Med |volume=38 |issue=7 |pages=501–5 |date=July 2013 |pmid=23486331 |doi=10.1097/RLU.0b013e318279f0f5 |url=}}</ref><ref name="pmid11896225">{{cite journal |vauthors=Jeung MY, Gasser B, Gangi A, Charneau D, Ducroq X, Kessler R, Quoix E, Roy C |title=Bronchial carcinoid tumors of the thorax: spectrum of radiologic findings |journal=Radiographics |volume=22 |issue=2 |pages=351–65 |date=2002 |pmid=11896225 |doi=10.1148/radiographics.22.2.g02mr01351 |url=}}</ref>
| '''Overdose / Toxicity'''
| align="center" style="background:#F5F5F5;" + |Chronic
|bgcolor="Beige"| chemical poisoning
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + | –
| align="center" style="background:#F5F5F5;" + | –
| style="background:#F5F5F5;" + |
* [[Shortness of breath]]
| style="background:#F5F5F5;" + |
* Twenty four hour urine for [[5-Hydroxyindoleacetic acid|5–HIAA]]
* Urinary excretion of [[serotonin]]
* High levels of [[Chromogranin|chromogranin concentration]] <ref name="pmid27594907">{{cite journal |vauthors=Mota JM, Sousa LG, Riechelmann RP |title=Complications from carcinoid syndrome: review of the current evidence |journal=Ecancermedicalscience |volume=10 |issue= |pages=662 |date= 2016 |pmid=27594907 |pmc=4990058 |doi=10.3332/ecancer.2016.662 |url=}}</ref>
| style="background:#F5F5F5;" + |
* Not specific
| style="background:#F5F5F5;" + |
* [[Cardiomegaly|Enlargement of the heart]] <ref name="pmid275949073">{{cite journal |vauthors=Mota JM, Sousa LG, Riechelmann RP |title=Complications from carcinoid syndrome: review of the current evidence |journal=Ecancermedicalscience |volume=10 |issue= |pages=662 |date= 2016 |pmid=27594907 |pmc=4990058 |doi=10.3332/ecancer.2016.662 |url=}}</ref>
| style="background:#F5F5F5;" + |
* Carcinoid tumors of [[jejunum]], [[appendix]] and [[colon]] are oberved in abdominal [[Computed tomography|CT]]
 
* Liver metastases are visualized in [[MRI]]
| style="background:#F5F5F5;" + |
* Abdominal and pelvic [[Computed tomography|CT]]<ref name="pmid27594907" />
| style="background:#F5F5F5;" + |
* [[Flushing]]
* [[Diarrhea]]
|-
|-
|-bgcolor="LightSteelBlue"
| align="center" style="background:#DCDCDC;" + |'''Heart failure'''<ref name="pmid16365214">{{cite journal |vauthors=Gheorghiade M, Zannad F, Sopko G, Klein L, Piña IL, Konstam MA, Massie BM, Roland E, Targum S, Collins SP, Filippatos G, Tavazzi L |title=Acute heart failure syndromes: current state and framework for future research |journal=Circulation |volume=112 |issue=25 |pages=3958–68 |date=December 2005 |pmid=16365214 |doi=10.1161/CIRCULATIONAHA.105.590091 |url=}}</ref><ref name="pmid17000631">{{cite journal |vauthors=Nieminen MS, Brutsaert D, Dickstein K, Drexler H, Follath F, Harjola VP, Hochadel M, Komajda M, Lassus J, Lopez-Sendon JL, Ponikowski P, Tavazzi L |title=EuroHeart Failure Survey II (EHFS II): a survey on hospitalized acute heart failure patients: description of population |journal=Eur. Heart J. |volume=27 |issue=22 |pages=2725–36 |date=November 2006 |pmid=17000631 |doi=10.1093/eurheartj/ehl193 |url=}}</ref>
| '''Psychiatric'''
| align="center" style="background:#F5F5F5;" + |Chronic
|bgcolor="Beige"| [[Psychogenic]] wheezing
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + | –
| align="center" style="background:#F5F5F5;" + | –
| style="background:#F5F5F5;" + |
* [[Crackles]]
* [[Leg edema]]
| style="background:#F5F5F5;" + |
* [[Blood urea nitrogen|BUN]] and [[Serum creatinine|serum creatinin]] concentration to evaluate [[renal function]]
* [[Liver function tests]]
* Fasting [[lipid profile]]<ref name="pmid23741057">{{cite journal |vauthors=Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, Fonarow GC, Geraci SA, Horwich T, Januzzi JL, Johnson MR, Kasper EK, Levy WC, Masoudi FA, McBride PE, McMurray JJ, Mitchell JE, Peterson PN, Riegel B, Sam F, Stevenson LW, Tang WH, Tsai EJ, Wilkoff BL |title=2013 ACCF/AHA guideline for the management of heart failure: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines |journal=Circulation |volume=128 |issue=16 |pages=1810–52 |date=October 2013 |pmid=23741057 |doi=10.1161/CIR.0b013e31829e8807 |url=}}</ref>
| style="background:#F5F5F5;" + |
* Not required
| style="background:#F5F5F5;" + |
* [[Pleural effusion]]
* [[Pulmonary edema]]
| style="background:#F5F5F5;" + |
** [[ST]] and [[T wave|T waves]] abnormalities in [[ECG]]
** [[Oxygen saturation|SaO2]] < 90%<ref name="pmid20937981">{{cite journal |vauthors=Weintraub NL, Collins SP, Pang PS, Levy PD, Anderson AS, Arslanian-Engoren C, Gibler WB, McCord JK, Parshall MB, Francis GS, Gheorghiade M |title=Acute heart failure syndromes: emergency department presentation, treatment, and disposition: current approaches and future aims: a scientific statement from the American Heart Association |journal=Circulation |volume=122 |issue=19 |pages=1975–96 |date=November 2010 |pmid=20937981 |doi=10.1161/CIR.0b013e3181f9a223 |url=}}</ref>
| style="background:#F5F5F5;" + |
* Clinical diagnosis (test are supportive)
| style="background:#F5F5F5;" + |
* High levels of [[Brain natriuretic peptide|BNP]] and pro–BNP<ref name="pmid15477431">{{cite journal |vauthors=Doust JA, Glasziou PP, Pietrzak E, Dobson AJ |title=A systematic review of the diagnostic accuracy of natriuretic peptides for heart failure |journal=Arch. Intern. Med. |volume=164 |issue=18 |pages=1978–84 |date=October 2004 |pmid=15477431 |doi=10.1001/archinte.164.18.1978 |url=}}</ref>
|-
|-
|-bgcolor="LightSteelBlue"
| align="center" style="background:#DCDCDC;" + |'''Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH)''' <ref name="pmid17099078">{{cite journal |vauthors=Davies SJ, Gosney JR, Hansell DM, Wells AU, du Bois RM, Burke MM, Sheppard MN, Nicholson AG |title=Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia: an under-recognised spectrum of disease |journal=Thorax |volume=62 |issue=3 |pages=248–52 |date=March 2007 |pmid=17099078 |pmc=2117154 |doi=10.1136/thx.2006.063065 |url=}}</ref>
| '''Pulmonary'''
| align="center" style="background:#F5F5F5;" + |Chronic
|bgcolor="Beige"| [[Bronchiectasis]], [[Bronchiolitis]], [[Bronchiolitis obliterans]], [[Bronchitis]], [[Bronchopulmonary dysplasia]], [[Carcinoid syndrome]], [[Chronic obstructive pulmonary disease]]: Chronic bronchitis and Emphysema, Cold induced [[wheezing]], [[Cystic fibrosis]], Pulmonary [[hemorrhage]], [[pneumonia]], [[Interstitial lung disease]], Postlobectomy bronchial torsion, Postradiation [[stenosis]], [[Primary ciliary dyskinesia]], [[Pulmonary edema]], [[Pulmonary embolism]], [[Tracheal stenosis]], [[Tracheobronchitis]], [[Tracheobronchomegaly]], [[Tracheomalacia]], [[Wegener's granulomatosis]], [[Pulmonary eosinophilia]], [[Tuberculosis]], [[Alpha 1-Antitrypsin Deficiency]], Extrinsic allergic alveolitis, Bronchial adenomata syndrome, [[Ciliary dyskinesia]]-bronchiectasis, Tracheobronchopathia osteoplastica, [[Aspergillosis]]  
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | –
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + |–
| style="background:#F5F5F5;" + |
* [[Shortness of breath]]
| style="background:#F5F5F5;" + |
* Not specific
| style="background:#F5F5F5;" + |
* [[FEV1/FVC ratio|FEV1/FVC]] < 70%
* Normal [[FVC]]
* Low levels of [[FEV1]]
| style="background:#F5F5F5;" + |
* Pulmonary [[Nodule (medicine)|nodules]]
| style="background:#F5F5F5;" + |
* Mosaic pattern and [[Nodule (medicine)|nodules]] observed in chest [[Computed tomography|CT]]
| style="background:#F5F5F5;" + |
* Hyperplasia showed in  [[biopsy]]  
| style="background:#F5F5F5;" + |
* Single [[neuroendocrine cell]] and/ or linear proliferation of the cells that involves bronchial epithelium
|-
|-
|-bgcolor="LightSteelBlue"
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="3" + |Etiology on the basis of anatomy
| '''Renal / Electrolyte'''
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="3" + |Diseases
|bgcolor="Beige"| No underlying causes
! align="center" style="background:#4479BA; color: #FFFFFF;" colspan="7" + |Clinical manifestations
! align="center" style="background:#4479BA; color: #FFFFFF;" colspan="5" + |Diagnosis
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="3" + |Other features
|-
|-
|-bgcolor="LightSteelBlue"
! align="center" style="background:#4479BA; color: #FFFFFF;" colspan="5" + |Symptoms
| '''Rheum / Immune / Allergy'''
! align="center" style="background:#4479BA; color: #FFFFFF;" colspan="2" + |Physical exam
|bgcolor="Beige"| [[Allergic bronchopulmonary aspergillosis]], [[Anaphylaxis]], [[Angioedema]], [[Asthma]], Cricoarytenoid arthritis, [[Immunodeficiency]], [[Interstitial lung disease]], [[Lymphadenopathy]], [[Milk allergy]], [[Relapsing polychondritis]], [[Wegener's granulomatosis]], [[Pulmonary eosinophilia]], Extrinsic allergic alveolitis, [[Graft-versus-host disease]], [[Hay fever]], [[Mastocytosis]], 
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="2" + |Labs
 
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="2" + |Pulmonary function testing
! align="center" style="background:#4479BA; color: #FFFFFF;" colspan="3" + |Imaging
|-
|-
|-bgcolor="LightSteelBlue"
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Onset
| '''Sexual'''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cough
|bgcolor="Beige"| No underlying causes
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Slurred speech
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cyanosis
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Auscultation
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Chest imaging
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Other
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard
|-
|-
|-bgcolor="LightSteelBlue"
! align="center" style="background:#DCDCDC;" rowspan="4" + |Lower airway obstruction
| '''Trauma'''
| align="center" style="background:#DCDCDC;" + |'''Noncardiogenic pulmonary edema'''<ref name="pmid23588761">{{cite journal |vauthors=Kanner C, Hardy SM |title=An unusual cause of unilateral pulmonary edema |journal=Ann. Intern. Med. |volume=158 |issue=8 |pages=639–40 |date=April 2013 |pmid=23588761 |doi=10.7326/0003-4819-158-8-201304160-00020 |url=}}</ref><ref name="pmid1735767">{{cite journal |vauthors=Neerukonda SK, Petty TL |title=Unilateral pulmonary edema |journal=Hosp. Pract. (Off. Ed.) |volume=27 |issue=2 |pages=85, 88–9, 92 passim |date=February 1992 |pmid=1735767 |doi= |url=}}</ref><ref name="pmid619405">{{cite journal |vauthors=Calenoff L, Kruglik GD, Woodruff A |title=Unilateral pulmonary edema |journal=Radiology |volume=126 |issue=1 |pages=19–24 |date=January 1978 |pmid=619405 |doi=10.1148/126.1.19 |url=}}</ref>
|bgcolor="Beige"| No underlying causes
| align="center" style="background:#F5F5F5;" + |Acute
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + | –
| align="center" style="background:#F5F5F5;" + | +
| style="background:#F5F5F5;" + |
* [[Crackles]]
| style="background:#F5F5F5;" + |
* [[Hypoxemia]] in [[Arterial blood gas|arterial blood gases]]
| style="background:#F5F5F5;" + |
* [[PaO2]]/[[FiO2]] <300 mmHg
| style="background:#F5F5F5;" + |
* Bilateral alveolar infiltration
| style="background:#F5F5F5;" + |
* Bilateral opacities in [[Computed tomography|CT]]
| style="background:#F5F5F5;" + |
According to Berlin definition:<ref name="pmid22797452">{{cite journal |vauthors=Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E, Fan E, Camporota L, Slutsky AS |title=Acute respiratory distress syndrome: the Berlin Definition |journal=JAMA |volume=307 |issue=23 |pages=2526–33 |date=June 2012 |pmid=22797452 |doi=10.1001/jama.2012.5669 |url=}}</ref>
* One week of new or worse respiratory symptoms or clinical insult
* Symptoms can not be explain by [[Heart|cardiac]] <nowiki/>disease
* Bilateral opacities in [[Chest X-ray|chest X–Ray]] or [[Computed tomography|CT]]
* Compromised [[oxygenation]]
| style="background:#F5F5F5;" + |
* High altitute pulmonary edema ([[HAPE]])
* Neurogenic pulmonary edema
|-
|-
|-bgcolor="LightSteelBlue"
| align="center" style="background:#DCDCDC;" + |'''Parasitic infection with VLM (eg, Ascaris, Strongyloides, filaria)'''<ref name="pmid9772920">{{cite journal |vauthors=Marchand E, Reynaud-Gaubert M, Lauque D, Durieu J, Tonnel AB, Cordier JF |title=Idiopathic chronic eosinophilic pneumonia. A clinical and follow-up study of 62 cases. The Groupe d'Etudes et de Recherche sur les Maladies "Orphelines" Pulmonaires (GERM"O"P) |journal=Medicine (Baltimore) |volume=77 |issue=5 |pages=299–312 |date=September 1998 |pmid=9772920 |doi= |url=}}</ref><ref name="pmid10966710">{{cite journal |vauthors=Johkoh T, Müller NL, Akira M, Ichikado K, Suga M, Ando M, Yoshinaga T, Kiyama T, Mihara N, Honda O, Tomiyama N, Nakamura H |title=Eosinophilic lung diseases: diagnostic accuracy of thin-section CT in 111 patients |journal=Radiology |volume=216 |issue=3 |pages=773–80 |date=September 2000 |pmid=10966710 |doi=10.1148/radiology.216.3.r00se01773 |url=}}</ref><ref name="pmid2773727">{{cite journal |vauthors=Mayo JR, Müller NL, Road J, Sisler J, Lillington G |title=Chronic eosinophilic pneumonia: CT findings in six cases |journal=AJR Am J Roentgenol |volume=153 |issue=4 |pages=727–30 |date=October 1989 |pmid=2773727 |doi=10.2214/ajr.153.4.727 |url=}}</ref><ref name="pmid8089322">{{cite journal |vauthors=Ebara H, Ikezoe J, Johkoh T, Kohno N, Takeuchi N, Kozuka T, Ishida O |title=Chronic eosinophilic pneumonia: evolution of chest radiograms and CT features |journal=J Comput Assist Tomogr |volume=18 |issue=5 |pages=737–44 |date=1994 |pmid=8089322 |doi= |url=}}</ref>
| '''Urologic'''
| align="center" style="background:#F5F5F5;" + |Acute
|bgcolor="Beige"| No underlying causes
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + | –
| style="background:#F5F5F5;" + |
* [[Rales]]
| style="background:#F5F5F5;" + |
* [[Leukocytosis]]
* [[Eosinophilia]]
* [[Toxocara]] antigens detected in [[ELISA]]
* [[Hypergammaglobulinemia]]<ref name="pmid20149289">{{cite journal |vauthors=Rubinsky-Elefant G, Hirata CE, Yamamoto JH, Ferreira MU |title=Human toxocariasis: diagnosis, worldwide seroprevalences and clinical expression of the systemic and ocular forms |journal=Ann Trop Med Parasitol |volume=104 |issue=1 |pages=3–23 |date=January 2010 |pmid=20149289 |doi=10.1179/136485910X12607012373957 |url=}}</ref>
| style="background:#F5F5F5;" + |
* Not specific
| style="background:#F5F5F5;" + |
* Bilateral peribronchial infiltration
* [[Parenchymal]] infiltration
| style="background:#F5F5F5;" + |
* Subpleural nodules, ground–glass opacities observed on chest [[Computed tomography|CT]] <ref name="pmid16714661">{{cite journal |vauthors=Sakai S, Shida Y, Takahashi N, Yabuuchi H, Soeda H, Okafuji T, Hatakenaka M, Honda H |title=Pulmonary lesions associated with visceral larva migrans due to Ascaris suum or Toxocara canis: imaging of six cases |journal=AJR Am J Roentgenol |volume=186 |issue=6 |pages=1697–702 |date=June 2006 |pmid=16714661 |doi=10.2214/AJR.04.1507 |url=}}</ref>
| style="background:#F5F5F5;" + |
* Larve on biopsy
| style="background:#F5F5F5;" + |
* [[Eosinophilia]] detected in [[bronchoalveolar lavage]]
|-
|-
|-bgcolor="LightSteelBlue"
| align="center" style="background:#DCDCDC;" + |'''Pulmonary thromboembolism '''<ref name="pmid13811755">{{cite journal |vauthors=COON WW, WILLIS PW |title=Deep venous thrombosis and pulmonary embolism: prediction, prevention and treatment |journal=Am. J. Cardiol. |volume=4 |issue= |pages=611–21 |date=November 1959 |pmid=13811755 |doi= |url=}}</ref><ref name="pmid6073360">{{cite journal |vauthors=Soloff LA, Rodman T |title=Acute pulmonary embolism. II. Clinical |journal=Am. Heart J. |volume=74 |issue=6 |pages=829–47 |date=December 1967 |pmid=6073360 |doi= |url=}}</ref>
| '''Miscellaneous'''
| align="center" style="background:#F5F5F5;" + |Acute, subacute, Chronic
|bgcolor="Beige"| Amyloid deposition, Tracheobronchopathia osteochondroplastica
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | –
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + |–
| style="background:#F5F5F5;" + |
* [[Tachypnea]]
* Decreased [[breath sounds]]
| style="background:#F5F5F5;" + |
* [[Leukocytosis]]
* Elevated [[Erythrocyte sedimentation rate|erythrocyte sedimentation]] 
* High levels of [[lactic acid]] in [[complete blood count]]
* [[Hypoxemia]] in [[arterial blood gas]]<ref name="pmid8549223">{{cite journal |vauthors=Stein PD, Goldhaber SZ, Henry JW, Miller AC |title=Arterial blood gas analysis in the assessment of suspected acute pulmonary embolism |journal=Chest |volume=109 |issue=1 |pages=78–81 |date=January 1996 |pmid=8549223 |doi= |url=}}</ref>
* [[D-dimer|D–dimer]] to rule out other diseases
* [[Troponin]] [[Troponin I|I]] or [[Troponin T|T]]
| style="background:#F5F5F5;" + |
* Not required
| style="background:#F5F5F5;" + |
* Hamptom and Westermark sign in [[Chest X-ray|chest X–Ray]] <ref name="pmid18716087">{{cite journal |vauthors=Pipavath SN, Godwin JD |title=Acute pulmonary thromboembolism: a historical perspective |journal=AJR Am J Roentgenol |volume=191 |issue=3 |pages=639–41 |date=September 2008 |pmid=18716087 |doi=10.2214/AJR.07.3989 |url=}}</ref>
| style="background:#F5F5F5;" + |
* Computed tomography pulmonary angiogram [[CT pulmonary angiogram|(CTPA)]] or catheter based [[pulmonary angiography]] <ref name="pmid17848685">{{cite journal |vauthors=Remy-Jardin M, Pistolesi M, Goodman LR, Gefter WB, Gottschalk A, Mayo JR, Sostman HD |title=Management of suspected acute pulmonary embolism in the era of CT angiography: a statement from the Fleischner Society |journal=Radiology |volume=245 |issue=2 |pages=315–29 |date=November 2007 |pmid=17848685 |doi=10.1148/radiol.2452070397 |url=}}</ref>
| style="background:#F5F5F5;" + |
* Computed tomography pulmonary angiogram [[CT pulmonary angiogram|(CTPA)]] or catheter based [[pulmonary angiography]] <ref name="pmid17848685" />
| style="background:#F5F5F5;" + |
* Most [[Embolic|emboli]] comes from [[iliac]], [[femoral]], and [[popliteal]] veins
|-
|-
| align="center" style="background:#DCDCDC;" + |'''Reactive airways dysfunction syndrome'''<ref name="pmid5765629">{{cite journal |vauthors=Weill H, George R, Schwarz M, Ziskind M |title=Late evaluation of pulmonary function after acute exposure to chlorine gas |journal=Am. Rev. Respir. Dis. |volume=99 |issue=3 |pages=374–9 |date=March 1969 |pmid=5765629 |doi= |url=}}</ref><ref name="pmid4028848">{{cite journal |vauthors=Brooks SM, Weiss MA, Bernstein IL |title=Reactive airways dysfunction syndrome (RADS). Persistent asthma syndrome after high level irritant exposures |journal=Chest |volume=88 |issue=3 |pages=376–84 |date=September 1985 |pmid=4028848 |doi= |url=}}</ref><ref name="pmid1952431">{{cite journal |vauthors=Kern DG |title=Outbreak of the reactive airways dysfunction syndrome after a spill of glacial acetic acid |journal=Am. Rev. Respir. Dis. |volume=144 |issue=5 |pages=1058–64 |date=November 1991 |pmid=1952431 |doi=10.1164/ajrccm/144.5.1058 |url=}}</ref><ref name="pmid20601629">{{cite journal |vauthors=White CW, Martin JG |title=Chlorine gas inhalation: human clinical evidence of toxicity and experience in animal models |journal=Proc Am Thorac Soc |volume=7 |issue=4 |pages=257–63 |date=July 2010 |pmid=20601629 |pmc=3136961 |doi=10.1513/pats.201001-008SM |url=}}</ref>
| align="center" style="background:#F5F5F5;" + |Acute
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + | +
| align="center" style="background:#F5F5F5;" + |–
| align="center" style="background:#F5F5F5;" + | –
| align="center" style="background:#F5F5F5;" + |–
| style="background:#F5F5F5;" + |
* [[Tachypnea]]
| style="background:#F5F5F5;" + |
* No required
* [[Complete blood count]] to rule out other diseases
| style="background:#F5F5F5;" + |
* [[FEV1/FVC ratio|FEV1/FVC]] < 70% <ref name="pmid4028848" />
| style="background:#F5F5F5;" + |
* Normal or hyperinflation
| style="background:#F5F5F5;" + |
* [[Computed tomography|CT]] to rule out other diseases
| style="background:#F5F5F5;" + |Clinical diagnosis:
* History of exposure
* Acute onset with sympotoms in 24h
* Airway obstruction > 3 months<ref name="pmid4028848">{{cite journal |vauthors=Brooks SM, Weiss MA, Bernstein IL |title=Reactive airways dysfunction syndrome (RADS). Persistent asthma syndrome after high level irritant exposures |journal=Chest |volume=88 |issue=3 |pages=376–84 |date=September 1985 |pmid=4028848 |doi= |url=}}</ref>
| style="background:#F5F5F5;" + |
* Burning sensation in the throat
* [[Chest pain]]
* High dose of inhalation of the irritant
|}
|}
<small/><small/>
== References ==
{{Reflist|2}}
{{WH}}
{{WS}}


[[Image:Asthma before-after.png|thumb|center|350px|'''Inflamed airways and bronchoconstriction in asthma'''. Airways narrowed as a result of the inflammatory response cause wheezing.]]
[[Category:Needs content]]
[[Category:Abnormal respiration]]
[[Category:Pulmonology]]

Latest revision as of 00:44, 30 July 2020

Wheeze Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Karina Zavaleta, MD [2], Iqra Qamar M.D.[3], Anmol Pitliya, M.B.B.S. M.D.[4]

Differential diagnosis of Wheezing

For the differential diagnosis of wheeze and cough, click here.
For the differential diagnosis of wheeze and fever, click here.
For the differential diagnosis of wheeze and slurred speech, click here.

Etiology on the basis of anatomy Diseases Clinical manifestations Diagnosis Other features
Symptoms Physical exam Labs Pulmonary function testing Imaging
Onset Cough Dyspnea Fever Slurred speech Cyanosis Auscultation Chest imaging Other Gold standard
Extrathoracic upper airway diseases Laryngeal edema

(Anaphylaxis)[1][2][3][4][5]

Acute + + + +
  • Not specific
  • Not required
  • Not required

Acute onset with one of them:

Two or more after the exposure to a likely allergen

BP reduced after exposure of a known allergen

Cricoarytenoid arthritis[6][7] Acute + + +
  • Clear chest
Vocal fold edema/hematoma/paralysis[9] Acute + + +
  • Not specific
  • Variable
  • Clear chest
  • Not required
Paradoxical vocal fold motion[10][11] Acute + + +
  • Clear chest
  • CT and color flow doppler to rule out other diseases[13]
Laryngeal stenosis[15] Acute, Chronic + + + +
  • Not specific
  • FV loop variable
  • Clear chest
Laryngocele[17][18][19][20][21] Chronic + +
  • Not specific
  • Normal function
  • Clear chest
Etiology on the basis of anatomy Diseases Clinical manifestations Diagnosis Other features
Symptoms Physical exam Labs Pulmonary function testing Imaging
Onset Cough Dyspnea Fever Slurred speech Cyanosis Auscultation Chest imaging Other Gold standard
Extrathoracic upper airway diseases Epiglottitis (supraglottitis)[22][23][24][25][26] Acute + + +
  • Normal function
  • Clear chest
  • Tripod posture
  • Drooling
  • Tenderness of the anterior part of the neck
Goiter[27][28][29][30][31][32][33][34] Chronic + +
  • Airflow limitation of the volume loop depending on the size and localization[35]
Postnasal drip syndrome[38][39][40] Acute + +
  • Increase of IgE
  • Positive intradermic test[41]
  • Clear chest
  • Sinus CT may be helpful
  • Clinical diagnosis
Relapsing polychondritis [42][43][44][45][46][47][48] Acute + + +
  • Variable flow volume loop
  • Tracheal narrowing
  • Cartilaginous calcification, bronchial wall thickness, and tracheal narrowing is observed on CT 
  • MRI can distinguish fibrosis from inflammation 

Mc Adam criteria:[47]

  • Involvement of cartilage of ears, ribs, nose, and eyes
Retropharyngeal abscess[50][51][52] Subacute + + +
  • Normal function
  • Neck CT or presence of pus during the surgical procedure[54]
Tonsillar hypertrophy[55] Acute, chronic + + hyponasal speech
  • Not specific
  • Flow loop shows inspiratory slowing
  • Clear chest
  • Not required
  • More in children and adolescents
Tumor of pharynx/larynx/upper trachea[57][58] Chronic + +
  • Not specific
  • Flow loop shows inspiratory slowing
  • Not required
  • CT provide information about the grade of invasion
  • MRI can make a difference between tumors in the mucosa or bone marrow[59]
Etiology on the basis of anatomy Diseases Clinical manifestations Diagnosis Other features
Symptoms Physical exam Labs Pulmonary function testing Imaging
Onset Cough Dyspnea Fever Slurred speech Cyanosis Auscultation Chest imaging Other Gold standard
Central airway diseases

(Intrathoracic upper airway obstruction)

Mediastinal mass/lymphadenopathy[60][61] Chronic + + +
  • Size, location, and density of the mass can be observed
  • In chest CT, location, size, tissue characteristic, and relationship with other structures of the mass is observed
  • Information of posterior mediastinal mass can be provided in chest or spine MRI [63]
Respiratory papillomatosis[64][65] Chronic + + +
  • Not specific
  • Not specific
Tracheobronchomalacia[67] Chronic + +
  • Not specifc
  • Airway compression from other structures
Tracheal stenosis[70][71][72][73] Acute + +
  • Not specific
  • FV loop variable
  • Extension of the narrowing observed in CT or MRI
  • Long segment stenosis incompatible with survival[75]
Tracheal and bronchial tumors[76][77][78] Chronic + +
  • Not specific
  • FV loop variable
Vascular ring or aneurysm[80][81][82][83][84][85] Chronic + +
  • Not required
  • Usually asymptomatic
  • Chest or abdominal pain appears when other structures are compressed
Etiology on the basis of anatomy Diseases Clinical manifestations Diagnosis Other features
Symptoms Physical exam Labs Pulmonary function testing Imaging
Onset Cough Dyspnea Fever Slurred speech Cyanosis Auscultation Chest imaging Other Gold standard
Lower airway obstruction Bronchiectasis[87][88] Chronic + +
  • Tram lines or end–on ring shadows in chest CT [90]
Bronchiolitis[91][92][93][94][95] Acute + + + + For bacterial infection in neonates:
  • Hyperinflation
  • Mosaic attenuation
  • Increased bronchial wall[96]
  • Clinical diagnosis
Carcinoid syndrome[97][98][99] Chronic +
  • Not specific
  • Liver metastases are visualized in MRI
Heart failure[102][103] Chronic + +
  • Not required
  • Clinical diagnosis (test are supportive)
Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) [107] Chronic + +
  • Not specific
  • Mosaic pattern and nodules observed in chest CT
  • Single neuroendocrine cell and/ or linear proliferation of the cells that involves bronchial epithelium
Etiology on the basis of anatomy Diseases Clinical manifestations Diagnosis Other features
Symptoms Physical exam Labs Pulmonary function testing Imaging
Onset Cough Dyspnea Fever Slurred speech Cyanosis Auscultation Chest imaging Other Gold standard
Lower airway obstruction Noncardiogenic pulmonary edema[108][109][110] Acute + + +
  • Bilateral alveolar infiltration
  • Bilateral opacities in CT

According to Berlin definition:[111]

  • One week of new or worse respiratory symptoms or clinical insult
  • Symptoms can not be explain by cardiac disease
  • Bilateral opacities in chest X–Ray or CT
  • Compromised oxygenation
  • High altitute pulmonary edema (HAPE)
  • Neurogenic pulmonary edema
Parasitic infection with VLM (eg, Ascaris, Strongyloides, filaria)[112][113][114][115] Acute + + +
  • Not specific
  • Bilateral peribronchial infiltration
  • Parenchymal infiltration
  • Subpleural nodules, ground–glass opacities observed on chest CT [117]
  • Larve on biopsy
Pulmonary thromboembolism [118][119] Acute, subacute, Chronic + +
  • Not required
Reactive airways dysfunction syndrome[123][124][125][126] Acute + +
  • Normal or hyperinflation
  • CT to rule out other diseases
Clinical diagnosis:
  • History of exposure
  • Acute onset with sympotoms in 24h
  • Airway obstruction > 3 months[124]
  • Burning sensation in the throat
  • Chest pain
  • High dose of inhalation of the irritant

References

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