FastTrack Complete Report: Upper vs. Lower Respiratory Disease 

Table of Contents

1. Purpose & Use - Case type

2. X-RAY Signals to Be Assessed

A. Upper Respiratory Tract

B. Lower Respiratory Tract

C. Additional Findings including the thorax, abdomen and musculoskeletal regions

1. Purpose & Use Cases

This FastTrack Complete Report is designed to assist in determining whether a patient’s respiratory signs are primarily attributable to upper respiratory tract or upper airway disease (including the nasal passages, pharynx, larynx, and trachea) versus lower respiratory tract or lower airway disease (including lower airways, lung parenchyma and pleural space).

In addition, the report systematically screens for high-value radiographic findings such as masses, hernias, or other findings, which, although not always directly related to the respiratory system, are essential to recognize due to their potential impact on clinical outcomes and overall case management.

Scenarios when to use this FastTrack Complete Report:

• Patients presenting with respiratory signs of unclear origin, where distinction between upper and lower respiratory tract involvement is needed.
• Cases requiring additional imaging interpretation to determine whether the primary cause of clinical signs arises from the upper respiratory tract (e.g., nasal passages, pharynx, larynx, trachea) or the lower respiratory tract (e.g., bronchi, lungs).
• Patients exhibiting mixed or overlapping radiographic findings, such as concurrent pulmonary and airway pathology, where a detailed review is necessary to identify the predominant disease process and establish the primary differential diagnosis.

Clinical Signs Checklist (when submitting):

This clinical signs checklist is used to summarize key clinical signs relevant to the presenting concern. It serves as a quick reference tool for observed or reported clinical signs, ensuring that radiographic findings are interpreted within the appropriate clinical context.

The checklist typically includes the following categories:

Upper Respiratory Symptoms

• Nasal discharge: 
  • Bloody - characterized by the presence of fresh or clotted blood. May indicate trauma, neoplasia, fungal infection, coagulopathy, or severe inflammation. Often unilateral but can be bilateral in systemic or extensive disease.  
  • Serous -  Clear to watery nasal discharge, usually mild and transparent. Commonly associated with early or mild upper respiratory irritation, viral infections, or noninfectious inflammation (e.g., allergies).
  • Mucopurulent - Thick, yellow to green discharge reflecting the presence of an infection. Typically seen with chronic rhinitis, bacterial or fungal infections, or secondary infection following prolonged inflammation.
• Upper respiratory congestion: noisy and/or open mouth breathing
• Stertor:  low-pitched, snoring-like respiratory sound
• Stridor: high-pitched, harsh inspiratory sound
• Wheezing: continuous, high-pitched sounds
• Sneezing: forceful, reflexive expulsion of air through the nasal passages
• Reverse sneezing: repeated rapid inhalations through the nose, often producing a loud snorting or honking sound.

Lower Respiratory Symptoms

• Respiratory distress - Trouble breathing
• Coughing
  • Acute - Sudden in onset; less than 14 days
  • Chronic - Persistent cough lasting more than 14 days
• Hemoptysis - coughing up blood
• Abnormal lung sounds - audible sounds detected during thoracic auscultation that indicate disease of the airways, lung parenchyma, or pleural space 
  • Crackles - Air passing through fluid-filled or collapsed alveoli. Often due to pulmonary edema, pneumonia, pulmonary fibrosis, hemorrhage
  • Wheezing - Airflow through narrowed bronchi/bronchioles. Often due to asthma, chronic bronchitis, airway collapse
  • Increased (Harsh or Bronchovesicular) Sounds - Increased turbulence through inflamed or narrowed airways. Often due to chronic bronchitis, early pneumonia, mild pulmonary edema
  • Dull or Absent Lung Sounds - Lack of air movement or presence of pathology in the pleural space.
• Tachypnea - increased respiratory rate

2. X-RAY Signals to Be Assessed

The FastTrack Complete Report focuses on identifying key radiographic signals that are clinically relevant to the patient’s presenting signs and support timely, informed decision-making. The following radiographic features are systematically evaluated to detect abnormalities that may warrant immediate clinical attention, further diagnostic workup, or medical intervention.

A. Upper Respiratory Tract (Pharynx, Larynx, Trachea)

1. Redundant Tracheal Membrane
2. Tracheal Narrowing
3. Tracheal foreign body
4. Laryngeal Opacity
5. Pharyngeal Opacity
6. Pharynx Narrowing
7. Nasal cavity opacity

B. Lower Respiratory Tract (Lungs, Bronchi, Pleural Space)

6. Bronchial Pulmonary Pattern
7. Cranioventral Parenchymal Pattern
8. Caudodorsal Parenchymal Pattern
9. Diffuse Parenchymal Pattern
10. Thoracic Mass
11. Pleural Fluid
12. Pleural Gas

C. Additional Findings (Critical Radiographic Findings) based on submitted views.

Thorax

14. Left Atrial Enlargement
15. General Cardiomegaly
16. Diaphragmatic Hernia
17. Esophageal Foreign Body

Abdomen

16. Abdominal Mass Effect
17. Mid Abdominal Mass
18. Limited Abdominal Detail
19. Peritoneal gas
20. Gastric Foreign Body
21. Abdominal hernia

Musculoskeletal

22. Rib Fracture
23. Vertebral Fracture
24. Appendicular Fracture
25. Skull Fracture
26. Pelvic Fracture
27. Bone Lesions