Dynamic Chest Radiography Visualizes Characteristic Respiratory Motion Impairment in Idiopathic Pleuroparenchymal Fibroelastosis: A Case Report

ABSTRACT Idiopathic pleuroparenchymal fibroelastosis (iPPFE) is a rare interstitial lung disease characterized by upper lobe‐predominant pleural fibrosis and restrictive ventilatory impairment. However, methods for functional assessment of respiratory motion remain limited. We reported a 74‐year‐old woman who had severe restrictive impairment secondary to iPPFE, for which dynamic chest radiography (DCR) was used to evaluate respiratory mechanics. Quantitative DCR indices were compared with those of controls without pulmonary disease. DCR demonstrated markedly reduced diaphragmatic excursion, substantial decrease in respiratory lung area changes, and pronounced increase in low‐motion areas, indicating extensive regional motion restriction. These findings were consistent with impaired transmission of diaphragmatic motion due to pleural and subpleural fibrosis. This case illustrated that DCR can visualize and quantify characteristic respiratory motion abnormalities in iPPFE and may serve as a useful complementary modality to high‐resolution computed tomography and pulmonary function testing for functional assessment of iPPFE.