Cough: diagnostic considerations with normal chest roentgenograms.

Cough is the second most frequent symptomatic reason given by patients visiting office-based physicians. The patient with cough and normal chest roentgenograms requires further evaluation in addition to a detailed history, careful general physical examination, meticulous otorhinolaryngology examination, and posterior-anterior and lateral chest roentgenograms. Additional studies may need to include bronchoscopy, paranasal sinus roentgenograms, pulmonary function tests (with possible inhalation challenge and exercise studies), biopsy of lung parenchyma, assessment for gastroesophageal reflux, esophogram, bronchography, echocardiography, and consideration of psychiatric factors.