Classical serial images of pulmonary hemorrhage.

Not unreasonably at the height of the COVID pandemic, the first chest radiograph was thought to relate to COVID not least as at that time the patient had no hemoptysis and was in the community.

The imaging has no specific features to identify a cause.

A transbronchial biopsy was undertaken and the results were in keeping with idiopathic pulmonary hemosiderosis.

This is a rare diagnosis and doesn't have any specific imaging appearances.