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No shift of mediastinum to left Deep sulcus Atelectatic right lung Increased haziness on left: Diversion of entire cardiac output Small fluid level near costophrenic angle: Hydro pneumothorax
Pneumothorax Atelectatic lung is dense implying that it is abnormal ("normal lung" will not be dense) Bleb is easily recognized in the close-up below
Bleb is easily recognizable. Look for blebs along the margin of the atelectatic lung in pneumothorax. If present, you can detect blebs easily
Pneumothorax Air in pleural space Atelectatic lung Deep pleural sulcus Large left hemithorax
Spontaneous Pneumothorax Air in pleural space Lung margin "Normal lungs": Note the radiolucency of atelectatic lung is the same as the opposite lung
Spontaneous Pneumothorax Air in pleural space Lung margin Same radiolucency as right lung: "Normal Lungs" Bleb along upper margin of lung in close up below
Necrotizing Pneumonia / Lung Abscess / Aspiration Superior segment RLL dense pneumonia
Progression / Cavity
The most common causes for round pneumonia are: Fungal Tuberculosis.The CXR on the left is from a patient with aspergillus pneumonia developed while on steroids.
Round Pneumonia
Heart Failure/Rapid Resolution Such rapid resolution as seen above is usually due to secondary cause such as fluid overload
Larger hemithorax
Pleural Effusion Massive Multiple Myeloma Plasmacytomas Unilateral homogenous density Mediastinal shift to right Left diaphragmatic and left heart silhouettes lost Left hemithorax larger Labeled and post tap films below
Pleural masses become evident after the fluid is removed and with some air. Pleural masses are not clearly evident except for the apical pleural mass.
Close up below.
Tuberculosis LUL cavity Cavity behind clavicle - note increased density of clavicle in the region over lying cavity Pleural effusion on right
Loculated Pleural Effusion Empyema Haziness of right hemithorax Density not corresponding to lobar anatomy Diaphragmatic and cardiac silhouettes intact Lateral film below Loculated fluid overlying vertebral column Loculated fluid overlying vertebral column