Radiology Cases
Save
Terms in this set (74)
, 1. Tracheal deviation to the
right (moderate) with a lateral
shift of the right mediastinal
border. Not necessarily
widening.
- Clear pleural effusion evident
by the dense opacification on
the left hand side with
meniscus sign
Exudative: Bi or uni lateral
Cause: Lymphatic dysfunction
or increased pleural capillary
permeability
- Infection (parapneumonic
effusion i.e abscess or
pneumonia)
1. Describe the Xray - Cancer
2. Discuss what can cause - Trauma (hemothorax,
this appearance chylothorax)
3. What further - Collagen vascular disease
investigation should be (RA, SLE)
done in relation to the
Xray finding Transudative: Mainly bilateral
4. How is it treated Cause: Capillary hydrostatic
and oncotic pressure issues
- CHF
- Nephrotic syndrome
- PE, dialysis
3. Ratio of protein and LDH to
the serum value, using lights
criteria to give transudate or
exudate.
- Protein: Pleural/serum of >0.5
- LDH: Pleural/serum of >0.6
- Pleural LDH >2/3 of the upper
limit of normal serum LDH
, 4. Thoracentesis, Tx underlying
cause and consider indwelling
pleural catheter
Hx: Progressive shortness of breath which becomes
worse as the effusion grows
- Pleuritic chest pain
1. What would you expect Px: Tracheal deviation on exam of neck
on Px and Hx for a - Reduced lower lobe expansion both in general
pleural effusion like the inspection and on lower lobe comparison
one above - Decreased tactile fremitus and dullness of
percussion
- Decreased breath sounds and vocal fremitus
locally
- Pleural friction rub on auscultation
1. Obvious large pleural
effusion with white out of the
left hemithorax
- Meniscus sign clear
- Tracheal deviation TOWARDS
the side of the lesion which
indicates it is most likely being
pulled (there are no obvious
1. Describe this X-ray
forces that would be pushing
2. How is it similar and
the trachea)
dis-similar to the one
- In the case it is being pulled
prior
there has probably been a lung
collapse which is greater in
volume then the pleural
effusion
A drain can be seen and some
other artefacts, most likely
ECG ports
, 1. Tracheal deviation to the
right (minor). Most likely being
pulled.
- Flattening of the left
hemidiaphragm and
hyperinflation (potential
emphysema and COPD)
- Loss of the medical aspect of
the right hemidiaphragm
- Clear costophrenic angles
1. Describe this X-ray
bilaterally
- Possible increased modularity
2. What needs to be
around the hilum bilateral
investigated when you
IMP: Volume loss in the
see this process
distribution of the lower third
occurring
of the right lung at the
- How would it be
cardiophrenic border
investigated
IMP: Esp. if history of a smoker,
could indicate lower lobe
collapse which is often
secondary to malignancy
Inves: Bronchoscopy indicated
which in this case showed RLL
collapse and malignant
process
Save
Terms in this set (74)
, 1. Tracheal deviation to the
right (moderate) with a lateral
shift of the right mediastinal
border. Not necessarily
widening.
- Clear pleural effusion evident
by the dense opacification on
the left hand side with
meniscus sign
Exudative: Bi or uni lateral
Cause: Lymphatic dysfunction
or increased pleural capillary
permeability
- Infection (parapneumonic
effusion i.e abscess or
pneumonia)
1. Describe the Xray - Cancer
2. Discuss what can cause - Trauma (hemothorax,
this appearance chylothorax)
3. What further - Collagen vascular disease
investigation should be (RA, SLE)
done in relation to the
Xray finding Transudative: Mainly bilateral
4. How is it treated Cause: Capillary hydrostatic
and oncotic pressure issues
- CHF
- Nephrotic syndrome
- PE, dialysis
3. Ratio of protein and LDH to
the serum value, using lights
criteria to give transudate or
exudate.
- Protein: Pleural/serum of >0.5
- LDH: Pleural/serum of >0.6
- Pleural LDH >2/3 of the upper
limit of normal serum LDH
, 4. Thoracentesis, Tx underlying
cause and consider indwelling
pleural catheter
Hx: Progressive shortness of breath which becomes
worse as the effusion grows
- Pleuritic chest pain
1. What would you expect Px: Tracheal deviation on exam of neck
on Px and Hx for a - Reduced lower lobe expansion both in general
pleural effusion like the inspection and on lower lobe comparison
one above - Decreased tactile fremitus and dullness of
percussion
- Decreased breath sounds and vocal fremitus
locally
- Pleural friction rub on auscultation
1. Obvious large pleural
effusion with white out of the
left hemithorax
- Meniscus sign clear
- Tracheal deviation TOWARDS
the side of the lesion which
indicates it is most likely being
pulled (there are no obvious
1. Describe this X-ray
forces that would be pushing
2. How is it similar and
the trachea)
dis-similar to the one
- In the case it is being pulled
prior
there has probably been a lung
collapse which is greater in
volume then the pleural
effusion
A drain can be seen and some
other artefacts, most likely
ECG ports
, 1. Tracheal deviation to the
right (minor). Most likely being
pulled.
- Flattening of the left
hemidiaphragm and
hyperinflation (potential
emphysema and COPD)
- Loss of the medical aspect of
the right hemidiaphragm
- Clear costophrenic angles
1. Describe this X-ray
bilaterally
- Possible increased modularity
2. What needs to be
around the hilum bilateral
investigated when you
IMP: Volume loss in the
see this process
distribution of the lower third
occurring
of the right lung at the
- How would it be
cardiophrenic border
investigated
IMP: Esp. if history of a smoker,
could indicate lower lobe
collapse which is often
secondary to malignancy
Inves: Bronchoscopy indicated
which in this case showed RLL
collapse and malignant
process
