Professional Documents
Culture Documents
Pleural Effusion X-Ray Findings: Jeetendra
Pleural Effusion X-Ray Findings: Jeetendra
findings
Jeetendra
Normal chest X-ray(PA view)
Index:
• a aorta;
• ca carina;
• cl clavicle;
• cpa costophrenic angle;
• g gastric air bubble;
• la left atrium;
• p main pulmonary artery;
• s scapula;
• t trachea.
Normal chest X-ray(PA view)
Index:
• Aaorta;
• Apw aortopulmonary window;
• Cap cardiophrenic angle;
• g gastric air bubble;
• ip interlobar (or descending)
pulmonary artery;
• L liver;
• lv left ventricle;
• rts right tracheal (or paratracheal)
stripe;
• sp spleen;
Normal chest X-ray(PA view)
Index
• A aorta
• Ajl anterior junction line
• Apw aortopulmonary window
• Ip interlobar (or descending)
pulmonary artery
• Pjl posterior junction line
Index:
• a aorta
Normal Chest X-ray (lateral view) • bi bronchus intermedius
• cpa costophrenic angle
• d diaphragm
• e esophagus
• ivc inferior vena cava
• lpa left pulmonary artery
• lul left upper lobe bronchus
• lv left ventricle
• m manubrium
• mf minor fissure
• MF major fissure
• rpa right pulmonary artery
• rul right upper lobe bronchus
• rv right ventricle
• st sternum
• svc superior vena cava
• t trachea
• v vertebral body
Introduction to pleural space
• Contain 2 layers i.e. Visceral and Parietal pleura
• Visceral pleura is outer lining of the lung
• Parietal pleura is lining of the chest cavity
• Normally, these surfaces are smooth and are separated by a minimal
amount of pleural fluid
• Provides nearly friction-free environment for movement of the lung
within the thorax
• Normally contains no more than 3 to 5 mL of pleural fluid
Reasons for accumulation of fluid
• Increase pulmonary capillary pressure (transudate)
• congestive heart failure
• hypoproteinemia
• fluid overload
• liver failure
• nephrosis
• Alter thoracic vascular or lymphatic pathways
• Alter pleural capillary or lymphatic permeability(Exudate)
• Infection or inflammation
• pulmonary embolism
• neoplasms
• Affect diaphragmatic peritoneal and pleural surfaces
• pancreatitis
• subphrenic abscesses
• liver abscesses
• ovarian tumors
• peritonitis
• ascites
Pleural effusion
• Most common radiographic sign is pleural meniscus
• Volume of fluid to produce pleural meniscus within costophrenic
angle varies in individual
Clinical findings
• Decreased breath sounds
• Dullness to percussion
• Decreased tactile fremitus
• Egophony
• Pleural friction rub
Pleural effusion(lateral view)
• Approx 100 mL of pleural fluid
will cause appreciable blunting of
the posterior costophrenic angle
on the lateral view
Pleural effusion(PA view)
• 200 mL will cause blunting of the
lateral costophrenic angle on the
PA projection in an upright
patient
Pleural effusion(lateral decubitus view)
• A lateral decubitus chest
radiograph, with the side
containing the pleural effusion
placed down (dependent),
demonstrate smaller amounts of
free-flowing pleural effusions
• 1 millimeter of thickness of
pleural fluid in the lateral
decubitus = approx 20 mL of
pleural fluid
Sub-pulmonic pleural effusions
• Sub-pulmonic pleural
effusions elevate the lung
base
• Mimics an elevated
diaphragmatic leaflet
• On the left side, a marked
separation (>2 cm) of the
lung from the stomach
bubble suggests a sub-
pulmonic effusion. Right Sub-pulmonic effusion
with elevated right hemi-
diaphargm
The Same thing.. Rt. Sub-pulmonic
effusion
The apex of the curvature at the lung base is shifted laterally,
and its slope slants sharply towards the lateral costophrenic
sulcus