When in a supine position, pleural effusion appears as a hazy opacity.
BRONCHOPNEUMONIA X RAY FINDINGS FREE
The fissural location of free fluid appears sharply marginated, biconvex and has a tail along the fissure. Then there is homogenous opacification of the lower chest.Īn empyema is radiologically indistinguishable from an effusion on a chest radiograph but should be suspected if pleural effusion is large, delayed in appearance, distributed unusually, or loculated. Later, there is blunting of posterior & lateral Costophrenic angles (200-500 ml of effusion). It collects first under the lower lobe - such subpulmonic effusions are detected by lateral decubitus Chest radiographs. Left lower lobe collapse: shows a retrocardiac triangular opacity.įigure 2: Right middle lobe collapse with minor effusionįigure 3: Right upper and lower left lobe collapseĪ small amount of free fluid is usually undetectable on chest radiographs. Hilar depression, hyperinflation of upper lobe are associated features. Lower lobe collapse: Triangular opacity in lower lobe with base on diaphragm. Lingular collapse: Left cardiac border is ill-defined. Right middle lobe collapse: Blurring of sharp right heart border & on lateral view, a triangular opacity with apex at hilum is seen. Adjacent mediastinal silhouette is effaced. Right upper lobe collapse: opacity in right upper lobe with minor fissure at cephalic position & its lateral aspect is higher than medial. Extralobar: hemidiaphragm elevation, mediastinal shift, hilar shift/distortion, compensatory hyperinflation, rib approximation.ĭifferent lobes of collapse show different features.Lobar: a shift of fissure, crowding of airways, increased opacity.The complete radiographic clearing is the rule in viral infection.Diffuse air trapping with hyperinflation & streaky densities radiating from hila is commonly seen with RSV infection.Pneumatoceles & classical bronchopneumonia pattern is suggestive of staphylococcal aureus.Hilar/mediastinal lymphadenopathy in conjunction with pulmonary consolidation suggests pulmonary tuberculosis, histoplasmosis, fungal infections.
Pneumonia & pleural fluid in a child less than one year indicate staphylococcal infection.Lobar or segmental consolidation & atelectasis are more typical of bacterial infection whereas hyperinflation, bilateral patchy/streaky densities, peribronchial thickening are suggestive of non-bacterial diseases.Though it is difficult to evaluate the organism causing pneumonia, some typical radiological features may suggest the likely etiology: Inflammatory involvement of airways leads to obstruction, atelectasis & occasionally pneumatoceleĪirways are patent so there is no volume lossĬommonly seen with streptococcal pneumoniaĬommonly seen with Staphylococcal aureus pneumonia Mainly involves distal airspaces & spares distal airwaysĪirways are affected by bronchiolitis. It is initially patchy and later distributed along the airways-thus it is segmental & non-homogenous. It is seen as uniform, homogenous, nonsegmental consolidation
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