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No vascular markings on right

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 No vascular markings on right


No vascular markings on right Shift of mediastinum to left Deep sulcus Atelectatic right lung Increased haziness on left: Diversion of entire cardiac output Note that the size of hemi thorax becomes equal after insertion of chest tube

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

Atelectatic lung is dense, indicating that it is abnormal

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

Pneumothorax Subpulmonic accumulation Atelectatic lung dense, indicating abnormality

Necrotizing Pneumonia / Lung Abscess / Aspiration Superior segment RLL dense pneumonia

Progression / Cavity

Round Pneumonia Round density Shorter doubling time Air bronchogram

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

This is a case of blastomycosis.

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.

Tuberculosis RUL cavity Posterior segment

Close up below.

Tuberculosis LUL cavity Cavity behind clavicle - note increased density of clavicle in the region over lying cavity Pleural effusion on right

Milary Tuberculosis Interstitial nodules Uniform size

Sharper edges Review the close up below.

Tuberculosis Left upper lobe cavity

Close up view below.

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