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Pleural effusion is not always visible as a meniscus in the costophrenic angle. 
A subpulmonic effusion
Pleural effusion ... with signs of CHF ... #Clinical #Radiology ... #CXR #CHF #Pleural ... SubpulmonicEffusion #RadiologyAssistant
Pleural effusion is bilateral in 70% of cases of CHF.
When unilateral, it is slightly more often
70% of cases of CHF ... of > 75 ml can ... #Clinical #Radiology ... #CXR #CHF #Pleural ... #RadiologyAssistant
Cardiac incisura
Click image to enlarge.
On the right side of the chest the lung will lie against
pericardial fat or effusion ... finding, which can ... #Clinical #Radiology ... #CXR #Lateral # ... Cardiac #Incisura #RadiologyAssistant
Mucoid impaction
Mucus plugs or mucoid impaction can mimick the appearance of lung nodules or a mass.
Sometimes
cystic fibrosis (CF ... with asthma or CF ... #Clinical #Radiology ... #CXR #CTChest # ... Mucus #Plugging #RadiologyAssistant
Especially in patients who had recent cardiac surgery an enlargement of the heart figure can indicate
minimal pericardial effusion ... #Clinical #Radiology ... #CTS #CXR #PostSurgical ... #Pericardial #Effusion ... PericardialEffusion #RadiologyAssistant
Stage I - Redistribution
In a normal chest film with the patient standing erect, the pulmonary vessels
In daily clinical ... with old fims can ... #Clinical #Radiology ... #CXR #CHF #Cephalization ... Redistribution #RadiologyAssistant
Pleural fluid may become encysted.
Here we see fluid entrapped within the fissure.
This can sometimes give the
This can sometimes ... #Clinical #Radiology ... #CXR #Lateral # ... Effusion #Fissure ... #Pseudotumor #RadiologyAssistant
On the left a patient with CHF. 
There is an increase in heart size compared to
a patient with CHF ... There is an increase ... #Clinical #Radiology ... #CXR #CHF #Exacerbation ... #Comparison #RadiologyAssistant
Notice that there are multiple densities in both lungs.
The larger ones are ill-defined and maybe there
maybe there is an ... dealing with the differential ... #Clinical #Radiology ... #CXR #Peripheral ... OrganizingPneumonia #BOOP #RadiologyAssistant
It is important to recognize Acute Decompensated Heart Failure (ADHF) as more than just simply a
just simply a clinical ... correct profile can ... #diagnosis #differential ... algorithm #management #cardiology ... #heartfailure #chf