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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
Pleural effusion ... 70% of cases of CHF ... #Clinical #Radiology ... #CXR #CHF #Pleural ... #RadiologyAssistant
Congestive heart failure
The findings are:
 - bilateral perihilar consolidation with air bronchograms and ill-defined borders
 -
bronchograms and ill-defined ... like to look at old ... #Clinical #Radiology ... #CXR #CHF #RadiologyAssistant
On the left a patient with CHF. 
There is an increase in heart size compared to
a patient with CHF ... compared to the old ... #Clinical #Radiology ... #CXR #CHF #Exacerbation ... #Comparison #RadiologyAssistant
Stage I - Redistribution
In a normal chest film with the patient standing erect, the pulmonary vessels
In daily clinical ... comparison with old ... #Clinical #Radiology ... #CXR #CHF #Cephalization ... Redistribution #RadiologyAssistant
Notice that there are multiple densities in both lungs.
The larger ones are ill-defined and maybe there
larger ones are ill-defined ... dealing with the differential ... #Clinical #Radiology ... #CXR #Peripheral ... OrganizingPneumonia #BOOP #RadiologyAssistant
When a rib fracture heals, the callus formation may create a mass-like appearance (blue arrow).
Sometimes a
formation may create ... is necessary to differentiate ... #Clinical #Radiology ... #CXR #Old #RibFracture ... #Pseudotumor #RadiologyAssistant
HRCT findings in OP
- Bilateral peripheral consolidations, sharply demarcated.
- Consolidations may be migratory.
- Lesions may show
restricted to areas ... small pleural effusions ... #Clinical #Radiology ... Organizing #Pneumonia #ILD ... #RadiologyAssistant
Based on the CXR that you just saw, you could have made the diagnosis of congestive
Based on the CXR ... compared to the old ... #Clinical #Radiology ... #CXR #CHF #InterstitialEdema ... Interstitial #Edema #RadiologyAssistant
It is important to recognize Acute Decompensated Heart Failure (ADHF) as more than just simply a
just simply a clinical ... #diagnosis #differential ... #algorithm #management ... #cardiology #treatment ... #heartfailure #chf