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The fourth pattern includes abnormalities that result in decreased lung attenuation or air-filled lesions.
These include:
- Emphysema
-
These include: - Emphysema ... - Lung cysts (LAM ... Radiology #Pulmonary #CTChest ... TractionBronchiectasis #Cysts #Emphysema ... #SignetRing #RadiologyAssistant
Low Attenuation pattern 
1. Lymphangiomyomatosis (LAM): uniform cysts in woman of child-bearing age; no history of
effusion; sometimes pneumothorax ... Centrilobular emphysema ... low attenuation areas ... Radiology #HRCT #CTChest ... Comparison #Table #RadiologyAssistant
Paraseptal emphysema is localized near fissures and pleura and is frequently associated with bullae formation (area
Paraseptal emphysema ... formation (area of emphysema ... to spontaneous pneumothorax ... compression of adjacent lung ... #Paraseptal #Emphysema
Radiographic Features of Pulmonary Diseases
 - Pneumonia
 - Atelectasis
 - Emphysema
 - Pneumothorax
 - Effusion
 -
Atelectasis - Emphysema ... - Pneumothorax ... Reticular - Emphysema ... Radiology #Patterns #Lung
Empyema Necessitans (EN) on Chest POCUS

Pulmonary teaching case: you are called to the bedside of a
Empyema Necessitans ... (EN) on Chest POCUS ... This is Empyema ... Because Empyema ... @nickmmark #Empyema
Subcutaneous Emphysema vs Pneumothorax on POCUS
Don't mistake for PTX -> Find ribs to confirm pleural line
Subcutaneous Emphysema ... vs Pneumothorax ... on POCUS Don't ... #Subcutaneous #Emphysema ... comparison #ultrasound #lung
On the left a typical case of panlobular emphysema.
There is uniform destruction of the underlying architecture
of panlobular emphysema ... Panlobular emphysema ... severe panlobular emphysema ... severe panlobular emphysema ... #Panlobular #Emphysema
Low Attenuation pattern (2) 
1. Centrilobular emphysema: low attenuation areas without walls. Notice the centrilobular artery
Centrilobular emphysema ... low attenuation areas ... Radiology #HRCT #CTChest ... Comparison #Table #RadiologyAssistant
Palpable Skin Crepitus on Physical Exam

Notice these air bubbles under the skin. An 86-year-old woman with
history of severe emphysema ... Subcutaneous emphysema ... any soft tissue emphysema ... with subcutaneous emphysema ... #Subcutaneous #Emphysema
Centrilobular emphysema due to smoking. The periphery of the lung is spared (blue arrows). Centrilobular artery
Centrilobular emphysema ... periphery of the lung ... Clinical #Radiology #CTChest ... Centrilobular #Emphysema ... CentrilobularEmphysema #RadiologyAssistant