Lung infarction Same patient. On follow up films first a cyst is seen. One year

Septic emboli On a follow up CXR only a small lungcyst is seen. #Clinical #Radiology #CXR #Lateral #Cyst #RadiologyAssistant

Lung infarction In pulmonar embolism it is not common to see consolidation. The consolidation is a result of lunginfarction and bleeding into the alveoli. In this case a lung cyst has formed in the infarcted area. Here we see an old chest film, which is normal. The pulmonary embolus has caused a triangular density on the chest film (arrow). On the CT we can see, that it is a segmental consolidation. #Clinical #Radiology #CXR #CTChest #LungInfarct #Infarct #PulmonaryEmbolism #RadiologyAssistant

Right ventricle enlargement First study the PA and lateral chest film and then continue reading. On these chest films the heart is extremely dilated. Notice that it is especially the right ventricle that is dilated. This is well seen on the lateral film (yellow arrow). There is a small aortic knob (blue arrow), while the pulmonary trunk and the right lower pulmonary artery are dilated. All these findings are probably the result of a left-to-right shunt with subsequent development of pulmonary hypertension. #Clinical #Radiology #CXR #RVEnlargement #RightVentricularEnlargement #RadiologyAssistant

On a normal lateral chest film the silhouette of the left diaphragm 2- can be seen from posterior up to where it is bordered by the heart, which has the same density (blue arrow). One should be able to follow the contour of the right diaphragm -1- from posterior all the way to anterior, because it is only bordered by the lung. Here we cannot follow the contour of the right diaphragm all the way to posterior, which indicates that there is something of water-density in the right lower lobe (red arrow). #Clinical #Radiology #CXR #Pneumonia #RLL #Lateral #SilhouetteSign #RadiologyAssistant

In this case there are calcifications that look like pericardial calcifications, but these are myocardial calcifications in an infarcted area of the left ventricle. Notice that they follow the contour of the left ventricle. #Clinical #Radiology #CXR #CTChest #Ventricular #MyocardialCalcifications #Myocardial #Calcifications #Infarct #RadiologyAssistant

Hemorrhage In this case there was a solitary nodule in the right upper lobe and a biopsy was performed. The lobar consolidation is the result of hemorrhage as a complication of the procedure. Hemorrhage is seen in: - Pulmonary contusion - Pulmonary infarction - Bleeding disorders: leukemia, anticoagulantion therapy, diffuse intravascular coagulation. - Vasculitis: SLE, Goodpasture's, Wegener's #Clinical #Radiology #CXR #Pulmonary #Hemorrhage #RadiologyAssistant

Congestive heart failure The findings are: - bilateral perihilar consolidation with air bronchograms and ill-defined borders - an increased heart size - subtle interstitial markings - probably a large vascular pedicle All these findings indicate, that we are dealing with pulmonary edema due to heart failure. You probably would like to look at old films to see if there are any changes. #Clinical #Radiology #CXR #CHF #RadiologyAssistant

Pericardial cyst Pericardial cysts are connected to the pericardium and usually contain clear fluid. The majority of pericardial cysts arise in the anterior cardiophrenic angle, more frequently on the rightside, but they can be seen as high as the pericardial recesses at the level of the proximal aorta and pulmonary arteries (11). Most patients are asymptomatic. On the chest x-ray it seems as if there is a elevated left hemidiaphragm. On CT however there is a cyst connected to the pericardium. #Clinical #Radiology #CXR #CTChest #PericardialCyst #Pericardial #Cyst #RadiologyAssistant

There is a right lower lobe atelectasis. Notice the abnormal right border of the heart. The right interlobar artery is not visible, because it is not surrounded by aerated lung but by the collapsed lower lobe, which is adjacent to the right atrium. On a follow-up chest film the atelectasis has resolved. We assume that the atelectasis was a result of post-traumatic poor ventilation with mucus plugging. Notice the reappearance of the right little finger (red arrow) and the normal right heart border (blue arrow). #Clinical #Radiology #CXR #Lateral #Atelectasis #RadiologyAssistant

Cavitation - Pneumonia In virulent pyogenic infections an abscess may form within the consolidated lung as a result of necrosis due to vasculitis and thrombosis. When some of the pus is coughed up, a cavity can be seen on the chest film. These patients are usually very ill. In granulomatous infection like TB, cavities may form, but these patients are usually not that ill. Cavitation is not seen in viral pneumonia, mycoplasma and rarely in streptococcus pneumoniae. These images are of a young patient with pneumonia. No micro-organism could be isolated. Within one month after treatment with antibiotics, there was almost complete resolution of the consolidation and the cavity. #Clinical #Radiology #CXR #CTChest #Cavity #Pneumonia #CavitaryPneumonia #RadiologyAssistant