Chest Wall, Pleura, And Diaphragm

Question 1

Write short notes on CT and MRI findings of soft tissue tumours.

Answer 1

Lipoma -well demarcated, homogenous. minus 90 to minus 150 HU. High T1, intermediate T2 and low fat suppression

Neurofibroma - lower density than muscle. Low to intermediate T1, high T2, and marked enhancement after gadolinium.

Hemangioma - phleboliths, bone remodeling. Intermediate T1 and high T2, hemorrhage.

Lymphangioma - fluid filled cyst, MRI cyst with low protein content.

Question 2

What are the radiology signs of a pectus excavatum?

Answer 2

Heart shift left, straightening of left heart border with prominence of main pulmonary artery segment, loss of descending aorta interface, increased opacity of right cardiophrenic angle

Question 3

What bilateral effusions can be exudative?

Answer 3

Mets, lymphoma, PE, RA, SLE, post cardiac injury, myxoedema

Question 4

Common causes of left or right effusions

Answer 4

Right - ascites, heart failure, liver abscess

Left - pancreatitis, pericarditis, oesophageal rupture, aortic dissection

Question 5

8 causes of opacified hemithorax.

Answer 5

Pleural effusion, collapse, consolidation, massive tumour, fibrothorax, pneumonectomy, lung agenesis, combination

Question 6

Causes of pneumoothorax

Answer 6

Spontaneous - primary
Spontaneous - secondary - airflow obstruction (asthma, COPD, CF), infection (cavitary pneumonia, TB, fungal, aids, pneumatocele), infarction, neoplasm, diffuse ( HX, LLM, FA), hereditary, endometriosis

Trauma- no iatrogenic - rupture trachea/osephagus, blunt chest trauma, penetrating
Trauma - iatrogenic - thoracotomy, perc biopsy, tracheostomy, CVP

Question 7

What are the 3 most common causes of fibrothorax?

Answer 7

Empyema, TB, haemorrhagic effusion

Question 8

Features of malignant Vs benign pleural thickening

Answer 8

Circumferential thickening, modularity, parietal thickening more than 1cm, mediastinal pleural involvement

Question 9

What are the causes of bilateral symmetrical elevation of diaphragm?

Answer 9

Supine, poor inspiration, obesity, pregnancy, abdominal distension, PF, lymphangitis, DLE, bilateral basal PE, pain after surgery, bilateral paralysis

Question 10

Causes of unilateral elevation of diaphragm?

Answer 10

Lateral decubitus, dorsal scoliosis, pulmonary hypoplasia, pulmonary collapse, phrenic nerve palsy, eventration, pneumonia/pleurisy, PE, rib fracture/ pain, subphrenic infection/mass

Question 11

Causes of focal bulge in diaphragm?

Answer 11

Partial eventration, hernia, tumour (pleural/diaphragm), focal diaphragmatic dysfunction/adhesions