Medical Imaging: Pleural Pathology Flashcards
If there is fluid in the pleura, will it accumulate posteriorly or anteriorly first? Why?
- Posteriorly
- The costophrenic recess is deepest posteriorly
What is the costophrenic recess also called?
Costodiaphragmatic recess
What is a pleural pseudotumour?
Focal interlobar pleural effusion (enclosed)
What does a sponatenoues pneumothorax look like on CXR?
- Visceral pleural line
What does a tension pneumothorax look like on CXR?
- Flattened diaphragm
- Collapsed lung
- Mediastinal shift to contralateral side
- On expiration, becomes more apparent
What is hydropneumothorax?
Presence of air and fluid in the pleural space
What does the fluid layer look like on hydropneumothorax?
Solid, straight line
What is a meniscus in terms of fluid in a container (or lung…)
Curving water when it touches another material
Signs of free pleural fluid
- Meniscus
- Blunt costodiaphragmatic recess
- Fluid in fissures
List four signs of subpulmonic effusion
- High pseudo-diaphragm
- Increased distance between stomach bubble and lung base
- Pseudodiaphragm apex is more lateral than usual
- Pseudodiaphragm appears more horizontal
How to determine haemothorax on CXR
Same as pleural effusion, but history will suggest blood (e.g., stabbing, trauma etc.)
Haemothorax X raysa fter taken supine in the trauma setting. How does this affect appearance?
Blood “veils” whole lung after settling superiorly
What does loculated mean on CXR
Localised to a particular place; “stuck”
What does empyema look like on CXR?
- Typically loculated
- Does not shift with changing positoin
- May simulate focal lung disease
- Convex borders; obtuse angle with pleura
What does empyema look like on CT chest?
- Split pleura sign
- Both layers of pleura are visible, and there is a different-looking layer of pus between them
