Thoracic X-ray Signs

Question 1

Trachea deviation - either pushing or pulling

Answer 1

Pushing - Pleural effusion or tension pneumothorax

Pulling - Consolidation with lobar collapse

Question 2

Hilar Enlargement - Bilateral Symmetrical

Answer 2

Sarcoidosis

Question 3

Hilar Enlargement - Unilateral/ asymmetrical

Answer 3

Malignancy

Question 4

Increased airspace shadowing

Answer 4

Consolidation/malignant lesions

Question 5

Absence of lung markings within a segment of the lung field

Answer 5

Pneumothorax

Question 6

Pleural thickening

Answer 6

Hydrothorax, haemothorax, hydropneumothorax or potentially mesothelioma

Question 7

Heart occupying more than 50% of thoracic space (ie cardiothoracic ratio >0.5)

Answer 7

Cardiomegaly - valvular disease, cardiomyopathy, pericardial effusion

Question 8

Free gas under diaphragm - lifting it above the liver

Answer 8

Bowel perforation

Question 9

Loss of costophrenic angle

Answer 9

Fluid consolidation, hyperinflation (like in COPD)

Question 10

The “Sail Sign”

Answer 10

Left lower lobe collapse