Emergency & Trauma – Page 2

Case 23

Emergency & Trauma, Infectious/Inflammatory / Age <30, Asthma, Peribronchial Cuffing, Portable, Reactive Airway Disease

This is a radiograph demonstrates peribronchial cuffing, which is increased density around the bronchioles when viewed end-on. This may represent thickening of the wall itself or fluid around the wall due to lymphatic congestion. The finding is nonspecific and can be seen in pulmonary edema, infectious and inflammatory bronchiolitis, and reactive airway disease. This particular case was a toddler with a previous diagnosis of asthma who presented to the emergency department with an acute asthma exacerbation.

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Case 18

Emergency & Trauma, Infectious/Inflammatory / Age <30, Aspiration, Clavicle, Consolidation, Endotracheal Tube, Enteric Tube, Esophageal Temperature Probe, Fracture, Portable

This radiograph shows hazy consolidation in the right lung base, with more subtle left lower lobe consolidation projecting over the heart. There is a displaced left mid-clavicular fracture. Lines and tubes include an endotracheal tube, an enteric tube, and an esophageal temperature probe which are all appropriately positioned. The distribution is typical for aspiration, with or without infection. Contusion is also a consideration in a trauma patient. In this case, the EMS report included witnessed aspiration which makes it the most likely etiology.

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Case 17

Emergency & Trauma, Infectious/Inflammatory / Age 31-60, Consolidation, Infection, Parapneumonic Effusion, Pleural Effusion, Pneumonia

This radiograph shows poorly defined peribronchovascular opacities in the left lung with an associated moderate pleural effusion. In this patient with a cough and leukocytosis, this appearance is consistent with pneumonia with parapneumonic effusion.

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Case 12

Emergency & Trauma / Age 31-60, Nodule, Pneumomediastinum

This radiograph demonstrates pneumomediastinum in the form of streaky lucencies at the base of the neck. A benign calcified granuloma is noted in the left lower lung field. The study is otherwise unremarkable.

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Case 5

Emergency & Trauma / Age <30, Pneumothorax

This radiograph shows a left pneumothorax without evidence of tension physiology. This was a spontaneous pneumothorax in a young patient, unknown etiology.

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