The Chest X-Ray Database
The Chest X-Ray Database
Discussion This radiograph shows a right lower lobe pneumonia. A focal opacity with indistinct margins is seen in the right lung base. The opacity silhouettes the right hemidiaphragm but not the right heart border, which localizes it to the right lower lobe. Along with a corroborating clinical history, this appearance is consistent with a lobar […]
This radiograph demonstrates a right upper lobe consolidation most consistent with lobar pneumonia in this patient with a cough and elevated white count. The consolidation has poorly defined margins with the exception of the inferior margin, which is sharp and linear. This is due to the consolidation abutting the minor fissure. The position of the consolidation superior to the minor fissure definitively localizes it to the right upper lobe. Uncomplicated community acquired lobar pneumonia does not typically cross fissures. While malignancy is not entirely excluded, a mass would be unlikely to respect the fissural boundary without exerting mass effect.
The exam is otherwise unremarkable.
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.
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.