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The lateral view is always
with the left chest against
casette so to diminish
affect of magnification of
heart. Right ribs are
always more posterior
The lingula (LUL) is in
contact with the left heart
border
If the vertebral bodies
appear more dense
(whiter) before you are at
the level of the
diaphragm, and part of
one of the diaphragms is
obscured (there is that
silhouette sign again),
then this is the "spine
sign"—a sign of a lower
lobe pneumonia
Spine sign:If vertebrae
appear more white on
lateral projection, there
may be consolidation in a
lower lobe (positive
"spine sign")
,"Silohette sign:R heart
border obscured by RML
consolidation
L heart border obscured
by lingual consolidation
Hemidiaphragms
obscured by lower lobe
consolidation
Lower descending aorta
obscured by LLL
consolidation
"
Air bronchograms are
when we see air-filled
bronchi within an area of
consolidation. Common
in pneumonia but is not
diagnostic as it can also
be seen in
adenocarcinoma and
lymphoma
"Follow-up Imaging in
Patients with Pneumonia
All patients > 40 years
History of recurrent
pneumonia
Current/former smokers
Patients whose symptoms
do not resolve
"
Airspace diseases- fluffly,
hazy indistinct margins
that tend to respect lobar
boundaries,
bronchograms. Types of
airspace diseases: pulm
edema, pna, pulm
hemorrhage, aspiration
, Interstitial/ infiltrative
lung dx:
nonhomogenous, does
not respect lobar
boundaries, reticular
nodular lines, usually no
air bronchograms.
Examples: cancer,
asbestos, sarcoid, CF
Nodular ILD: miliary TB,
hematogenous mets,
silicosis
Reticular: eosinophilic
granulomatosis,
idiopathic pulm fibrosis.
Honeycombing:
bronchiectasis
Ground glass" is a
radiology descriptive
term (used in both chest
radiographs and CT
imaging) to indicate that
blood vessels are not
obscured, as would be
the case in alveolar lung
opacities. Interstitial.
Atypical pna: PJP
ARDS: dense diffuse
bilateral ground glass
opacities. As the disease
progresses, however, a
more dense airspace
(alveolar) type of pattern
develops, which may
have air bronchograms.
The radiographs can
appear very similar to
pneumonia or cardiac
failure/fluid overload