Let me give a try .There is increase opacity in RLL . Increased density mainly can be due to consolidation,interstitial, nodules/mass or atelectasis. In this case it is peripheral consolidation(consolidation at the pleural base in the lower lung) so it is most likely to be pulmonary infarctions . this patient presented with SOB and pleuritic chest pain and the cxr shows peripheral consolidation so we can dx as PE .Most CXRs in patients with a PE are normal. Signs that may be present in PE are Westermark's sign (oligemia in area of involvement), increased size of a hilum (caused by thrombus impaction), atelectasis with elevation of hemidiaphragm and linear or disk shaped densities, pleural effusion, consolidation, and Hampton's hump (rounded opacity).To confirm the diagnosis we should do lab test ( D-dimer ) and CT pulmonary angiography.
i m shooting in the dark here bro. 1) costophrenic angle on right side is blunted and is shown on the lateral xray too however left side seems to be fine. 2) increase opacity in middle of chest on frontal xray although heart borders can still be seen plus is confirmed on the lateral xray in the space just infront of ventricle. and a small triangular-ish opacity in rgiht lobe as well not far from right heart border. 3) in the later xray suggest increased opacity in upper lobes tht and frontal shows a small increased in opacity next to the bronchus on left which seems to be pushing it a bit (the hump along the spine there) so i m guessing its right middle and lower lobe with left upper lobe? plox?
Let me give a try .There is increase opacity in RLL . Increased density mainly can be due to consolidation,interstitial, nodules/mass or atelectasis. In this case it is peripheral consolidation(consolidation at the pleural base in the lower lung) so it is most likely to be pulmonary infarctions . this patient presented with SOB and pleuritic chest pain and the cxr shows peripheral consolidation so we can dx as PE .Most CXRs in patients with a PE are normal. Signs that may be present in PE are Westermark's sign (oligemia in area of involvement), increased size of a hilum (caused by thrombus impaction), atelectasis with elevation of hemidiaphragm and linear or disk shaped densities, pleural effusion, consolidation, and Hampton's hump (rounded opacity).To confirm the diagnosis we should do lab test ( D-dimer ) and CT pulmonary angiography.
ReplyDeletei m shooting in the dark here bro. 1) costophrenic angle on right side is blunted and is shown on the lateral xray too however left side seems to be fine. 2) increase opacity in middle of chest on frontal xray although heart borders can still be seen plus is confirmed on the lateral xray in the space just infront of ventricle. and a small triangular-ish opacity in rgiht lobe as well not far from right heart border. 3) in the later xray suggest increased opacity in upper lobes tht and frontal shows a small increased in opacity next to the bronchus on left which seems to be pushing it a bit (the hump along the spine there)
ReplyDeleteso i m guessing its right middle and lower lobe with left upper lobe? plox?