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Typically, an area of white lung is seen on a standard X-ray. [5] Consolidated tissue is more radio-opaque than normally aerated lung parenchyma, so that it is clearly demonstrable in radiography and on CT scans. Consolidation is often a middle-to-late stage feature/complication in pulmonary infections.
A pleural effusion appears as an area of whiteness on a standard posteroanterior chest X-ray. [14] Normally, the space between the visceral pleura and the parietal pleura cannot be seen. A pleural effusion infiltrates the space between these layers. Because the pleural effusion has a density similar to water, it can be seen on radiographs.
Chest x-ray is the first test done to confirm an excess of pleural fluid. The lateral upright chest x-ray should be examined when a pleural effusion is suspected. In an upright x-ray, 75 mL of fluid blunts the posterior costophrenic angle. Blunting of the lateral costophrenic angle usually requires about 175 mL but may take as much as 500 mL.
Chest x-ray showing dense opacity pleural effusion in the lower left lung of primary pulmonary TB. 5. Hilar or mediastinal lymphadenopathy ( bihilar lymphadenopathy ) - Enlargement of lymph nodes in one or both hila or within the mediastinum, with or without associated atelectasis or consolidation.
Pleural effusion and empyema - Microorganisms from the lung may trigger fluid collection in the pleural cavity, or empyema. Pleural fluid, if present, should be collected with a needle and examined. Depending on the results, complete drainage of the fluid with a chest tube may be necessary to prevent proliferation of the infection.
Laterolateral chest radiographs can increase the diagnostic accuracy of lung consolidation and pleural effusion. [ 41 ] A CT scan can give additional information in indeterminate cases [ 42 ] and provide more details in those with an unclear chest radiograph (for example occult pneumonia in chronic obstructive pulmonary disease).
A subpulmonic effusion is excess fluid that collects at the base of the lung, in the space between the pleura and diaphragm. It is a type of pleural effusion in which the fluid collects in this particular space but can be "layered out" with decubitus chest radiographs.
Chest x-ray of infant showing CPAM in the left lung causing a mediastinal shift towards the right. The cysts appear as bubbles in the left lung. Congenital pulmonary airway malformation (CPAM) is a rare disease in which the lung airways develop abnormally in the fetus. This leads to infants having pockets of air and cystic masses in their lungs.