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With pleural effusion, fluid often builds up in the costophrenic angle (due to gravity). This can push the lung upwards, resulting in "blunting" of the costophrenic angle. The posterior angle is the deepest. Obtuse angulation is sign of disease. Chest x-ray is the first test done to confirm an excess of pleural fluid.
In radiology, the deep sulcus sign on a supine chest radiograph is an indirect indicator of a pneumothorax. [ 1 ] [ 2 ] In a supine film, it appears as a deep, lucent, ipsilateral costophrenic angle [ 3 ] within the nondependent portions of the pleural space as opposed to the apex (of the lung ) when the patient is upright.
The cardiophrenic angle is the angle between the heart and the diaphragm, as seen on imaging (most commonly X-ray).There are two cardiophrenic angles, however the one on the right is obscured by the cardiohepatic angle (the angle between the heart and liver).
A) Normal chest radiograph; B) Q fever pneumonia affecting the right lower and middle lobes. Note the loss of the normal radiographic silhouette (contour) between the affected lung and its right heart border as well as between the affected lung and its right diaphragm border. This phenomenon is called the silhouette sign: Differential diagnosis
Massive right sided pleural effusion later confirmed to be a hemothorax. Hemothorax, or accumulation of blood in the pleural space, can result from trauma or surgical procedures in the chest. This accumulation of blood can grow large enough to compress the lung and push away other structures in the chest, thus causing a mediastinal shift. [6]
Harrison's groove, also known as Harrison's sulcus, is a horizontal groove along the lower border of the thorax corresponding to the costal insertion of the diaphragm; it is usually caused by chronic asthma or obstructive respiratory disease.
They may be seen in any zone but are most frequently observed at the lung bases at the costophrenic angles on the PA radiograph, and in the substernal region on lateral radiographs. [3] Causes of Kerley B lines include pulmonary edema, lymphangitis carcinomatosa and malignant lymphoma, viral and mycoplasmal pneumonia, interstitial pulmonary ...
In effusions, the fluid layers out (by comparison to an up-right view, when it often accumulates in the costophrenic angles). Lordotic view – used to visualize the apex of the lung, to pick up abnormalities such as a Pancoast tumor. Expiratory view – helpful for the diagnosis of pneumothorax.