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The Chest X-Ray-The Systematic Teaching Atlas 2

(BQ) Part 2 book "The chest X-ray - A systematic teaching atlas" presents the following contents: Patchy lung changes, focal opacities, linear and reticular opacities, foreign bodies, thoracic trauma, intensive care unit. | Chapter 6 105 Matthias Hofer Patchy Lung Changes Chapter Goals When analyzing patchy changes in the radiographic density of the lung the first step is to differentiate between opacities areas of increased density which appear lighter and hyperlucent areas areas of increased lucency which appear darker . After working through this chapter you should be able to distinguish physiological lung opacities from pathological opacities list the differential diagnoses for a unilateral white lung distinguish atelectasis airless lung from a massive effusion or hemothorax describe adjunctive methods for the investigation of patchy opacities recognize typical forms of atelectasis involving specific lobes and segments explain how radiographic parameters can influence opacities and lucent areas in the lung detect a pneumothorax or impending tension pneumothorax at an early stage correctly classify emphysematous changes. Opacities Pleural Effusion p.106 Crescent Sign p.107 DD of Pleural Effusion p.108 DD of White Lung p.110 Upper Lobe Atelectasis p.111 Middle Lobe Atelectasis p.112 Lower Lobe Atelectasis p.113 Segmental Atelectasis p.114 DD of Segmental Atelectasis p.115 Pneumonia p.116 Misdirected Intubation and Tumors P-117 Hyperlucent Areas General DD Emphysema p.118 Tension Pneumothorax p.120 Quiz - Test Yourself p.121 106 Patchy Lung Changes 6 Pleural Effusion Pleural effusions may occur in the setting of heart failure renal disease tumors and inflammatory processes. Even large pleural effusions usually leave some residual ventilation at the apex I in Figs. 106.1a 106.2 before they become so extensive Fig. 106.1b that they create a fully established white lung Fig. 106.1c . These films illustrate a malignant effusion in a patient with bronchial carcinoma BC . Fig. 106.1b Fig. 106.1a Fig. 106.1c Radiographs typically show a slight mediastinal shift toward the contralateral side as in Figure 106.2. If the effusion is accompanied by compression atelectasis however the volume of .