tailieunhanh - Ebook Chest X-ray in clinical practice: Part 2

(BQ) Part 2 the book "Chest X-ray in clinical practice" presents the following contents: The pleura, soft tissues and bony structures, foreign structures and other devices on chest X-rays, computed tomography - Technical information, computed tomography (CT) - Clinical indications. | Chapter 5 The Pleura Pleural Abnormalities Pleural abnormalities are a common finding on chest X-ray the significance of which varies from trivial to marked. In order to ensure that such abnormalities are not missed it is important that all check areas are examined on each chest X-ray. Some abnormalities of the pleura can be subtle and may be missed. Typical areas to identify pleural abnormalities are at the costophrenic and cardiophrenic angles the apices and the peripheral outline of both lungs. Three main categories of pleural abnormalities are seen effusions pleural thickening or calcification and pneumothoraces. These are dealt with separately in the following sections and in the first section we will consider pleural effusions. R. Joarder N. Crundwell eds. Chest X-Ray in Clinical Practice 113 Springer-Verlag London Limited 2009 Chapter 5a Pleural Effusions Pleural effusions are a common finding. Further investigation of a pleural effusion in addition to a detailed history and examination may include a pleural tap. This establishes whether the effusion is a result of an exudate or a transudate. This knowledge further helps elucidate the cause of the effusion Table . We will be limiting our discussion to the chest X-ray findings although clearly interpretation needs to be made within the clinical context of the patient. The typical findings of an effusion are opacity at the lung base with a meniscal appearance laterally at the costophrenic angle. If the effusion is small it may be difficult to be certain that the abnormality is not simply related to minor thickening of the pleura. Comparison with previous films can be very useful. If the abnormality is longstanding and unchanged thickening is more likely. If doubt persists examination with ultrasound is a very sensitive method of demonstrating fluid. A moderate effusion is usually easier to identify as a fluid level with again a laterally placed meniscus Fig. . It is also .