Rawalpindi Medical college

3. Eurofighter

4. Tension hydropneumothorax
• Air fluid level at right
costophrenic angle
• Deeper right
costophrenic angle as
compared to the left
• Contralateral shift of
mediastinum
•

5. ARDS
• Bilateral diffuse
fluffy infiltrates
• Normal cardiac
size
• Tracheostomy
tube
• Right
subclavian
central line
going inside the
right atrium
• ECG wires

6. Right lung collapse - PA view
•
•
•
•
•
•
•
•
Ipsilateral shift of
mediastinum and trachea
Bronchial cut-off sign
suggestive of
endobronchial
obstruction
Rib crowding
Loss of volume
Obscured right
mediastinal and cardiac
outline
Obscured right
hemidiaphragm
(silhouette sign)
Compensatory
hyperinflation of left lung
Prominent left pulmonary
artery (cardiac output
passing through single
artery)

7. Right lung collapse – lateral view
• Loss of gradually
increasing
transradiancy
down the spine
• Only one
hemidiaphragm is
visible (left)
• Suspicion of
mass in lower
lobe with lymph
node in
mediastinum

8. Left lung collapse
• Ipsilateral shift of
trachea, carina
and mediastinum
• Bronchial cut-off
sign (left
mainstem
bronchus)
• Rib crowding
• Loss of volume
• Compensatory
hyperinflation of
right lung

9. Collapse with airbronchogram
•
Airbronchogram sign
– Produced as a
result of airspace
opacification of the
lung parenchyma
– This results in
visibility of the
normally invisible
black bronchi
against a
background of
white opacification
•
Seen in
consolidation and
collapse with at least
some patency of the
bronchus

10. Left upper lobe collapse – PA view
• Loss of volume on left
side
• Ipsilateral shift of
trachea and
mediastinum
• Compensatory
hyperinflation of left
lung
• Raised left
hemidiaphragm
(compare with right)
with tenting
• Haziness over the aortic
knuckle (silhouette
sign)

11. Left upper lobe collapse –
Lateral view
• Oblique fissure
displaced
anteriorly
• Opacification
anterior to the
oblique fissure

12. Right upper lobe collapse - PA view
• Loss of
volume on
right side
• Opacification
of right upper
lobe
• Transverse
fissure raised
• Right hilum is
also raised

13. Right upper lobe collapse –
lateral view
• Oblique fissure
displaced anteriorly
• Transverse fissure
pulled upwards
• Opacification with
loss of volume of
right upper lobe

14. Left lower lobe collapse – PA view
•
•
•
•
•
•
Loss of volume on left side
Ipsilateral shift of the heart
Both hila are at the same
level (left hilum has come
down)
Double opacity behind the
heart
Outline of left
hemidiaphragm is
obscured (silhouette sign)
Left hemidiaphragm is
raised (watch the gastric
bubble)

15. Left lower lobe collapse – Lateral
view
• Loss of gradually
increasing
transradiancy
down the spine
• One
hemidiaphragm is
clearly visible
• Oblique fissure is
displaced
posteriorly

16. Miliary shadowing
• Multiple small
millet sized
nodules
throughout both
lung fields

17. Mediastinal mass with left lower
lobe collapse
• Mediastinal widening
in upper part
mediastinum
• Loss of volume on
left side
• Double opacity
behind the heart
• Left hemidiaphragm
not visible
• Heart shifted to the
left side

18. Aspergilloma
• Fungus ball
with
surrounding
rim of air

19. Mesothelioma
• Left sided
pleural effusion
• Associated
lobulated
pleural
thickening
• No shift of
mediastinum
due to
encasement by
mesothelioma

20. Pleural based mass
• Cat under the
rug appearance
indicative of
pleural based
origin
• Angle between
chest wall and
opacity is obtuse
(>90o)

21. Sarcoidosis
• Bilateral hilar
lymphadenopathy
• Right paratracheal
strip enlargement
• Bilateral infiltrates
involving
predominantly the
mid zones

22. Rib erosion
• 3rd posterior rib
on the right side
• 2nd anterior rib
on the left side

23. Pneumothorax
• Left sided apical
pneumothorax
• Visceral pleural
line is clearly
visible
– There should be
no lung markings
distal to the
visceral pleural
line

24. Effusion with collapse
• Complete opacification of
right hemithorax without
significant contralateral
shift of mediastinum
• Absence of shift is
indicative of concomitant
collapse
• Usually a sign of
malignancy