PLEURAL EFFUSION

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PLEURAL EFFUSION
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Right pleural effusion blunting the right
costophrenic angle extending posteriorly with
some fluid tracking into the major fissure seen
on the lateral exam.
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Upright
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The difference in an effusion on an upright film
and on a supine film with the typical veil type
density layering on the supine film and the
upright film showing findings more suspicious for
an elevated hemidiaphragm due to subpulmonic
collection of fluid.
Supine
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Small amount of fluid tracking laterally in the
right hemithorax.
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Larger effusion with some fluid tracking into the
minor fissure.
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Fluid tracking into the major fissure on the left
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Large pleural effusion collecting laterally along
the right lateral chest wall with extension into
the minor fissure.
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Films show large pleural effusion and its change
with decubitus position with the fluid layering
dependently note the beads in the left marker
change position to indicate the position of the
patient.
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Decubitus
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Decubitus
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Large subpulmonic effusion colleting under the
inferior aspect of the left lower lobe notice
the apparent distance between the gastric bubble
and the lung this is the subpulmonic fluid.
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Notice how large the effusion is with the
decubitus position.
Decubitus
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Normal right costophrenic angle.
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Supine
Upright
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Subpulmonic effusion collecting on the right.
Note change in the effusion with supine
positioning.
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Lateral
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Opacified hemithorax with mediastinal shift.
Notice only one hemidiaphragm is visualized on
lateral.
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Patient with a pneumonectomy notice the
opacified chest with shift of the mediastinum
towards the side of increased density. This is
the distinguishing feature of the shift of the
mediastinum towards or away from the opacifying
thorax.
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Pneumothorax and pleural fluid (hydropneumothorax)
note the straight air fluid level inferiorly in
the right costophrenic angle and the elongated
air fluid level on the lateral view.
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Films show an empyema in the left costophrenic
angle notice the convex margin with the air
fluid level. Compare that with the
hydropneumothorax with a small amount of air in
the pleural space collecting superiorly.
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Films shows a pleural pseudo tumor due to
loculated fluid tracking in the major fissure on
the PA and lateral.
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The CT Scan shows the loculated fluid simulating
a mass.
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Films show rounded density representing a rounded
atelectasis in the right base with some pleural
fluid as well. The effusion allows for
atelectasis of the lung due to some compression
of the effusion.
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On the CT scan this can be seen as atelectatic
lung. This is another pseudotumor where the
rounded density simulates a mass.
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Soft tissue window
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Bone window
Films shows density laterally in the left hemi
thorax on PA view representing loculated pleural
fluid collecting along the left lateral chest
wall seen on soft tissue and lung windows.
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LT.
LT.
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Films show loculated effusion collecting on the
PA and lateral with vague hazy density over the
right hilar region and pleural fluid laterally.
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The loculated fluid seen on the previous film is
best demonstrated on this CT scan.
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