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By Agustí A., Silvestri G.A., Albert R.K.

ISBN-10: 0323048250

ISBN-13: 9780323048255

A necessary instrument for all physicians who deal with sufferers with respiration illness

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Example text

For example, ascertaining whether the patient is well, acutely or chronically unwell, of normal immune status, or immunocompromised can dramatically narrow a wide radiologic differential diagnosis. A FIGURE 1-59 Multiple pulmonary nodules. A, The multiple pulmonary nodules are smoothly defined and vary in size; some are cavitating (arrowheads). B, Subsequent chest radiograph obtained shortly afterward. The left perihilar nodules are no longer visible because they lie within the now collapsed left upper lobe.

Because the horizontal fissure tends to be more mobile, it usually shows greater displacement. On the frontal radiograph, middle lobe collapse may be subtle because the horizontal fissure may not be visible, and increased opacity does not become apparent until collapse is almost complete. Critical analysis of the radiograph sometimes reveals obscuration of the right heart border as the only clue. The lordotic AP projection is rarely required but may be used to bring the displaced fissure into the line of the X-ray beam and occasionally may elegantly demonstrate middle lobe collapse.

Of abnormality suggested by the chest radiograph. The summation of multiple, small, linear opacities on the chest radiograph may produce the appearance of multiple small nodules. Likewise, the superimposition of multiple small nodules may produce a granular or ground-glass pattern. A variety of descriptive terms are used in the analysis of a chest radiograph in this context, and frequently appearances are classified as being either interstitial or airspace. However, a number of processes are capable of producing both patterns, so that the differential diagnosis may be erroneously narrowed at an early stage of analysis.

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Clinical Respiratory Medicine by Agustí A., Silvestri G.A., Albert R.K.

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