Atelectasis chest x ray: Difference between revisions

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{{CMG}}; {{AE}}  
{{CMG}}; {{AE}}  
==Overview==
==Overview==
There are no x-ray findings associated with [disease name].
An x-ray may be helpful in the diagnosis of atelectasis. Findings on an x-ray suggestive of atelectasis include [[displacement]] of [[Fissure|fissures]], [[rib]] crowding, elevation of ipsilateral [[Thoracic diaphragm|diaphragm]], volume loss on ipsilateral hemithorax, [[Hilum|hilar]] displacement and compensatory hyperlucency of the remaining lobes. Complete lung atelectasis and atelectasis involving different parts of the lung have their own characteristic appearance. While complete atelectasis of the lung may lead to opacification of the entire hemithorax and ipsilateral shift of the [[mediastinum]], a right midle and lower lobe atelectasis may show [[Pleural effusions|subpulmonic effusions]] along with right [[Thoracic diaphragm|hemidiaphragmatic]] elevation on X-ray.
 
OR
 
An x-ray may be helpful in the diagnosis of [disease name]. Findings on an x-ray suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
 
OR
 
There are no x-ray findings associated with [disease name]. However, an x-ray may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].


==X Ray==
==X Ray==
*An x-ray may be helpful in the diagnosis of atelectasis. Findings on an x-ray suggestive of atelectasis include:
**Signs of lobar collapse such as:
***[[Mediastinal|Shifting of the mediastinum]] towards the collapsed [[Lung|lung lobe]]
***[[Hilum|Hilar]] displacement
***Silhouetting of the [[Thoracic diaphragm|diaphragm]] or the heart border
***[[Rib]] crowding
***Compensatory hyperlucency of the remaining lobes
***Elevation of [[Diaphragm|ipsilateral diaphragm]]
***Opacification of the collapsed lung lobe
***Displacement of fissures
***Volume loss on ipsilateral hemithorax


*There are no x-ray findings associated with [disease name].
*X-ray findings in cases with complete atelectasis of the lung include:
OR
**Opacification of the entire hemithorax due to complete collapse of a lung
*An x-ray may be helpful in the diagnosis of [disease name]. Findings on an x-ray suggestive of/diagnostic of [disease name] include:
**Ipsilateral shift of the [[mediastinum]], that helps distinguish atelectasis from [[pleural effusion]]
**[Finding 1]
*X-ray findings suggestive of right upper lobe (RUL) collapse include:
**[Finding 2]
**Medial and superior shift of RUL
**[Finding 3]
**Sign of Golden S: Concave appearance of minor [[fissure]]
OR
**Right minor [[fissure]] elevation
*There are no x-ray findings associated with [disease name]. However, an x-ray may be helpful in the diagnosis of complications of [disease name], which include:
**Right [[Hilum|hilar]] elevation
**[Complication 1]
*X-ray appearance of right middle lobe collapse:
**[Complication 2]
**Traingular opacity
**[Complication 3]
*X-ray appearance of right lower lobe (RLL) collapse:
CXR
**Posterior and inferior shift of RLL due to collapse
Chest radiograph
**Superior triangle sign: Rightward shift of structures in the superior [[mediastinum]]
Signs of lobar collapse may be visualised on CXR
**Blurring of the right hemidiaphragm (posterior third)
Direct signs:
**Visibility of the major [[fissure]], which is usually not seen
Displacement of fissures
*X-ray appearance of a right midle and lower lobe atelectasis:
Opacification of the collapsed lung lobe
**[[Pleural effusion|Subpulmonic effusion]]
Indirect signs:
**Elevation of the right hemidiaphragm
Hilar displacement
*X-ray appearance of left upper lobe (LUL) collapse:
Shifting of the mediastinum towards collapsed lung lobe
**Atelectatic left upper lobe shifts anteriorly and superiorly
Volume loss on ipsilateral hemithorax
**PA view: Faint opacity of the atelectatic lobe in the left upper hemithorax
Elevation of ipsilateral diaphragm
Rib crowding
Compensatory hyperlucency of the remaining lobes
Silhouetting of the diaphragm or the heart border


Complete atelectasis of an entire lung:
* X-ray appearance of left lower lobe (LLL) collapse:
Opacification of the entire hemithorax due to complete collapse of a lung  Ipsilateral shift of the mediastinum, that helps distinguish atelectasis from pleural effusion
** Retrocardiac opacity  
 
** Downward displacement of the [[hilum]]
Right upper lobe (RUL) collapse:
** Aortic-knob sign: Obliteration of the [[aortic arch]] by the [[superior mediastinum]]
Medial and superior shift of collapsed RUL
** Lateral view: Indistinct appearance of the posterior third of the [[Thoracic diaphragm|diaphragm]] due to opacity
Right hilum elevation
Right minor fissure elevation
Sign of Golden S: Concave appearance of minor fissure
 
 
Right middle lobe (RML) collapse:
Appears as a triangular opacity
 
Right lower lobe (RLL) collapse:
Posterior and inferior shift of collapsed RLL
The major fissure, which normally is not visible, is seen
Superior triangle sign: shift of superior mediastinal structure to the right
Collapsed RLL blurs the posterior third of the right hemidiaphragm. Concomitant RML and RLL atelectasis:
Appears as an elevated right hemidiaphragm or a subpulmonic effusion
 
Left upper lobe (LUL) collapse:
Atelectatic LUL shifts anteriorly and superiorly
PA view: Atelectatic LUL produces a faint opacity in the left upper hemithorax
 
Left lower lobe (LLL) collapse:
Retrocardiac opacity  
Downward displacement of the hilum  
Aortic-knob sign: obliteration of the aortic arch by the superior mediastinum
Lateral radiographs
Opacity makes the posterior third of the left diaphragm indistinct
 
 
Rounded atelectasis:
Formation of fibrous bands which adhere the lung to the pleura in patients with asbestosis
Location: Lower lobes, lingula, or RML
Chest radiographs:
Subpleural mass
Comet-tail sign:  bronchovascular structures projecting out of the mass toward the hilum, in a swirl appearance 
parietal pleural plaque
 
 
 
Post-surgical atelectasis will be bibasal in pattern.


* X-ray appearance of rounded atelectasis:
** Subpleural mass 
** Location of rounded atelectasis: Right middle lobe, lower lobes or [[lingula]]
** Comet-tail sign: Bronchovascular structures projecting out of the mass toward the [[hilum]], in a swirl appearance 
** [[Pleural plaque|Parietal pleural plaque]]
* X-ray appearance of post-surgical atelectasis:
* Bibasal pattern
Images shown in this section are courtesy of RadsWiki and copylefted.
Images shown in this section are courtesy of RadsWiki and copylefted.


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Revision as of 14:15, 22 February 2018

Atelectasis Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

An x-ray may be helpful in the diagnosis of atelectasis. Findings on an x-ray suggestive of atelectasis include displacement of fissures, rib crowding, elevation of ipsilateral diaphragm, volume loss on ipsilateral hemithorax, hilar displacement and compensatory hyperlucency of the remaining lobes. Complete lung atelectasis and atelectasis involving different parts of the lung have their own characteristic appearance. While complete atelectasis of the lung may lead to opacification of the entire hemithorax and ipsilateral shift of the mediastinum, a right midle and lower lobe atelectasis may show subpulmonic effusions along with right hemidiaphragmatic elevation on X-ray.

X Ray

  • An x-ray may be helpful in the diagnosis of atelectasis. Findings on an x-ray suggestive of atelectasis include:
  • X-ray findings in cases with complete atelectasis of the lung include:
    • Opacification of the entire hemithorax due to complete collapse of a lung
    • Ipsilateral shift of the mediastinum, that helps distinguish atelectasis from pleural effusion
  • X-ray findings suggestive of right upper lobe (RUL) collapse include:
    • Medial and superior shift of RUL
    • Sign of Golden S: Concave appearance of minor fissure
    • Right minor fissure elevation
    • Right hilar elevation
  • X-ray appearance of right middle lobe collapse:
    • Traingular opacity
  • X-ray appearance of right lower lobe (RLL) collapse:
    • Posterior and inferior shift of RLL due to collapse
    • Superior triangle sign: Rightward shift of structures in the superior mediastinum
    • Blurring of the right hemidiaphragm (posterior third)
    • Visibility of the major fissure, which is usually not seen
  • X-ray appearance of a right midle and lower lobe atelectasis:
  • X-ray appearance of left upper lobe (LUL) collapse:
    • Atelectatic left upper lobe shifts anteriorly and superiorly
    • PA view: Faint opacity of the atelectatic lobe in the left upper hemithorax
  • X-ray appearance of left lower lobe (LLL) collapse:
  • X-ray appearance of rounded atelectasis:
    • Subpleural mass
    • Location of rounded atelectasis: Right middle lobe, lower lobes or lingula
    • Comet-tail sign: Bronchovascular structures projecting out of the mass toward the hilum, in a swirl appearance
    • Parietal pleural plaque
  • X-ray appearance of post-surgical atelectasis:
  • Bibasal pattern

Images shown in this section are courtesy of RadsWiki and copylefted.

  • Right lower lobe collapse

    Right lower lobe collapse

  • Right lower lobe collapse. The same patient. Lateral view.

    Right lower lobe collapse. The same patient. Lateral view.

  • Left upper lobe collapse

    Left upper lobe collapse

  • Left upper lobe collapse

    Left upper lobe collapse

  • Left lower lobe collapse

    Left lower lobe collapse

  • S Sign of the Golden

    S Sign of the Golden

  • S Sign of the Golden

    S Sign of the Golden

References

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