Atelectasis chest x ray

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Atelectasis Microchapters

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Case #1

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

Overview

There are no x-ray findings associated with [disease name].

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

  • There are no x-ray findings associated with [disease name].

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]
    • [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]
    • [Complication 3]

CXR Chest radiograph Signs of lobar collapse may be visualised on CXR Direct signs: Displacement of fissures Opacification of the collapsed lung lobe Indirect signs: Hilar displacement Shifting of the mediastinum towards collapsed lung lobe Volume loss on ipsilateral 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: Opacification of the entire hemithorax due to complete collapse of a lung Ipsilateral shift of the mediastinum, that helps distinguish atelectasis from pleural effusion

Right upper lobe (RUL) collapse: Medial and superior shift of collapsed RUL 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.

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




References

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