20 Pleural effusion Fig. 20.1A This radiograph demonstrates a moderate right pleural effusion, with a meniscus at its upper aspect, and loss of the contour of the right hemidiaphragm. Background Pleural effusion refers to a collection of fluid in the pleural space. There are several causes: • Exudates (high protein) – causes include infection and malignancy. • Transudates (low protein) – causes include cardiac, renal and hepatic failure, pancreatitis, etc. • Empyema – pus in the pleural space – is a type of pleural effusion – (see Chapter 21). This is an important appearance to be aware of, as a pleural effusion can be a sign of underlying disease and may be responsible for patient symptoms such as shortness of breath. The presence of an effusion should prompt a search for an underlying cause. Radiological features Diagnosis is not always straightforward, as these cases illustrate. Fig. 20.2 This different patient has a small pleural effusion (arrow). The earliest sign of an effusion is blunting of the costophrenic angle. This does not necessarily mean that the effusion is small – 500 ml can collect beneath the hemidiaphragm on an erect film before anything is seen at all. The pleural space surrounds the lung and fluid sinks to the bottom. This may help in understanding the progression in appearances as the effusion gets bigger. This is an erect film. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related posts: Permanent pacemakers Gastric outlet obstruction Caecal volvulus Small bowel obstruction Brodie’s abscess Slipped upper femoral epiphysis Stay updated, free articles. Join our Telegram channel Join Tags: On-Call X-Rays Made Easy Aug 20, 2016 | Posted by admin in ULTRASONOGRAPHY | Comments Off on Pleural effusion Full access? Get Clinical Tree
20 Pleural effusion Fig. 20.1A This radiograph demonstrates a moderate right pleural effusion, with a meniscus at its upper aspect, and loss of the contour of the right hemidiaphragm. Background Pleural effusion refers to a collection of fluid in the pleural space. There are several causes: • Exudates (high protein) – causes include infection and malignancy. • Transudates (low protein) – causes include cardiac, renal and hepatic failure, pancreatitis, etc. • Empyema – pus in the pleural space – is a type of pleural effusion – (see Chapter 21). This is an important appearance to be aware of, as a pleural effusion can be a sign of underlying disease and may be responsible for patient symptoms such as shortness of breath. The presence of an effusion should prompt a search for an underlying cause. Radiological features Diagnosis is not always straightforward, as these cases illustrate. Fig. 20.2 This different patient has a small pleural effusion (arrow). The earliest sign of an effusion is blunting of the costophrenic angle. This does not necessarily mean that the effusion is small – 500 ml can collect beneath the hemidiaphragm on an erect film before anything is seen at all. The pleural space surrounds the lung and fluid sinks to the bottom. This may help in understanding the progression in appearances as the effusion gets bigger. This is an erect film. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related posts: Permanent pacemakers Gastric outlet obstruction Caecal volvulus Small bowel obstruction Brodie’s abscess Slipped upper femoral epiphysis Stay updated, free articles. Join our Telegram channel Join Tags: On-Call X-Rays Made Easy Aug 20, 2016 | Posted by admin in ULTRASONOGRAPHY | Comments Off on Pleural effusion Full access? Get Clinical Tree
