Background

White-out hemithorax is an important radiological appearance because all three causes occur in unwell patients. These three causes are extensive pneumonia, collapse of the whole lung, and a massive pleural effusion.

They can be differentiated by clinical and radiological features, and by complex imaging.

Clinical features

See each separate chapter for clinical presentations:

Radiological features

The key to interpretation is the position of the mediastinum.

In pneumonia (Fig. 9.1), there is no loss of volume in the lung so the mediastinum and trachea remain central. The other clue in pneumonia is that the shadowing may be a little patchy and there may be air bronchograms.

Fig. 9.1 White-out of the right hemithorax caused by a right-sided pneumonia.

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