CXR Case 013

76 year old male presents with severe respiratory distress and is intubated

CXR CASE 013 LITFL

Describe and interpret this CXR

CHEST X-RAY INTERPRETATION

There is complete collapse of the right upper lobe
* Note the resultant elevation of the right horizontal fissure *
Patchy Left Upper Lobe (LUL) opacification suggestive of consolidation
*ETT and NG tube also present*


CLINICAL CORRELATION

This is a case of severe pneumonia *

Right upper lobe collapse has distinctive features, and is often easily identifiable on CXR.

Features include: increased density in the right upper lung field, elevation of both the right hilum and right horizontal fissure, and loss of the right cardiomediastinal contour.


CLINICAL PEARLS

A common cause of upper lobe collapse is a proximal tumour or mediastinal mass.

* An acute collapse normally correlates with a sudden worsening of symptoms, particularly breathlessness *

Consider malignancy in patients who present with weight loss, cough and/or haemoptysis


TOP 150 CXR SERIES



Prof Fraser Brims Curtin Medical School, acute and respiratory medicine specialist, immediate care in sport doc, ex-Royal Navy, academic| Top 100 CXR | Google Scholar |

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