CXR Case 022
A 76 year old man presents with worsening breathlessness over 3-4 weeks.
AP CXR 
CT Chest
click images to enlarge
Describe and interpret this CXR and CT chest
CXR and CT chest INTERPRETATION
CXR Interpretation:
There is a small right pleural effusion.
There is loss of the left hemidiaphragm and left heart border with diffuse increased opacification in the left lower zone.
CT Interpretation:
CT chest demonstrates a moderate pericardial effusion with associated peripheral atelectasis.
CLINICAL CORRELATION
At first glance the appreances on the plain PA CXR could be mis-interpretted as a pleural effusion.
*This gentleman is breathless due to a pericardial effusion and worsening heart failure.*
CLINICAL PEARLS
This case highlights the near-mandatory need for further confirmatory imaging prior to attempting aspiration of a (non-existent) pleural effusion.
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 | ICIS Course ANZ