CXR Case 022

A 76 year old man presents with worsening breathlessness over 3-4 weeks.

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 |

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