CXR Case 043

An 85 year old lady presents with worsening dyspnoea and chronic cough

CXR CASE 043 CXR LITFL

Describe and interpret this CXR

CHEST X-RAY INTERPRETATION

There is bilateral apical pleural calcification, more pronounced on the right.
There is additional right upper lobe fibrosis and traction causing the right hilum to be elevated, mediastinal shift and volume loss on the right side.


CLINICAL CORRELATION

This lady has old Right upper lobe (RUL) and pleural TB.

She will likely have chronic airways limitation due from the architectural distortion.


CLINICAL PEARLS

Bilateral apical pleural calcification like this is highly likely old TB.

Unilateral apical calcification is most likely TB, although previous haemothorax or empyema are other causes.
Asbestos related pleural plaque does not affect the apicies.


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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