CXR Case 092

A 42 year old man is sent in for CXR by his GP. He has a 5 day history of worsening cough, aches and chills.

click images to enlarge


Describe and interpret this CXR

CHEST X-RAY INTERPRETATION

There is a rounded opacity projected over the right hilum with some slight increased airspace shadowing in the right middle lobe. Rounded artifact over the left 6th posterior rib.

Lateral X-Ray demonstrates loculated fluid within the horizontal fissure and inflammatory changes in the middle lobe.


CLINICAL CORRELATION

This is a localized parapneumonic effusion.


CLINICAL PEARLS

(Ignoring that this is nearly impossible to tap anyway) …small parapneumonic effusions do not necessarily need a tap – response to broad spectrum antibiotics and close vigilance to ensure the effusion does not get bigger is usually appropriate.


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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