CXR Case 092

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.

This is a localized parapneumonic effusion.

(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.