Presenting today the leading case of the next webinar. PA radiograph of a 58-year-old woman with cough and fever.
What do you see?
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Findings: PA chest radiograph shows an ill-defined opacity behind the right hemidiaphragm (A, red arrows), better seen in the cone-down view (B, red arrows). The fact that the opacity is visible indicates that it is surrounded by air, placing it in the right lower lobe.
A lateral view confirms air-space disease in the RLL (C, circle), blurring the posterior aspect of the right hemidiaphragm.
Final diagnosis: RLL pneumonia
Congratulations to archanareddyt who was the first to see the opacity and to MK who saw it and suggested the right diagnosis.
Teaching point: Remember that in the PA view the lower lobes go deep behind the diaphragm. Pulmonary disease of any kind can be seen in the upper quadrants of the abdomen, as demonstrated by the present case.
Remember to check the webinar published on the EBR youtube channel!
5 thoughts on “Dr. Pepe’s Diploma Casebook 150 – All you need to know to interpret a chest radiograph – Fourth Session”
Good morning professor
Chest PA view –
Prominent aortic knuckle with mild deviation of trachea to right side.
Correlation to lateral chest view needed.
The patient is 58 y.o. and a mild prominence of the aortic knob is normal at this age. Try again 🙂
There is a partly well defined nodule in the right lower zone. it is seen through the hepatic shadow
The right hilum is lower than the left one. There is an incrased opacity proyected over the right diaphragm and with the symptoms of the patient I think about alveolar infection associated with lost of volume.
….è’ ispessita la linea para tracheale dx…