Tension hydropneumothorax
• Air fluid level at
right costophrenic
angle
• Deeper right
costophrenic angle
as compared to the
left
• Contralateral shift
of mediastinum
ARDS
• Bilateral diffuse
fluffy infiltrates
• Normal cardiac
size
• Tracheostomy
tube
• Right
subclavian
central line
going inside the
right atrium
• ECG wires
Right lung collapse - PA view
• Ipsilateral shift of
mediastinum and trachea
• Bronchial cut-off sign
suggestive of
endobronchial
obstruction
• Rib crowding
• Loss of volume
• Obscured right
mediastinal and cardiac
outline
• Obscured right
hemidiaphragm
(silhouette sign)
• Compensatory
hyperinflation of left lung
• Prominent left pulmonary
artery (cardiac output
passing through single
artery)
Right lung collapse – lateral view
• Loss of gradually
increasing
transradiancy
down the spine
• Only one
hemidiaphragm is
visible (left)
• Suspicion of
mass in lower
lobe with lymph
node in
mediastinum
Left lung collapse
• Ipsilateral shift of
trachea, carina
and mediastinum
• Bronchial cut-off
sign (left
mainstem
bronchus)
• Rib crowding
• Loss of volume
• Compensatory
hyperinflation of
right lung
Collapse with airbronchogram
• Airbronchogram sign
– Produced as a
result of airspace
opacification of the
lung parenchyma
– This results in
visibility of the
normally invisible
black bronchi
against a
background of
white opacification
• Seen in
consolidation and
collapse with at least
some patency of the
bronchus
Left upper lobe collapse – PA view
• Loss of volume on left
side
• Ipsilateral shift of
trachea and
mediastinum
• Compensatory
hyperinflation of left
lung
• Raised left
hemidiaphragm
(compare with right)
with tenting
• Haziness over the aortic
knuckle (silhouette sign)
Left upper lobe collapse –
Lateral view
• Oblique fissure
displaced
anteriorly
• Opacification
anterior to the
oblique fissure
Right upper lobe collapse - PA view
• Loss of volume
on right side
• Opacification
of right upper
lobe
• Transverse
fissure raised
• Right hilum is
also raised
Right upper lobe collapse –
lateral view
• Oblique fissure
displaced anteriorly
• Transverse fissure
pulled upwards
• Opacification with
loss of volume of
right upper lobe
Left lower lobe collapse – PA view
• Loss of volume on left side
• Ipsilateral shift of the heart
• Both hila are at the same
level (left hilum has come
down)
• Double opacity behind the
heart
• Outline of left
hemidiaphragm is
obscured (silhouette sign)
• Left hemidiaphragm is
raised (watch the gastric
bubble)
Left lower lobe collapse – Lateral
view
• Loss of gradually
increasing
transradiancy
down the spine
• One
hemidiaphragm is
clearly visible
• Oblique fissure is
displaced
posteriorly
Miliary shadowing
• Multiple small
millet sized
nodules
throughout both
lung fields
Mediastinal mass with left lower
lobe collapse
• Mediastinal widening
in upper part
mediastinum
• Loss of volume on
left side
• Double opacity
behind the heart
• Left hemidiaphragm
not visible
• Heart shifted to the
left side
Aspergilloma
• Fungus ball
with
surrounding
rim of air
Mesothelioma
• Left sided
pleural effusion
• Associated
lobulated
pleural
thickening
• No shift of
mediastinum
due to
encasement by
mesothelioma
Pleural based mass
• Cat under the
rug appearance
indicative of
pleural based
origin
• Angle between
chest wall and
opacity is
obtuse (>90o)
Sarcoidosis
• Bilateral hilar
lymphadenopathy
• Right paratracheal
strip enlargement
• Bilateral infiltrates
involving
predominantly the
mid zones
Pneumothorax
• Left sided apical
pneumothorax
• Visceral pleural
line is clearly
visible
– There should be
no lung markings
distal to the
visceral pleural
line
Effusion with collapse
• Complete opacification of
right hemithorax without
significant contralateral
shift of mediastinum
• Absence of shift is
indicative of concomitant
collapse
• Usually a sign of
malignancy