Lung Collapse
Lung collapse is an important finding in a chest X-ray. Being able to identify different types of lung collapse is a key clinical skill.
Example 1
Take a look at the following example. Let us go through how we would systematically analyse this and the diagnosis.
Analysis and Diagnosis
D – This is a Chest X-Ray taken on ….., of the following patient….. Is there a previous CXR to compare to
R – Commenting first on the quality, it is not rotated, there is adequate inspiration, the projection is posterior-anterior and it is adequately exposed as I can see the vertebral bodies clearly
“On initial inspection, there appears to be increased opacification in the right upper zone, but I will proceed to go through it systematically.”
A – Starting with the airways, the trachea is not deviated, and the carina is visible.
B – The pleural markings go all the way to the costal margin so there is no evidence of a pneumothorax. Going through the lung zones, there is increased opacification in the right upper lobe. The opacification is in a regular shape and displays the “S” sign which is suggestive of right upper lobe collapse.
C – The heart is not enlarged. There is loss of the silhoueete sign in the right border of the heart.
D – The hemidiaphragms are clearly visible. The right hemidiaphragm is higher than the left. There is no blunting of the costophrenic angles. There is no free air under the diaphragm.
E – There are no foreign objects or bone fractures.
There is no abnormality in the review areas, including the apices, behind the lung
In summary the key finding is right upper lobe collapse with pulling up of the right hemidiaphragm.
Diagnosis
Right upper lobe collapse
Example 2
Diagnosis
Left Lower Lobe Collapse
Example 3
Diagnosis
Left Upper Lobe Collapse
Example 4
Diagnosis
Right middle lobe collapse
Check out the following pages to see more examples of common pathologies seen on Chest X-Ray.
Sources
Image 1: http://www.wikiradiography.net/page/File:O2ZWd9HKVfas1Jyj3Ft1lw94915.jpeg#metadata
Image 2: http://www.wikiradiography.net/page/File:ZcMMgKzW4LGIPNtF4rNlhA117018.jpeg
Image 3:http://www.wikiradiography.net/page/File:JoR0HHw_mGRetPDiiKSskw285323.jpeg
Image 4:http://www.wikiradiography.net/page/File:UiCctJ-kuS_H8_fexKCGEQ245236.jpeg
Image 5: http://www.wikiradiography.net/page/File:P1PjjIn6aGLNWaGwOfcYvQ102249.jpeg
Disclaimer
The intended purpose of this website is to be used as a resource for revision for exams. It should not be used as a guideline or reference for clinical practice/decision making or by patients looking for medical information or advice. In2Med takes no responsibility for any loss or damaged resulting from the use of information from this website.
