Common Radiological Abnormalities in Diseases of the Respiratory System
Consolidation, collapse, fibrosis, pleural effusion, pneumothorax, cavities and Opacities in the lungs are all common radiological abnormalities. What are their significance?
Consolidation
The presence of homogenous opacities with well defined margins indicates pulmonary consolidation, since there is no change in the volume of the lung the trachea and mediastinum are not shifted.
Collapse
Pulmonary collapse throws a homogenous opacity with clear-cut concave margins. The trachea, mediastinum, and interlobar fissure are shifted towards the area of collapse. The dome of the diaphragm on the affected side is elevated. The unaffected portions of the lung show hyper-translucency due to compensatory emphysema.
Fibrosis
Presence of streaky linear or reticular shadows with shift of trachea and mediastinum to the same side and compensatory emphysema of the unaffected regions is suggestive of fibrosis.
Pleural effusion
The presence of small quantities of fluid (less than 300ml) in the pleura causes only obliteration of the costophrenic angle. As the quantity of fluid increases, more extensive homogenous opacity appears with obliteration of the costophrenic and cardiophrenic angles. The upper margin tends to be concave with its higher level towards the axilla and the lower level towards the mediastinum. Midline structures are shifted to the opposite side. The presence of fluid and air (hydropneumothorax) is diagnosed by the presence of a horizontal level of fluid below, with hypertranslucency (due to air) above. The lung markings are not visible since the lung is collapsed towards the helium.
Consolidation
The presence of homogenous opacities with well defined margins indicates pulmonary consolidation, since there is no change in the volume of the lung the trachea and mediastinum are not shifted.
Collapse
Pulmonary collapse throws a homogenous opacity with clear-cut concave margins. The trachea, mediastinum, and interlobar fissure are shifted towards the area of collapse. The dome of the diaphragm on the affected side is elevated. The unaffected portions of the lung show hyper-translucency due to compensatory emphysema.
Fibrosis
Presence of streaky linear or reticular shadows with shift of trachea and mediastinum to the same side and compensatory emphysema of the unaffected regions is suggestive of fibrosis.
Pleural effusion
The presence of small quantities of fluid (less than 300ml) in the pleura causes only obliteration of the costophrenic angle. As the quantity of fluid increases, more extensive homogenous opacity appears with obliteration of the costophrenic and cardiophrenic angles. The upper margin tends to be concave with its higher level towards the axilla and the lower level towards the mediastinum. Midline structures are shifted to the opposite side. The presence of fluid and air (hydropneumothorax) is diagnosed by the presence of a horizontal level of fluid below, with hypertranslucency (due to air) above. The lung markings are not visible since the lung is collapsed towards the helium.
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