Common X-Ray Findings Of Chest Disease.

 

chest

1. CHRONIC BRONCHITIS:

  • Acute bronchitis does not show any X-ray findings.
  • Chronic bronchitis of 3 consecutive months for more than 2 years may show:

           -Linear shadows become prominent.

           -Small ill defined opacities anywhere in lung.

           -Wide alteration in lung markings noted.

           -Emphysematous changes seen.

2.  BRONCHIECTASIS:

  • It is commonest in lower zones of lings.
  • In many X-ray we may not find anything conclusive.
  • There may be patchy consolidations.
  • In some cases dilated bronchi filled with mucus may be visualised.
  • In many cases the actual wall of bronchi may be visible as thin parallel lines raditing outwards
  • In some terminal dilatation may be seen giving honeycomb appearance.
  • Secondary pneumonia may be seen.
  • Mediastinal glands do not enlarge.

 

3.  PRIMARY CHILDHOOD TYPE OF TUBERCULOSIS:

  • Ghone focus is a pneumonic consolidation of few mm usually at periphery.
  • Lesion may undergo fibrosis and may calcify
  • Hilar lymph glands are enlarged.
  • It may produce pneumonia and consolidation.
  • It is single and homogeneous lesion.
  • Cavitation is rare.
  • Small pleural effusion may be noted.

 

4.  CHRONIC PULMONARY TUBERCULOSIS.

  • More common type is motting of individual shadow of 1-5 mm diameter.Shadows do not coalesce and remain discrete.
  • Less commonly there may be isolated large opacities roughly circular 1/2 to 2 cm in diameter.
  • Occasionally lesion may appear as areas of homogeneous consolidation.
  • Mediastinal glandular enlargement does not occur.
  • Lung destruction heals by fibrosis.Emphysema may also be present.
  • Cavity may appear when homogeneous area of consolidation breaks down.Cavity appears in acute phase and inner margin is rough and irregular.
  • Tuberculous lesion often cavitate and many of them calcify.Calcified foci are irregular in size and shape and are grouped in clusters.
  • Calcification of tuberculous focus always implies some degree of healing but in some cases viable bacilli may be recovered.

 

5.  MILIARY TUBERCULOSIS;

  • Lung fields are studded by innumerable dots of opacity,varying in size from pin head to 2-3 mm.
  • Normal lung marking tend to disappear.
  • Initially discrete may also coalesce into areas of patchy consolidation.
  • Mediastinal glands do not enlarge.
  • Lung do not become fibrotic or emphysematous.

 

6.  EMPHYSEMA.

  • Hypertranslucent lungs
  • Horizontal ribs.
  • Intercostal spaces are widened.
  • Pear shaped narrow heart.
  • Hilar shadows become prominent.
  • Diaphragms are lowered down.

 

7.  PRIMARY PNEUMONIA.

  • The outline of individual shadows of pneumonia are hazy and indistinct.
  • There is not much of loss of volume.
  • when area of consolidation is breaking down and forming an abscess,the volume is slightly increased.
  • Hilar glands are generally not enlarged.
  • Mostly primary pneumonies resolve completely and do not leave any residual fibrosis.it completes within 3 weeks.
  • Often accompained by pleural effusion.

 

8.  LUNG ABSCESS.

  • At first only a fluid level in consolidated lung is seen.
  • As consolidation clears,abscess may reveal a well defined 3 to 5 mm thick wall of cavity which later on becomes thin.
  • Amount of fluid varies from time to time.
  • Increased lung marking but no enlargement of hilar glands seen..

9.  HODGKIN`S DISEASE.

  • Parayracheal glands are more commonly involved than hilar glands.
  • Enlargement tends to be asymmetrical having no lobulation.
  • Pulmonary appearances are pleomorphic.
  • Pulmonary fibrosis is coarse linear type.

10.  METASTASIS.

  • Pleural metastasis—commonest is pleural effision specially in breast cancer.Less frequently pleural nodular metastasis is seen.
  • Ribs—expansion ,localised erosion or pathological fracture is obvious.
  • Mediastinal glands—tracheobronchial group is first to enlarge.
  • Lung prenchyma—Canon ball metastasis .

 

11.  HONEYCOMB LUNG.

  • Cystic bronchiectasis.
  • Cystic fibrosis.
  • Rheumatoid lung.
  • idiopathic interstitial fibrosis

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