This document discusses air space diseases, which are pathological processes that displace air from the alveoli. Air spaces can be filled with fluid, pus, blood or cells. Characteristics of air space disease include fluffy, cloudlike opacities that are confluent and have fuzzy margins. Common signs are air bronchograms and the silhouette sign. Different patterns include nodular, ground glass opacification and consolidation. The causes and differential diagnosis of each pattern are described based on location, time course and appearance.
Apparently a lengthy presentation actually very good for junior physicians as it covers all aspects of assessment, diagnosis and treatment of pleural effusion
Apparently a lengthy presentation actually very good for junior physicians as it covers all aspects of assessment, diagnosis and treatment of pleural effusion
Pulmonary Lobar Collapse: Essential Considerations 14 Dr. Muhammad Bin ZulfiqarDr. Muhammad Bin Zulfiqar
This presentation is from 15th chapter of Grainger and Allison--Diagnostic Radiology A TEXTBOOK OF MEDICAL IMAGING.
My aim behind all these presentation is to provide authentic images. As our all radiology revolve around images of diseases. We can put these ppts in our androids for study and references.
This presentation is almost a complete Pictoral view of Radiograph chest.
This presentation will help radiologist in daily reporting.
This presentation will help physicians, surgeons, anesthetist and almost all medical professionals in diagnosing commonly presenting cardiac diseases.
This will also help all in preparaing TOACS examination.
Pulmonary Lobar Collapse: Essential Considerations 14 Dr. Muhammad Bin ZulfiqarDr. Muhammad Bin Zulfiqar
This presentation is from 15th chapter of Grainger and Allison--Diagnostic Radiology A TEXTBOOK OF MEDICAL IMAGING.
My aim behind all these presentation is to provide authentic images. As our all radiology revolve around images of diseases. We can put these ppts in our androids for study and references.
This presentation is almost a complete Pictoral view of Radiograph chest.
This presentation will help radiologist in daily reporting.
This presentation will help physicians, surgeons, anesthetist and almost all medical professionals in diagnosing commonly presenting cardiac diseases.
This will also help all in preparaing TOACS examination.
evaluation of fetal anatomy in 1st trimester.pptxdypradio
EVALUATION OF FETAL ANATOMY IN FIRST TRIMESTER .
FETAL DEVELOPMENT IN FIRST YAER.
NORMAL ULTRASOUND FINDINGS IN THE FIRST TRIMESTER.Evaluation of fetal anatomy, including a detailed fetal cardiac examination, is possible in the late first trimester.
Many anatomic abnormalities can be detected in the first trimester, giving families time to make important decisions regarding pregnancy management and the opportunity for early termination of pregnancy to reduce maternal morbidity risks.Week 6: By the 6th week, the limb buds begin to differentiate into upper and lower limbs with large hand plates, which develop primordial digits. The lower extremities lag behind the upper limbs by approximately 4 to 5 days. The primordial ear develops and the eyes become obvious as the retina becomes pigmented. The fetal liver occupies the majority of the abdominal cavity at the 6th week. As the rapid growth of the intestines exceeds the growth of the abdominal cavity the physiologic herniation of the intestines into the umbilical cord occurs. Spontaneous twitching movements and reflex responses to touch begin to take place.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Ocular injury ppt Upendra pal optometrist upums saifai etawah
Air Space Diseases.pptx
1. AIR SPACE DISEASES
By:
Dr. NITIN WADHWANI
D.Y.PATIL MEDICAL COLLEGE,RESEARCH INSTITUTE
AND HOSPITAL KOLHAPUR.
2.
3. DEFINITION:
Any pathological process that displaces air from the alveoli will be depicted as airspace
opacification
WHAT FILLS THE AIRSPACES IN AIRSPACE DISEASE?
FLUID
PUS
BLOOD
CELLS
4. CHARACTERISTICS OF AIRSPACE DISEASE
• Produces opacities in the lung that can be described as fluffy, cloudlike, and
hazy.
• The opacities tend to be confluent, merging into one another.
• The margins of airspace disease are fuzzy and indistinct.
• Air bronchograms or the silhouette sign may be present.
5. Air bronchogram
• The visibility of air in the bronchus because of surrounding airspace disease is called an air
bronchogram.
• An air bronchogram is a sign of airspace disease.
• Bronchi are normally not visible because their walls are very thin, they contain air, and they are
surrounded by air.
• When something like fluid or soft tissue replaces the air normally surrounding the bronchus,
then the air inside of the bronchus becomes visible
6.
7. The silhouette sign
• The silhouette sign occurs when two objects of the same radiographic density (such as
water and soft tissue)touch each other so that the edge or margin between them
disappears.
• It will be impossible to tell where one object begins and the other ends.
10. • A nodular pattern as a sole manifestation of airspace disease is relatively uncommon.
• ‘Acinar nodules’ or ‘acinar rosettes’ has been used to describe the appearance of poorly defined
infiltrates on chest radiography and HRCT
• Bacterial infection or pulmonary haemorrhage
NODULAR PATTERN
11.
12. Ground-glass opacity (GGO) represents:
• Filling of the alveolar spaces with pus, edema, hemorrhage, inflammation or tumor cells.
• Thickening of the interstitium or alveolar walls below the spatial resolution of the HRCT as
seen in fibrosis.
• So ground-glass opacification may either be the result of air space disease (filling of the
alveoli) or interstitial lung disease (i.e. fibrosis).
• On plain radiography - hazy increased lung opacity with the margins of pulmonary vessels
may be indistinct
• on CT appears as a hazy increase in lung attenuation but without obscuration of bronchial and
vascular markings
13.
14.
15. The location of the abnormalities in ground glass pattern can be
helpful:
Upper zone predominance: Respiratory bronchiolitis, Pneumocystis pneumonia.
Lower zone predominance: UIP, NSIP, DIP.
Centrilobular distribution: Hypersensitivity pneumonitis, Respiratory bronchiolitis
16. Consolidation
• Increase in lung density on chest radiography or CT in which
the margins of vessels and airways are obscured
• An air bronchogram may be seen.
17. • Pathologic processes can result in air-space
consolidation:
1. Water (e.g., the various types of pulmonary edema)
2. Blood (e.g., pulmonary hemorrhage)
3. Pus (e.g., pneumonia)
4. Cells (e.g., pulmonary adenocarcinoma, lymphoma, eosinophilic
pneumonia, organizing
pneumonia [OP])
5. Other substances (e.g., lipoprotein in alveolar proteinosis, lipid in lipoid
pneumonia
19. Radiographic and CT Findings of Consolidation
• Homogeneous opacity obscuring vessels
• Air bronchograms
• Ill-defined or fluffy opacities
• “Air alveolograms”
• Patchy opacities
• “Acinar” or air-space nodules
• Preserved lung volume
• Extension to pleural surface
• “CT angiogram” sign
20. Homogeneous Opacity Obscuring Vessels
• With complete replacement of alveolar air, homogeneous
opacification of the lung results.
• Vessels within the consolidated lung are invisible
21.
22.
23.
24. Patterns of Consolidation
Diffuse or Extensive Consolidation
.
WATER (EDEMA)
• Hydrostatic (cardiogenic) pulmonary edema
Increased permeability (noncardiogenic)
pulmonary
• edema
BLOOD (HEMORRHAGE)
• Aspiration of blood
• Bleeding diathesis
• Collagen-vascular disease and immune comple
vasculitis
• Goodpasture's syndrome
• Idiopathic pulmonary hemosiderosis
• Trauma
• Vasculitis
OTHER SUBSTANCES
• Alveolar proteinosis
(lipoprotein)
• Lipoid pneumonia (lipid)
CELLS
• Neoplasm -Pulmonary adenocarcinoma
• Lymphoma and other lymphoproliferative
diseases
• Eosinophilic pneumonia or other eosinophilic
diseases
• Organizing pneumonia (OP)
• Idiopathic interstitial pneumonias
• Sarcoidosis
25. Perihilar “Bat-Wing” Consolidation
Shows central consolidation with sparing of the lung periphery
Pulmonary edema
This pattern also may be seen with:
• pulmonary hemorrhage
• pneumonias
(including bacteria and atypical pneumonias such as Pneumocystis jiroveci pneumonia
[PCP]
and viral pneumonia)
• inhalational lung injury.
26.
27. • Peripheral or subpleural consolidation is the opposite of a bat-wing pattern (i.e., a
reverse bat wing pattern).
• Consolidation is seen adjacent to the chest wall, with sparing of the perihilar
regions.
• It is classically associated with eosinophilic lung diseases, particularly
eosinophilic pneumonia but may also occur with OP, sarcoidosis, radiation
pneumonitis, lung contusion, or mucinous adenocarcinoma.
Peripheral or Subpleural Consolidation
31. Diffuse Air-space Nodules
This appearance is seen in patients with endobronchial spread
of infection such as :
• Tuberculosis (TB) or Mycobacterium avium complex (MAC) bacterial
• bronchopneumonia
• viral pneumonia (cytomegalovirus [CMV], measles)
• invasive mucinous adenocarcinoma with endobronchial spread
• pulmonary hemorrhage
• aspiration.
34. Differential Diagnosis of Focal Consolidation
Water (Edema)
• Edema in a patient with Pulmonary artery obstruction
(e.g., pulmonary embolism)
• Pulmonary vein occlusion
• Atelectasis with drowned lung
CELLS
• Neoplasm
• Pulmonary adenocarcinoma
• Lymphoma and other lymphoproliferative diseases
• Eosinophilic pneumonia or other eosinophilic
diseases
• Organizing pneumonia (OP)
• Sarcoidosis
PUS (PNEUMONIA)
• Bacterial
• Tuberculosis or nontuberculous mycobacterial
• Fungal
• Virus (uncommon)
• Pneumocystis (uncommon)
• Aspiration pneumonia
• Atelectasis with postobstructive pneumonia
Blood (hemorrhage)
• Contusion
• Infarction
• Aspiration of blood
• Vasculitis
35. Lobar Consolidation
• Consolidation involving a single (or more than one) lobe is most typical of pneumonia
(including Streptococcus pneumoniae, Klebsiella , Legionella, and TB) and
abnormalities associated with bronchial obstruction.
• Consolidation can be localized to one or more lobes if its relationship to a specific fissure or fissures is
apparent on either frontal or lateral radiographs, or on CT.
36.
37.
38. Segmental (or Subsegmental) Consolidation
• Segmental (or subsegmental) consolidation may be diagnosed if a wedge-shaped opacity of more than a
few centimeters in size is visible with the apex of the wedge pointing toward the hilum
• This finding suggests an abnormality related to a segmental (or subsegmental) bronchus or artery
such as bronchial obstruction due to mucus or tumor,bronchopneumonia, focal aspiration, or pulmonary
embolism with infarction.
39.
40. Differential Diagnosis of Consolidation Based on Time
Course
Rapidly Appearing Consolidation or Consolidation with Acute Symptoms
• atelectasis with drowned lung,
• aspiration,
• pulmonary edema,
• pulmonary hemorrhage,
• pulmonary embolism with infarction,
• or rapidly progressing pneumonia,
particularly in an immunocompromised host
. Of these, only pulmonary edema and drowned lung may clear quickly.
41. Long-standing Consolidation or Consolidation with Chronic
Symptoms
Long-standing (chronic) consolidation (4 to 6 weeks or longer) suggests
• eosinophilic pneumonia,
• organizing pneumonia
• mucinous adenocarcinoma
• lymphoma
• lipoid pneumonia
• indolent pneumonias caused by fungal organisms.
Recurrent processes (e.g., recurrent pulmonary edema, pulmonary hemorrhage, or aspiration)
may appear to be chronic if radiographs are obtained only during the acute episodes.
The air spaces are defined as the air containing part of the lung which includes the respiratory but not the terminal bronchioles. The latter are the last purely conducting airways of the bronchial tree and the region of lung subtended by a terminal bronchiole is the acinus.6
left upper lobe with fluffy, indistinct margins (red arrow) containing air bronchograms (white arrows). This was found to be a staphylococcal pneumonia.
n, Right Middle Lobe Mass. On the frontal image, there is a large mass in the right lower lung field. We note it is "silhouetting" the right heart border (red arrow) which is no longer seen as a distinct edge. It is not silhouetting the right hemidiaphragm (black arrow). The mass is therefore (1) touching the right heart border and is anterior and (2) the mass is soft tissue or fluid density. The lateral view shows the mass (M) is in the right middle lobe. It was a large bronchogenic carcinoma.
n, Right Middle Lobe Mass. On the frontal image, there is a large mass in the right lower lung field. We note it is "silhouetting" the right heart border (red arrow) which is no longer seen as a distinct edge. It is not silhouetting the right hemidiaphragm (black arrow). The mass is therefore (1) touching the right heart border and is anterior and (2) the mass is soft tissue or fluid density. The lateral view shows the mass (M) is in the right middle lobe. It was a large bronchogenic carcinoma.
represent the range of radiological abnormalities.
image of the right lung showing numerous ill-defined nodules in a patient with disseminated pulmonary tuberculosis.
Ground-glass opacification on CT in an immunocompromised patient with Pneumocystis jiroveci infection.
This radiological pattern occurs when air in the air spaces is replaced by any pathological process (e.g. inflammatory cells, blood or tumour). In some patients, a characteristic perilobular distribution (giving the spurious impression of thickened interlobular septa) may be seen
In general, the differential diagnosis is based on a consideration of what may be replacing alveolar air:
One of the principal limitations of imaging studies is that a multitude of pathological processes in the air spaces manifest in only a limited number of ways: thus, for most airspace diseases, a modular pattern, ground-glass opacification and consolidation represent the range of radiological abnormalities.
Right lung consolidation due to pulmonary edema. Air bronchograms
are visible bilaterally within the consolidated lung, and pulmonary vessels are obscured.
Enhanced CT in a patient with right middle and lower lobe pneumonia shows homogeneous
consolidation, preserved lung volume, air bronchograms (black arrows), and opacified
vessels (white arrows), appearing denser than surrounding consolidated lung (i.e., the “CT
angiogram” sign).Preserved Lung Volume
In the presence of consolidation, because alveolar air is replaced by something else the volume of affected lung tends to be preserved
: Ill-defined fluffy consolidation (white arrows) is visible on CT in a patient with right lower lobe pneumonia. Small focal lucencies (black arrows) within the area of consolidation are “air alveolograms.”
Consolidation: patchy opacities. A: Chest radiograph in a patient with pulmonary
edema due to renal failure shows patchy perihilar consolidation. B: Patchy areas of fluffy
consolidation are seen on CT. The fluffy margins are due to variable involvement of alveoli
at the edges of the pathologic process.
Based on the radiographic or CT pattern of abnormalities, patients with consolidation may be
divided into two primary groups for the purpose of differential diagnosis: those with diffuse
or bilateral consolidation and those with focal consolidation.Diffuse consolidation has a number of possible causes (Table 1.1), and the clinical history is
often more important than the radiographic findings in making the diagnosis. Several patterns
or distributions of diffuse consolidation may suggest possible causes.
Perihilar “bat-wing” consolidation in pulmonary edema. A: Chest radiograph
shows a distinct perihilar predominance of consolidation. The heart is enlarged. B: CT shows
sparing of the lung periphery.
It is most often seen in patients with a chronic lung disease.
Peripheral subpleural (reverse bat-wing) consolidation. A: Chest radiograph in a
patient with chronic eosinophilic pneumonia shows areas of consolidation in the subpleural
lung. The perihilar regions are spared. B: CT in a patient with OP shows patchy areas of
consolidation in the subpleural lung.
Diffuse patchy consolidation in a patient with viral pneumonia.
4. Diffuse air-space nodules in bronchopneumonia. Multiple small nodular opacities
are typical of spread of infection through the airways. This represented a bacterial
bronchopneumonia, but other organisms such as TB, MAC, fungus, or viruses may be
involved.
Diffuse homogeneous consolidation is most typical in patients with
. Lobar consolidation with expansion. A: A patient with right upper lobe
consolidation due to Klebsiella pneumonia shows downward bowing of the minor fissure
(arrows) because of lobar expansion. B: Invasive mucinous adenocarcinoma involving the
left upper lobe with posterior bulging (arrows) of the left major fissure.
6. Spherical consolidation due to pneumonia. A: On the initial radiograph, a patient
with Legionella pneumonia shows a poorly defined area of consolidation (arrows) in the right
upper lobe. This may be termed “round pneumonia.” B: Over the next several days, the
spherical consolidation increases in size because of local interalveolar spread. This
appearance may be seen in the early stages of lobar pneumonias. C: Further progression
results in consolidation of the right upper lobe, marginated by the minor fissure (arrows). D:
A lateral view at the same time as (C) shows upper lobe consolidation marginated by the
major and minor fissures (arrows). Partial right middle lobe consolidation is also present.
Segmental consolidation. A patient with pneumonia shows consolidation of the lateral segment of the right middle lobe. The segmental bronchus is seen within the consolidated lung as an air bronchogram. The medial segment, adjacent to the right heart border, is normally aerated. The consolidated segment borders posteriorly on the major fissure.
Rapidly appearing consolidation (a few hours) or consolidation associated with acute
symptoms suggests
Anatomic relationships and the silhouette sign on a frontal radiograph.
Obscuration of the borders shown in this diagram is associated with consolidation of the
listed lobes. RUL, right upper lobe; RML, right middle lobe; RLL, right lower lobe; LUL, left
upper lobe; LLL, left lower lobe.
The silhouette sign in right upper lobe pneumonia. A: Consolidation of the right upper lobe obscures (i.e., silhouettes) the border of the right superior mediastinum and superior vena cava. The upper part of the right hilum is also invisible. B: On the lateral view, the consolidated upper lobe is outlined superiorly by the upper aspect of the major fissure (black arrows). Inferiorly, it is outlined by the minor fissure (white arrows).
he silhouette sign in right middle lobe pneumonia. A: Consolidation of the right middle lobe obscures (“silhouettes”) the right heart border (i.e., it is not clearly seen).In contrast, the left heart border is sharply marginated. The right hemidiaphragm appears sharply marginated. The pneumonia is marginated by the minor fissure (arrow). B: On the lateral view, middle lobe consolidation is visible, marginated above by the minor fissure (large arrows); inferiorly, it is marginated by the major fissure (small arrows).
The silhouette sign in right lower lobe pneumonia. A: The frontal view shows right lower lobe consolidation with obscuration of the diaphragm. The right heart border (arrows) remains visible as an edge. B: On the lateral view, complete right lower lobe consolidation is visible, outlined anteriorly by the major fissure (white arrows). The right hemidiaphragm (large black arrows) is sharply marginated anterior to the consolidated lobe but is invisible posteriorly. The posterior left heart border and left hemidiaphragm are sharply marginated (small black arrows).
A: The left heart border is obscured because of lingular consolidation. The left superior mediastinum remains sharply marginated because the medial portions of the anterior and apical segments of the left upper lobe remain aerated. B: Typical findings of left upper lobe (LUL; and lingular)consolidation: (1) the left superior mediastinum and aortic arch are obscured, (2) the superior left hilum is obscured, (3) the descending aorta remains visible, (4) the left heart border is obscured, and (5) the left hemidiaphragm remains visible.
The silhouette sign in left lower lobe pneumonia. A:The left hemidiaphragm is partially obscured by left lower lobe consolidation (arrows). B: On the lateral view, a portion of the left hemidiaphragm (arrow) also is obscured.
