CXR: Silhoutte Sign

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Stanley Medical College, Department of Medicine

A 40-year-old woman presented with a one-week history of fever, breathlessness, and cough. On examination, she was febrile and tachypneic with high-pitched bronchial breath sounds in the right infraclavicular and mammary area. A chest x-ray revealed involvement of the right upper lobe with infiltrates in the apical segment, suggestive of reactivation of tuberculosis based on her history of completing ATT treatment one year ago.

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Chest x ray of the week Prof.Dr.A .GowriShankar’s unit M4 Jagdish.k

History 40 yrs old lady, Mrs.Mallika, presented with 1 wk history of fever, breathlessness, and cough. Pt had completed ATT 1 year back. No other significant history

Examination Pt was febrile, tachypneic Pulse – 104/min Bp – 110/70 mm hg RR -28/min CVS – S1 S2 normal. no added sounds CNS –NFND RS – high pitched bronchial breath sounds rt infra clavicular and mammary area. BAE. Inspiratory fine creps present

Which lobe is involved? Which segment is involved? Why? What s the pathology?

Silhouette sign Fallacies of silhouette sign

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