Unilateral hyperlucent hemithorax
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SHORT TALK ABOUT DIFFERENTIAL DIAGNOSIS ABOUT UNILATERAL HYPERLUCENT HEMITHORAX , COMMON AND LESS COMMON CAUSES WITH CLUES TO DIAGNOSIS AND SOME EXAMPLES HOPPING YOU LIKE IT DR HISHAM ALKHATIB CONSULTANT RADIOLOGIST
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Airway management in ER @ nbe presentation 2017
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Unilateral hyperlucent hemithorax
- 1. Unilateral Hyperlucent Hemithorax Hisham AlKhatib, M.D. Consultant Radiologist
- 2. •اله وعلى هللا رسول على والسالم والصالة هلل الحمد اجمعين مّلوس وصحبه •، علما وزدني ينفعني بما وعلمني علمتني بما انفعني اللهم الحكيم العليم انك • Praise be to Allah and prayers be upon the Messenger of Allah and his family and companions. • Oh God, give me the benefit of what you have taught me and teach me what benefits me.
- 4. Key Differential Diagnosis Issues • Check for central airway obstruction – Endobronchial tumors, extrinsic compression, foreign bodies • Check lung parenchyma for focal air-trapping – Exhalation CT helpful to increase confidence • Check chest wall for evidence of prior surgery or deformities
- 6. Common Causes • Pneumothorax • Mastectomy • Prior Surgery • Bronchial Obstruction
- 7. Helpful Clues for Common Diagnoses
- 8. Pneumothorax • Look for “deep sulcus” sign on supine radiographs
- 11. Mastectomy • Breast asymmetry; surgical clips in axilla
- 13. Prior Surgery – Single lung transplant – Ipsilateral lobectomy
- 14. Bronchial Obstruction – Hyperlucency from air-trapping, ball-valve effect – Lobar collapse and hyperinflation of other lobes – Foreign body in children – Endobronchial tumors in adults • Primary malignancy > endobronchial metastases • Carcinoids commonly have central, chunky calcifications
- 16. Less Common Causes • Swyer-James Syndrome • Bronchial Atresia • Congenital Lobar Emphysema
- 17. Helpful Clues for Less Common Diagnoses
- 18. Swyer-James Syndrome – Unilateral postinfectious constrictive bronchiolitis – Decreased vascular markings; air-trapping on exhalation – CT: Bronchiectasis often present; more extensive air-trapping than on radiograph
- 21. Bronchial Atresia – Collateral ventilation; air-trapping on expiratory imaging – Mucocele common in airway distal to obliteration – Left upper lobe > right middle lobe > lower lobes
- 24. Congenital Lobar Emphysema – Focal overinflation and air-trapping in disorganized parenchyma – Left upper lobe > right middle lobe > right lower lobe
- 25. THANK YOU
- 26. Helpful Clues for Rare Diagnoses