Right Lower Lobe – Evaluate
The pathological process can be localized in the right lower lobe when the right hemidiaphragm interface is lost (“Silhouette” sign).
Right Lower Lobe – Anatomy
Lingula – Evaluate
The pathological process can be localized in the lingula when the left heart border interface is lost (“Silhouette” sign).
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Left Upper Lobe – Anatomy
Left Lower Lobe – Evaluate
The pathological process can be localized in the left lower lobe when the left hemidiaphragm interface is lost (“Silhouette” sign).
Left Lower Lobe – Anatomy
Review Densities
Compare Tissue Attenuation
On x-rays because air is less dense and therefore shows up radiolucent (black), increasing amounts of soft tissue or less air shows up more radio-opaque or white. Similarly a “line” on an x-ray signifies air is present on both sides of the line, while an “interface” describes a separation of structures of differing densities.
Pneumothorax – Sulcus Sign
2. Evaluate for Pneumothorax – Sulcus Sign
Left Image: Depicts the deep sulcus sign.
Right Image: Lateral decubitis view of the pneumothorax. The pleural air will rise above the lung in this view.
Pneumothorax – Mediastinal Shift
3. Evaluate for Pneumothorax – Mediastinal Shift
Large pleural effusions may cause a mass effect, shifting the mediastinum and trachea to the opposite side, and/or causing atelectasis of the adjacent lung.
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Pneumothorax – Lung and Air Contrast
1. Evaulate for Pneumothorax – Lung/Air Contrast
A pneumothorax allows visualization of the viscerla pleura as a curvilinear line, paralleling the chest wall, separating the partially collapsed lung from pleural air.
Left Image: Pneumothorax on inspiration.
Right Image: Pneumothorax on expiration.
