Approach to Chest X-Rays

Pulmonary Edema – Kerly B Lines

Kerly lines result fomr thickened connective tissue planes occurring as a result of pulmonary edema or carcinomatosis.

Kerly A Lines: Radiate towards hila in mid- and upper-lung zones, 3-4 cm long, smaller than vascular markings (not useful)
Kerly B Lines: Horizontal, <2 cm long an d1 mm thick, at periphery of lung, reach lung edge (very useful)
Kerly C Lines: Thickened interlobular septa

Pulmonary Edema - Kerly B Lines

Interstitial Disease – Kerly B Lines

Kerly lines result fomr thickened connective tissue planes occurring as a result of pulmonary edema or carcinomatosis.

Kerly A Lines: Radiate towards hila in mid- and upper-lung zones, 3-4 cm long, smaller than vascular markings (not useful)
Kerly B Lines: Horizontal, <2 cm long an d1 mm thick, at periphery of lung, reach lung edge (very useful)
Kerly C Lines: Thickened interlobular septa

Interstitial Disease - Kerly B Lines

Interstitial Disease

Interstitial disease is a pathological process involving the interlobular connective tissue (i.e. scaffolding of the lung).

Differential diagnosis of interstitial disease includes:

  1. Pulmonary edema (which can move into the alveoli)
  2. Collagen disease (fibrosis)
  3. Sarcoidosis
  4. Pneumoconiosis
  5. Metastatic disease (from the lymphatics)
  6. Inflammatory conditions (viral/interstitial pneumonia)

Interstitial Disease