4. Evaluate for Effusion Mediastinal Shift A mediastinal shift can occur if there is tension. In this image, notice the collapsed right lung. This patient requires a chest tube to relieve the pressure.
1. Evaulate for Effusion – Meniscus In an uncomplicated effusion, fluid is usually higher laterally than medially, thus forming a meniscus with the pleura. A horizontal fluid line will be seen only with a mixture of air and water in the pleura space...
3. Evaluate for Effusion – Fluid Pooling Pooling of fluid can first be seen posteriorly. If there is enough it will then move laterally. This is why the lateral film is most sensitive for pleural effusion. A lateral decubitis view will show the effusion in a...
2. Evaluate for Effusion – Blunted Angles/Thickening Blunting of the costophrenic angles (see normal sharp angles) generally indicates a pleural effusion. Blunting can also indicate thickening of the pleura.
4. Evaluate for Diaphragm – Free Air Free air under the diaphragm suggests pneumonperitoneum (i.e. bowel perforation). Right image indicates where free air is located.
