Chest Imaging

Question 1

With respect to chest imaging - big heart? ….

Answer 1

Needs echo

Question 2

What are the causes of alveolar opacity on chest xray?

Answer 2

• Mostly due to transudate - e.g. APO from heart failure, aspiration,
• Also due to exudate - e.g. pus, bacteria
• Also due to non-aerated lung (deflated distal to gas trapping)
• Also due to neoplasms
• Also due to pulmonary haemorrhage (iatrogenic, warfarinised, Goodpasture’s etc.)
• Rare: connective tissue disorders, sarcoidosis etc.

Question 3

What are the signs of cardiac failure on chest xray?

Answer 3

• Perihilar haziness
• Indistinct pulmonary marking
• Perihilar bronchial wall thickening
• Kerley B lines (also consider lymphangitis as these are due to lymph fluid increase)
• Pleural effusions
• Confluent alveolar opacity
• Enlarged cardiac outline