This is a Chest Xray of a 43 year woman who came to the hospital complaining of High fever ( not documented at home) associated with rigors and  productive and painful cough.
Comment on her Xray?
What are important Chest examination findings that are likely to find in this lady?



ANSWER - RIGHT UPPER LOBE CONSOLIDATION(LOBAR PNEUMONIA)







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23 comments

  1. Anonymous Says:
  2. No abnormality in soft tissue and bones.
    Trachea deviation to the right.
    Radioluscent in both of pulmonal area.
    Conclusion: Pneumothorax caused by severe pneumonia.

     
  3. emfezema lung

     
  4. Anonymous Says:
  5. i am arash from iran
    no tracheal deviation
    upper lobe consolidation
    air bronchogram
    no soft tissue or bone abnormality
    most probably pneumonia caused by pneumococci

     
  6. Anonymous Says:
  7. incomplete without the lateral view..though appears to be consolidation secondary to pnuemonia.important physical findings..decreased chest expansion, dull percussion, bronchial breathing.

     
  8. Anonymous Says:
  9. Severel pneumonia

     
  10. Anonymous Says:
  11. upper right lobe consolidation, incomplete without L-L

     
  12. Anonymous Says:
  13. Right upper lobar pneumonia with right pneurisy.


    At first, must look lateral X-ray of the right lung.

     
  14. CXR - high intensity opacity of the upper lobe of right lung, limited byt the fisure.

    no other patho. finding on other sites of lung.
    considering the clinical presentation of patient : high fever, productive cough, preliminary diagnosis - PNEUMONIA!

     
  15. Anonymous Says:
  16. Catlictasis caused by severe pneumothorax

     
  17. Anonymous Says:
  18. rt upper lobe pneumonia

     
  19. Anonymous Says:
  20. there must be an infective agent(bacterial/TB) causing fever
    pneumothorax left
    consolidation right upper lobe lung
    both causing right tracheal deviation

    -->pneumonia

    clinically: dyspnoea, tachycardia, reduced chest expansion
    reduced air entry left
    bronchial breathing right upper zones

     
  21. Anonymous Says:
  22. why pneumothorax, when there's still lung pattern on the periphery side of the lung field... look at it properly, then make the conclusion....

     
  23. Anonymous Says:
  24. why dont you write correct diagnosis
    arash
    zabanbaste@gmail.com
    please send correct dx to my email

     
  25. Anonymous Says:
  26. why dont you tell us correct diagnosis
    please send it to
    zabnbaste@gmail.com

     
  27. Anonymous Says:
  28. classic finding of right upper lobe consolidation as evident from airbronchogram(pathognomonic)

    There is no pleural effusion since the costophrenic angle is not obliterated and pleurisy is not diagnosed on X ray.

    there is no atelectasis since there is no loss in the lung volume.

    comments should be done based on ones knowledge and experience.

    this patient should receive treatment for community acquired pneumonia namely rocephine(ceftriaxone) and a macrolide to cover the atypicals.

    TB is out of the question.

    Pneumothorax is more than a blunder.

    trachea is not shifted.

     
  29. Yousof Says:
  30. upper right lobe consolidation with air-bronchogram indicates pneumonia,but there could be a malignant tumor, such as bronchogenic carcinoma of the right bronchus that should be ruled out by bronchoscopy and ....

     
  31. Anonymous Says:
  32. Right upper lobar pneumonia with pneurisy, on right side.

     
  33. Anonymous Says:
  34. pneumonia lobaris superior l. dex.

     
  35. Bobbymurjani Says:
  36. Its off course lobar pnemonia for any reason..

     
  37. Anonymous Says:
  38. there is right upper Lobe consoLidation, i just wanna ask what wiLL we caLL Left Lower Lobe opacity? is it consoLidation as weLL or some thing eLse?

     
  39. Anonymous Says:
  40. we will call it - the heart.

     
  41. Anonymous Says:
  42. lobe collapes

     
  43. Kit Byatt Says:
  44. Agree consolidation of RUL with air bronchogram. Lateral view won't add much useful information here.
    NB the horizontal fissure is elevated & convex upwards, suggesting some volume loss. Raises possibility of RUL endobronchial obstructing lesion (?(sub)segmental) as predisposing cause for pneumonia; could also be sputum plug?
    Treat pneumonia, but investigate further: CT +/- bronchoscopy...

     

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