Wednesday, March 10, 2010

Black and White

Challenge: Anatomically, where is the abnormality in this PA CXR?

Image shown under Fair Use.


tree said...

The right heart border looks obscured. The transverse fissure is kind of difficult to make out (at least for me), but I'll still vote for right middle lobe anyways because of the silhouette sign.

Suheil said...

Lower Lobe of the Right Lung.. Look for Cardiac silhouette which is seen if the pathology is in the right middle lobe.. Here, the right cardiac border seems to merge with the homogenous opacity in the right lower lung field, suggesting that the abnormality lies more anteriorly in the right lower lung field i.e. in the right lower lobe..

Craig Chen said...

Black and White

This is the silhouette sign; the right heart border is obscured by a lung opacity. Anatomically, this corresponds to a right middle lobe abnormality. The opacity also has a straight upper border suggesting margination along the horizontal fissure.

Sources: UpToDate;

Suheil said...

damn! i switched middle and lower lobe! ugh!