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LEFT sided lower zone pneumothorax in patient with COPD.
Note hyperinflated lungs and coarse lung markings
Pericardial effusion, pleural effusion,
Mediastinal drains in situ. Pericardial effusion and bilateral pleural effusions with collapse/consolidation of the adjacent lung.
Lung cancer affecting left upper lobe, mediastinal lymphadenopathy and left sided pleural effusion with patchy consolidation.
Fractured RIGHT sided pubic rami
There are fractures of the right superior and inferior pubic rami with disruption of the symphysis pubis.
Multiple, well-defined, rounded nodules in left upper zone. Commonest cause in the elderly is metastasis.
Lung cancer - apical Pancoast tumour
CXR: Dense opacity at the right apex, in keeping with symptoms of Pancoast tumour
Pneumoperitoneum with air visible under both diaphragms as a result of peptic ulcer perforation.
X-ray illustrates the 'continuous diaphragm sign' - the diaphragm is not usually seen in its entirety due to the cardiac shadow.
Large pulmonary emboli were found bilaterally - thrombosis is visible in the origin of the right pulmonary artery in the above image.
Pneumonia - upper lobe consolidation
It should be noted that this CT scan shows a rather expiratory scan (note collapse of bronchi).
There is a dense consolidation of the right upper and lower lobes with some adjacent ground glass consolidation.
There is a small right pleural effusion. Tiny left pleural effusion with adjacent atelectasis.
Right sided consolidation + pleural effusion. Note also important hardware: endotracheal tube, right sided central venous catheter and ECG leads.
Adult Polycystic Kidney Disease
Large polycystic kidneys with multiple cysts bilaterally. Several of the cysts have high attenuation, suggestive of previous haemorrhage
Aspiration pneumonia with right sided consolidation.
Right sided patchy consolidation.
Previous oesophagectomy and gastric pull-through overlying left chest wall.
There is diffuse swelling of the pancreatic tail and haziness of the peripancreatic fat.
There is also low attenuation in the spleen peripherally which may represent an area of infarction.
Large pleural effusion affecting RIGHT side of chest with visible meniscus
RIGHT upper lobe consolidation
Perforated Duodenal Ulcer, Pneumoperitoneum
Pneumoperitoneum
Abdo Film shows distended bowel loops and Rigler's sign
Erect chest shows air under the diaphragm
Dilated bowel loops.
There is also Rigler's sign - both sides of the bowel wall are visible due to air outside and inside the bowel.
CT pulmonary angiogram on bone windows shows a massive pulmonary embolism straddling right and left pulmonary arteries (saddle embolus). Even large emboli can be missed if the contrast in the main pulmonary arteries is very dense and the images are viewed on normal mediastinal windows. Altering the windows can help to increase visibility of thrombus.
There is almost complete occlusion
Right spontaneous pneumothorax
Large right sided pneumothorax with collapse of the right lung.
Left apical shadowing suspicious of Pancoast Tumour.
Subsequently confirmed on CT thorax
Adult Polycystic Kidney Disease(APKD)
CT Abdomin: Multiple cysts of varying sizes seen throughout both kidneys,liver and pancreas.
A selected coronal image from a contrasted CT examination of the abdomen and pelvis demonstrates:
1. A large quantity of intra-abdominal ascites.
2. Inferior scalloping of the right lobe of the liver due to pressure effect, indicating the dense and likely mucinous composition of the ascitic fluid.
2. Peritoneal enhancement and a swollen appendix.
Diagnosis:
Pulmonary fibrosis ? Usual interstitial pneumonia
There is diffuse reticulo-nodular shadowing, which is most marked in the lower lower zones bilaterally. There is differential volume loss in the lower zones. There are reticular changes seen adjacent to the heart borders and subpleurally. Findings are suggestive pulmonary fibrosis. The radiographic appearances are most typical of Idiopathic Pulmonary fibrosis.
Marked ground glass attenuation bilaterally. There is no evidence of COPD, bronchiectasis or lung fibrosis. Lung fields show extensive patchy areas of ground glass haziness with some centrilobular nodularity. There is early traction bronchiectasis in the periphery. There are some areas of air trapping.
Fluid overload and pulmonary odema with concomitant cardiomegally
The heart is enlarged. There is bilateral perihilar linear shadowing representing intersititial oedema. There is also upper lobe venous blood diversion. There is also thickening of the right horizontol fissure. Features are in keeping with pulmonary oedema.
RIGHT sided pneumothorax
\"Saddle thrombus\" in Pulmonary artery
Large "Saddle Pulmonary Embolism".
Large scrotal hernia Right total hip replacement
Large scrotal hernia containing loops of bowel.
General osteopenia.
Right total hip replacement
Widespread pulmonary fibrosis, horizontal fissure is picked out due to fiborsis at based of RIGHT upper lobe
Bronchiolitis and Pneumothorax
Due to poor clinical picture a preliminary diagnosis of bronchiolitis was made.
X-ray was performed after admission showing a RIGHT pneumothorax of RIGHT upper lobe, with minimal compression of Middle and Lower lobes.
Fractured rib, left sides pneumothorax and haemothorax to left lung.
Fracture of 7th rib
Small pneumothorax and haemothorax to left lung with loss of costophrenic angle.
Visible artifact - nasal cannulae NOT chest drain
Pagets disease also known as osteitis deformans
Pagets disease of hip
Asymetrical presentation of the disease, as is commonly the case, localising to LEFT femur and LEFT half of the pelvis
Image shows classical picture of Paget's with:
- Scattered steolytic (lucent) regions of bone
- Coarsened trabeculae particularly so on the left femur
- Bony enlargement, particularlt of the left femur and left hemi-pelvis
