This PA Chest X-Ray demonstrates a left sided pleural effusion. In this condition fluid collects between the parietal and visceral pleura and appears as a shadowy fluid level on the X-Ray with obliteration of the costophrenic angles. If you were to examine this patient they might be in respiratory distress from reduced oxygen uptake (so have low sats, high resp rate, possible cyanosis and accessory muscle useage) - they may have reduced chest expansion on the affected side and it would be stony dull to percussion. Fluid transmits sound poorly so breath sounds would be decreased as would vocal resonance/fremitus. Someone with consolidation may have very similar clinical findings but the underlying area of lung is almost solid due to pus from the infective process - as sounds travel well through solids they would have increased vocal fremitus which is how you can clinically differentiate between the two conditions. Clinical examination and understanding of conditions is paramount to practice effective medicine. Before you recieved this X-Ray you should be able to diagnose the condition and use the X-Ray to confirm your suspicions.
over 10 years ago
Ophthalmology Hypothetical Case Presentation & Management Ben Savage, Adam Pill Jemma Slingsby, Victoria Tuck Clement Guineberteau
Dr Ben Savage
almost 11 years ago