Thursday, April 22, 2010

what`s your diagnosis? Why?

The patient shown below most likely has:

a. A large right pleural effusion

b. A large left pneumothorax

c. Atelectasis of the right lung

d. Pneumonia in the right lung

e. Unilateral pulmonary edem

Correct Answer:in 23 April 10
A large right pleural effusion

There is opacification of the right hemithorax. There is a shift of the heart and mediastinal structures (i.e. the trachea) away from the side of opacification. This eliminates atelectasis, pneumonia and pulmonary edema as possibilities. There is never a shift of the heart or mediastinal structures toward the side of a pneumothorax. In addition, there should be no lung markings visible in the hemithorax which contains the pneumothorax. This is a large effusion which produces a mass-like effect and pushes the mediastinal structures away from the opacified side.