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Questions and Answers
What is the most common cause of cavitating lesions on a chest X-ray?
Which of the following is NOT a common cause of unilateral hilar enlargement on a chest X-ray?
What is the main use of conventional magnetic resonance imaging (MRI) of the lung parenchyma?
Which of the following is NOT a common cause of reticular, nodular and reticulonodular shadows on a chest X-ray?
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What is the most common cause of lobar collapse on a chest X-ray?
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Which of the following is NOT a common cause of multiple nodules on a chest X-ray?
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What can experienced operators distinguish using transthoracic ultrasound in the pleural space?
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When using ultrasound, what can be identified by directly visualizing solid organs in the body?
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In cases of suspected intermittent laryngeal obstruction (ILO), what procedure allows direct inspection of the larynx?
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What is a common symptom that may arise if a left lung tumor involves the left recurrent laryngeal nerve?
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Which procedure involves inspecting the trachea and first few generations of bronchi using a flexible fiber-optic scope?
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What condition can continuous laryngoscopy during exercise tests help identify?
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Study Notes
Chest X-ray Abnormalities
- Consolidation can be caused by infection, infarction, inflammation, or rarely, bronchoalveolar cell carcinoma
- Lobar collapse can be caused by mucus plugging, tumour, compression by lymph nodes
- Solitary nodule is a common chest X-ray abnormality
- Multiple nodules can be caused by miliary tuberculosis (TB), dust inhalation, metastatic malignancy, healed varicella pneumonia, or rheumatoid disease
- Ring shadows, tramlines, and tubular shadows are indicative of bronchiectasis
- Cavitating lesions can be caused by tumour, abscess, infarct, pneumonia (Staphylococcus/Klebsiella), or granulomatosis with polyangiitis (GPA)
- Reticular, nodular, and reticulonodular shadows are indicative of diffuse parenchymal lung disease or infection
- Pleural abnormalities can include fluid, plaques, or tumour
- Increased translucency, bullae, and pneumothorax can also be observed
Magnetic Resonance Imaging (MRI)
- Conventional MRI of lung parenchyma is not commonly used, but is being explored for distinguishing benign from malignant pleural disease and tumour invasion of chest wall or diaphragm
- Hyperpolarized He MRI is a developing method for assessing ventilation distribution within the lung
Ultrasound
- Transthoracic ultrasound is a point-of-care investigation for assessing pleural space
- It can distinguish pleural fluid from pleural thickening, identify pneumothorax, and guide pleural aspiration, biopsy, and intercostal chest drain insertion
- It can also be used to guide needle biopsy of superficial lymph node or chest wall masses and provides information on diaphragm shape and movement
Endoscopic Examination
- Laryngoscopy can be used to inspect the larynx directly with a fibreoptic laryngoscope in cases of suspected intermittent laryngeal obstruction (ILO)
- It can identify paradoxical movement of the vocal cords, mimicking asthma
- Left-sided lung tumours can involve the left recurrent laryngeal nerve, paralysing the left vocal cord and leading to a hoarse voice and a 'bovine' cough
- Continuous laryngoscopy during exercise tests can identify exercise-induced ILO
- Bronchoscopy can inspect the trachea and the first 3-4 generations of bronchi using a flexible fibreoptic bronchoscope
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Description
Test your knowledge on common chest X-ray abnormalities in respiratory medicine, including pulmonary and pleural shadowing, consolidation, lobar collapse, solitary nodules, multiple nodules, and cavitating lesions. Learn about different patterns seen in chest X-rays and their possible underlying causes.
