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The main chest X-ray findings that can suggest inactive TB are: [2] 1. Discrete fibrotic scar or linear opacity—Discrete linear or reticular densities within the lung. The edges of these densities should be distinct and there should be no suggestion of airspace opacification or haziness between or surrounding these densities.
A chest radiograph, chest X-ray (CXR), or chest film is a projection radiograph of the chest used to diagnose conditions affecting the chest, its contents, and nearby structures. Chest radiographs are the most common film taken in medicine.
Cavitation or consolidation of the apexes of the upper lobes of the lung or the tree-in-bud sign [15] may be visible on an affected patient's chest X-ray. [1] The tree-in-bud sign may appear on the chest CTs of some patients affected by tuberculosis, but it is not specific to tuberculosis. [15]
Miliary tuberculosis is a form of tuberculosis that is characterized by a wide dissemination into the human body and by the tiny size of the lesions (1–5 mm). Its name comes from a distinctive pattern seen on a chest radiograph of many tiny spots distributed throughout the lung fields with the appearance similar to millet seeds—thus the term "miliary" tuberculosis.
A) Normal chest radiograph; B) Q fever pneumonia affecting the right lower and middle lobes. Note the loss of the normal radiographic silhouette (contour) between the affected lung and its right heart border as well as between the affected lung and its right diaphragm border. This phenomenon is called the silhouette sign: Differential diagnosis
Typically, an area of white lung is seen on a standard X-ray. [5] Consolidated tissue is more radio-opaque than normally aerated lung parenchyma, so that it is clearly demonstrable in radiography and on CT scans. Consolidation is often a middle-to-late stage feature/complication in pulmonary infections.
In some cases, chest CT can reveal pneumonia not seen on x-rays. However, congestive heart failure or other types of lung damage can mimic CAP on x-ray. [15] When signs of pneumonia are discovered during evaluation, chest X-rays and examination of the blood and sputum for infectious microorganisms may be done to support a diagnosis of CAP.
Diagnosis is usually done by chest imaging, e.g. chest X-ray or CT scan. Among these, a CT scan is the most sensitive test, which shows loss of lung architecture and multiple small thin walled cavities. [3] Often cultures from bronchoalveolar lavage and blood may be done for identification of the causative organism(s). [8]