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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.
A chest X-ray, computed tomography (CT) scan, or ultrasound is usually used to confirm its presence. [5] Other conditions that can result in similar symptoms include a hemothorax (buildup of blood in the pleural space), pulmonary embolism, and heart attack. [2] [11] A large bulla may look similar on a chest X-ray. [3]
Atelectasis is the partial collapse or closure of a lung resulting in reduced or absence in gas exchange. It is usually unilateral, affecting part or all of one lung. [2] It is a condition where the alveoli are deflated down to little or no volume, as distinct from pulmonary consolidation, in which they are filled with liquid.
Chest x-ray demonstrating severe atelectasis or collapse of the right lung and mediastinal shift towards the right. Atelectasis is the partial collapse of a lung that is reversible. There are numerous etiologies, including post-operative atelectasis, surfactant deficiency, mucus plugging, and foreign body aspiration.
A pleural effusion: as seen on chest X-ray. The A arrow indicates fluid layering in the right chest. The B arrow indicates the width of the right lung. The volume of the lung is reduced because of the collection of fluid around the lung. In pneumonia, a collection of fluid may form in the space that surrounds the lung. [141]
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
Chest Imaging: either chest x-ray or CT scan, must show bilateral opacities that cannot be fully explained by other conditions such as effusion, lung/lobar collapse, or lung nodules. Origin of Edema: respiratory failure that cannot be fully explained by cardiac failure or fluid overload, this needs objective assessment such as an echocardiogram.
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.