CXR Quiz 1

Question

A 41 year old man is brought to emergency following a motorbike accident. He is intubated at the scene for decreased LOC. He has a BP 90/60, sats 95% on 80% oxygen.

The following Chest Xray is taken. What does it show?

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Answer

Extensive opacity is seen bilaterally in both the lungs which suggests extensive consolidation. This can be due to infection or ARDS, but in this context is likely to be pulmonary contusion.

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There is blunting of the right costophrenic angle with opacity along the right inner chest wall suggesting right pleural effusion - in this case, this is likely to be haemorrhage. The left costophrenic angle is not seen. There is no opacity along the left inner chest wall.

No obvious pneumothorax is seen. Heart size is normal. There is no mediastinal shift. There are no apparent fractures and no signs of mediastinal injury are seen.

The endotracheal tube is seen in situ with the lower end at the level of clavicle.  It appears slightly too high and should be advanced. A central venous line is seen with the lower end being in the approximate location of superior vena cava.

 

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