Ultrasonography Pleural Effusion Part 4 -Dr. Sheetu Singh

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Radiology Chest X ray

• Lateral decubitus film
• Free pleural fluid is evidenced by a homogenous
  density with a straight horizontal superior
  border between the dependent chest wall and the
  lower border of the lung
• This appearance is due to the lung floating in
  the fluid.
• Minimum amount of pleural fluid to be visualized
  on lateral decubitus x ray 25 ml

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Chest X ray Lateral decubitus view
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Ultrasonography

• (a)determining whether pleural fluid is present
• (b) identification of the appropriate location
  for an attempted thoracentesis, pleural biopsy,
  or chest tube placement
• (c) identification of pleural fluid loculations
• (d) distinction of pleural fluid from pleural
  thickening
• (e) semiquantitation of the amount of pleural
  fluid
• (f) differentiation of a pyopneumothorax from a
  lung abscess
• (g) evaluation of the trauma patient for the
  presence of a hemothorax or a pneumothorax.
• (h) Special utility in ICU where supine films can
  miss pleural effusion in many cases

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Computed Tomography (CT)

• Helps identify underlying parenchymal
  abnormalities
• Differentiate transudative from exudative pleural
  effusion
• Differentiate malignant pleural effusion by
  presence of pleural nodularity, pleural rind,
  pleural thickening gt 1 cm and mediastinal pleural
  involvement