By Jonathan Corne; Kate Pointon

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9 Lung nodule . . . . . 10 Cavitating lung lesion . . 11 Left ventricular failure . . 12 Acute respiratory distress syndrome . . . . . 13 Bronchiectasis . . . . 14 Fibrosis . . . . . . 15 Chickenpox pneumonia . 16 Miliary shadowing . . . 1 Collapse Collapse of a lung is an important cause of a white lung on X-ray. When confronted with a white lung it is important to be thorough in looking for the features suggestive of collapse since the presence of collapse indicates possible serious pathology.

1 The lungs 1 This pair of films shows a right upper zone mass lesion. The PA film shows that it lies above the horizontal fissure (1) and the lateral film that it lies in front of the oblique fissure, as well as above the horizontal fissure (2), so the mass lies in the right upper lobe. 1 As well as knowing what a lesion is it is often important to know its position within the lung. To accurately localize a lesion on a chest X-ray you need to look at both the PA and lateral films. First look at the PA film: 1.

These should get more translucent (darker) as one moves caudally. Check that they are all the same shape, size and density. Look for collapse of a vertebra or for vertebrae that are significantly lighter or darker than the others, which may indicate bone disease. Consolidation in the posterior costophrenic sulcus can also make the vertebral bodies appear abnormally white. 1 The lungs . . . . . . 2 The heart . . . . . . 1 The lungs 1 This pair of films shows a right upper zone mass lesion.

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