CXR and Pleural Effusion – Blunting of the Costophrenic Angle
Not Obvious when the Effusion is Small

92-year-old female presents with a dyspnea. CXR shows a moderate sized right effusion. CT scan shows bilateral pleural effusions. On the right there is a moderate effusion with compressive atelectasis and on the left, there is a small effusion with a minor degree of atelectasis with atelectasis of the left lung.
Ashley Davidoff MD TheCommonVein.net

58year old male presents with dyspnea. CT scan shows bilateral pleural effusions with crescentic region of compressive atelectasis in the left lower lobe
Ashley Davidoff MD TheCommonVein.net

79 year-old female with bilateral simple pleural effusions and compressive atelectasis with a variation in the shape of the atelectasis in the right lower lobe.
Ashley Davidoff MD TheCommonVein.net

66 year-old female with bilateral simple pleural effusions and compressive atelectasis
Ashley Davidoff MD TheCommonVein.net

86 year-old female presents with a dyspnea. US shows a left effusion with compressive atelectasis. CT scan shows bilateral pleural effusions with atelectasis of the left lung.
Ashley Davidoff MD TheCommonVein.net

48 year-old male presents with a dyspnea. CXR shows a total white out of the left chest with pulmonary congestion. CT scan shows a large left pleural effusion with total atelectasis of the left lung. Incidental note is made of premature calcific coronary artery disease.
Ashley Davidoff MD TheCommonVein.net

Ashley Davidoff MD TheCommonVein.net

46-year-old female presents with a dyspnea and a cough. Imaging of the chest shows cardiomegaly with bilateral moderate sized pleural effusion with crescentic region of compressive atelectasis noted on the axial images at the bases and crowding of the bronchovascular bundles best evaluated on the coronal image. The 3D reconstructions show functionally “bare” lower lobe segmental airways.
Ashley Davidoff MD TheCommonVein.net

88 year old male with bilateral effusions shown on the CXR. Axial CT shows thickened pleura on the left with compressive atelectasis of the lower lobe and a smaller region of crescentic compressive atelectasis on the right. 3D reconstruction shows atelectasis of the left lower lobe and portion of the lingula
Ashley Davidoff MD TheCommonVein.net

Ashley Davidoff MD
Tension Hydrothorax

85-year-old female with a history of lung cancer, presents with a dyspnea and hypotension. CT scan shows a large right pleural effusion under pressure, with mediastinal shift to the right. In addition, there is compression of the heart with back up of venous return due the pressure effect on the heart and vascular structures. Among the structures showing venous distension are the SVC (blue arrowhead, a) right sided upper limb veins (blue arrowhead b) and the left upper pulmonary veins (red arrowhead, b. The effusion in the right pleural cavity with atelectatic lung herniates into the left hemithorax, (white arrowhead, c). There is a dense sediment in the pleural fluid (red arrowhead, d) suggesting blood in the pleural cavity. The left atrium is compressed (maroon arrowhead, d)
Ashley Davidoff MD TheCommonVein.net