Systemic lupus erythematosus x ray: Difference between revisions

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! style="background: #4479BA; color: #FFFFFF; " |Description
! style="background: #4479BA; color: #FFFFFF; " |Description
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| rowspan="2" style="background: #DCDCDC; " |Gastrointestinal system
| rowspan="2" style="background: #DCDCDC; " |Gastrointestinal system
|[[Dysphagia]]
|[[Dysphagia]]
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|
*[[Barium swallow]] / esophagography
*[[Barium swallow]] / esophagography
**[[Esophageal]] stricture
**[[Esophageal]] stricture
*** Peptic strictures that appear as smooth, tapered narrowing in the distal esophagus
*** Peptic strictures that appear as smooth, tapered narrowing in the distal [[esophagus]]
** [[Esophageal dilatation]] 
** [[Esophageal dilatation]] 
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* Small bowel wall thickening
* Small bowel wall thickening
** [[Thumbprinting|Thumbprinting sign]]
|-
|-
| rowspan="3" style="background: #DCDCDC; " |Pulmonary involvement
| rowspan="3" style="background: #DCDCDC; " |Pulmonary involvement
|[[Pleural effusion]]
|[[Pleural effusion]]
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|
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** Blunting of the [[costophrenic angle]]
** Blunting of the [[costophrenic angle]]
** Blunting of the cardiophrenic angle
** Blunting of the cardiophrenic angle
** Fluid within the horizontal or oblique fissures
** Fluid within the [[Horizontal fissure of right lung|horizontal]] or [[Oblique fissure|oblique fissures]]
** Mediastinal shifts with large amounts of fluid
** [[Mediastinal]] shifts with large amounts of fluid
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|[[Pulmonary hypertension]]
|[[Pulmonary hypertension]]
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*Elevated [[cardiac apex]] due to right ventricular hypertrophy
*Elevated [[cardiac apex]] due to [[right ventricular hypertrophy]]
* Enlarged right atrium
* [[Enlarged right atrium]]
* Prominent pulmonary outflow tract
* Prominent pulmonary outflow tract
* Enlarged [[pulmonary arteries]]
* Enlarged [[pulmonary arteries]]
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|[[Pneumonitis|Acute pneumonitis]]
|[[Pneumonitis|Acute pneumonitis]]
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|
*Bilateral patchy airspace opacification
*[[Bilateral]] patchy airspace opacification
|-
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| rowspan="2" style="background: #DCDCDC; " |Cardiac involvement
| rowspan="2" style="background: #DCDCDC; " |Cardiac involvement
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|[[Mitral stenosis]]
|[[Mitral stenosis]]
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|
** [[Cardiomegaly]] with widening the heart shadow
** [[Cardiomegaly]] with [[Widened mediastinum|widening the heart shadow]]
** Double right heart border (enlarged [[left atrium]] and normal [[right atrium]])
** Double right heart border (enlarged [[left atrium]] and normal [[right atrium]])
** Prominent left atrial appendage
** Prominent [[left atrial]] appendage
** Splaying of the subcarinal angle (>120 degrees)
** Splaying of the subcarinal angle (>120 degrees)
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**[[Swan neck deformity]]
**[[Swan neck deformity]]
**[[Boutonniere deformity|Boutonniere deformities]]
**[[Boutonniere deformity|Boutonniere deformities]]
**Subluxation with ulnar deviation at [[MCP joints]]
**[[Subluxation]] with [[ulnar deviation]] at [[MCP joints]]
**Subluxation of the 1st [[Metacarpophalangeal joints|metacarpophalangeal joint]]
**[[Subluxation]] of the 1st [[Metacarpophalangeal joints|metacarpophalangeal joint]]
*Widened forefoot
*Widened forefoot
*[[Hallux valgus]]
*[[Hallux valgus]]
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*Insufficiency fracture:
*Insufficiency fracture:
**[[Periosteal reaction]] progressing to callus formation in diaphyseal fractures
**[[Periosteal reaction]] progressing to callus formation in diaphyseal fractures
**Linear [[sclerosis]] and cortical thickening more frequent in [[metaphyseal]] and [[epiphyseal]] fractures
**Linear [[sclerosis]] and cortical thickening more frequent in [[metaphyseal]] and [[epiphyseal]] [[fractures]]
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*Dilated [[bowel]] loops with or without the presence of fluid levels
*Dilated [[bowel]] loops with or without the presence of fluid levels
*Erect [[chest]] radiographs for perforation evaluating
*Erect [[chest]] radiographs for [[perforation]] evaluating
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|-
|[[Autosplenectomy]]
|[[Autosplenectomy]]
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|-
|-
| rowspan="4" style="background: #DCDCDC; " |Pulmonary involvement
| rowspan="4" style="background: #DCDCDC; " |Pulmonary involvement
|Respiratory muscle dysfunction
|[[Respiratory failure|Respiratory muscle dysfunction]]<ref name="pmid11571369">{{cite journal |vauthors=Rockall AG, Rickards D, Shaw PJ |title=Imaging of the pulmonary manifestations of systemic disease |journal=Postgrad Med J |volume=77 |issue=912 |pages=621–38 |year=2001 |pmid=11571369 |pmc=1742125 |doi= |url=}}</ref>
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* Elevated hemidiaphragms at [[CXR]]
* Elevated hemidiaphragms at [[CXR]]
* Linear [[atelectasis]] and an ill-defined juxtadiaphragmatic areas of increased opacity
* Linear [[atelectasis]] and an ill-defined juxtadiaphragmatic areas of increased opacity
PMC1742125
|-
|-
|[[Pulmonary hemorrhage]]
|[[Pulmonary hemorrhage]]
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** [[Fleischner sign|Fleishner sign]]: enlarged [[pulmonary artery]]
** [[Fleischner sign|Fleishner sign]]: enlarged [[pulmonary artery]]
** [[Hampton's hump|Hampton hump]]: peripheral wedge of airspace opacity and implies [[lung infarction]]
** [[Hampton's hump|Hampton hump]]: peripheral wedge of airspace opacity and implies [[lung infarction]]
** [[Westermark sign]]: regional oligaemia
** [[Westermark sign]]: regional oligoemia
** [[pleural effusion]]
** [[pleural effusion]]
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|Shrinking lung syndrome
|Shrinking lung syndrome
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*Small but clear lungs with [[diaphragmatic elevation]]
*Small but clear [[lungs]] with [[diaphragmatic elevation]]
*Basal [[atelectasis]] 
*Basal [[atelectasis]] 
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|-
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|[[Mitral regurgitation]]
|[[Mitral regurgitation]]
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* Left [[atrial]] enlargement
* [[Left atrial enlargement]]
** Convexity or straightening of the left atrial appendage just below the main [[pulmonary artery]] (along left heart border)
** Convexity or straightening of the [[left atrial appendage]] just below the main [[pulmonary artery]] (along left heart border)
** Double density sign: An addition contour superimposed over the right heart due to left [[atrium]] enlargement
** Double density sign: An addition contour superimposed over the [[right heart]] due to [[Left atrial enlargement|left atrium enlargement]]
** Elevation of the left main [[bronchus]] and splaying of the [[carina]]
** Elevation of the left main [[bronchus]] and splaying of the [[carina]]
* Upper zone venous enlargement due to [[pulmonary hypertension]]
* Upper zone venous enlargement due to [[pulmonary hypertension]]
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* Globular enlargement of the cardiac shadow giving a water bottle configuration
* Globular enlargement of the cardiac shadow giving a water bottle configuration
* Lateral [[CXR]]:
* Lateral [[CXR]]:
** Vertical opaque line ([[pericardial fluid]]) separating a vertical lucent line directly behind sternum (epicardial fat) anteriorly
** Vertical opaque line ([[pericardial fluid]]) separating a vertical lucent line directly behind [[sternum]] ([[Epicardial fat pad|epicardial fat]]) anteriorly
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| style="background: #DCDCDC; " |Musculoskeletal involvement
| style="background: #DCDCDC; " |Musculoskeletal involvement
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*Initial minor [[osteopenia]], followed by variable density
*Initial minor [[osteopenia]], followed by variable density
*Gradually microfractures of the subchondral bone accumulate in the dead bone
*Gradually micro-fractures of the subchondral bone accumulate in the dead bone
*Collapse of the [[articular]] surface
*Collapse of the [[articular]] surface
*Crescent sign of [[AVN]]
*Crescent sign of [[AVN]]

Revision as of 15:16, 26 July 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

On X ray imaging, systemic lupus erythematosus (SLE) may be characterized by different features regarding the present complication. the most common characteristic findings of SLE in X ray include:

X Ray

On X ray imaging, systemic lupus erythematosus (SLE) may be characterized by the following features, based on the organ system involvement.

More common complications

Organ Disease Description
Gastrointestinal system Dysphagia
Enteritis
Pulmonary involvement Pleural effusion
Pulmonary hypertension
Acute pneumonitis
Cardiac involvement Cardiomegaly
Mitral stenosis
Musculoskeletal involvement Arthritis
Osteoporosis

Less common complications

Organ Disease Description
Gastrointestinal system Intestinal pseudo-obstruction
  • Dilated bowel loops with or without the presence of fluid levels
  • Erect chest radiographs for perforation evaluating
Autosplenectomy
  • Calcified spleen may be visible in the left upper quadrant
Pulmonary involvement Respiratory muscle dysfunction[1]
  • Elevated hemidiaphragms at CXR
  • Linear atelectasis and an ill-defined juxtadiaphragmatic areas of increased opacity
Pulmonary hemorrhage
  • Patchy bilateral and acinar areas of increased opacity, predominantly in the lower lungs
Pulmonary emboli
Shrinking lung syndrome
Cardiac involvement Mitral regurgitation
Pericardial effusion
  • Globular enlargement of the cardiac shadow giving a water bottle configuration
  • Lateral CXR:
Musculoskeletal involvement Osteonecrosis (Avascular necrosis)
  • Initial minor osteopenia, followed by variable density
  • Gradually micro-fractures of the subchondral bone accumulate in the dead bone
  • Collapse of the articular surface
  • Crescent sign of AVN

References

  1. Rockall AG, Rickards D, Shaw PJ (2001). "Imaging of the pulmonary manifestations of systemic disease". Postgrad Med J. 77 (912): 621–38. PMC 1742125. PMID 11571369.

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