Pneumonia chest x ray: Difference between revisions
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===Findings=== | ===Findings=== | ||
* [[X-ray]]s of the chest reveal areas of opacity. | * [[X-ray]]s of the chest reveal areas of opacity. | ||
*A normal [[Chest X-ray|chest x-ray]] makes community-acquired pneumonia (CAP) less likely; however, CAP is sometimes not seen on x-rays because the disease is either in its initial stages or involves a part of the lung not easily seen by x-ray. | *A normal [[Chest X-ray|chest x-ray]] makes community-acquired pneumonia (CAP) less likely; however, CAP is sometimes not seen on [[x-rays]] because the disease is either in its initial stages or involves a part of the lung not easily seen by [[X-rays|x-ray]]. | ||
* X-rays can be misleading, because other problems, like lung scarring and [[congestive heart failure]], can mimic pneumonia on x-ray.<ref name="syrjala">Syrjala H, Broas M, Suramo I, et al. ''High resolution computed tomography for the diagnosis of community-acquired pneumonia.'' Clin Infect Dis 1998; 27:358-363 PMID 9709887</ref> Chest x-rays are also used to evaluate for complications of pneumonia. | * [[X-rays]] can be misleading, because other problems, like [[lung]] scarring and [[congestive heart failure]], can mimic pneumonia on [[X-rays|x-ray]].<ref name="syrjala">Syrjala H, Broas M, Suramo I, et al. ''High resolution computed tomography for the diagnosis of community-acquired pneumonia.'' Clin Infect Dis 1998; 27:358-363 PMID 9709887</ref> [[Chest X-ray|Chest x-rays]] are also used to evaluate for complications of pneumonia. | ||
* [[Chest x-ray]] findings are usually nonspecific in [[viral pneumonia]]. | * [[Chest x-ray]] findings are usually nonspecific in [[viral pneumonia]]. | ||
* [[Computed tomography]] is used in situations when the diagnosis is not clear with a chest x-ray | * [[Computed tomography]] is used in situations when the diagnosis is not clear with a chest x-ray | ||
==Hospital Acquired== | ==Hospital Acquired== | ||
*The American Thoracic Society recommends that all patients with a suspicion of nosocomial pneumonia should have a chest x-ray to confirm diagnosis and determine the severity of the disease.<ref>{{cite journal|title=Guidelines for the Management of Adults with Hospital-acquired, Ventilator-associated, and Healthcare-associated Pneumonia|journal=American Journal of Respiratory and Critical Care Medicine|volume=171|issue=4|year=2005|pages=388–416|issn=1073-449X|doi=10.1164/rccm.200405-644ST}}</ref> | *The American Thoracic Society recommends that all patients with a suspicion of [[Nosocomial infection|nosocomial]] pneumonia should have a [[Chest X-ray|chest x-ray]] to confirm diagnosis and determine the severity of the disease.<ref>{{cite journal|title=Guidelines for the Management of Adults with Hospital-acquired, Ventilator-associated, and Healthcare-associated Pneumonia|journal=American Journal of Respiratory and Critical Care Medicine|volume=171|issue=4|year=2005|pages=388–416|issn=1073-449X|doi=10.1164/rccm.200405-644ST}}</ref> | ||
* A chest X-ray also helps to determine [[pleural effusion]]s or [[cavitation]]s, as a possible complication. | * A chest X-ray also helps to determine [[pleural effusion]]s or [[cavitation]]s, as a possible complication. | ||
*Ideally, the [[chest X-ray]] should be posteroanterior and lateral, but this will depend on the patient's condition. | *Ideally, the [[chest X-ray]] should be posteroanterior and lateral, but this will depend on the patient's condition. | ||
| Line 30: | Line 30: | ||
:*Air bronchogram | :*Air bronchogram | ||
:*[[Pleural effusion]] | :*[[Pleural effusion]] | ||
:*Cavitation | :*[[Cavitation]] | ||
:*Ground glass opacities | :*Ground glass opacities | ||
*Chest X-ray is also used to assess improvement or lack of clinical response in hospitalized patients. | *[[Chest X-ray|Chest x-ray]] is also used to assess improvement or lack of clinical response in hospitalized patients. | ||
===Chest X-ray Gallery=== | ===Chest X-ray Gallery=== | ||
Revision as of 22:40, 5 March 2018
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Pneumonia Microchapters |
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Pneumonia chest x ray On the Web |
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American Roentgen Ray Society Images of Pneumonia chest x ray |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2], Priyamvada Singh, M.D. [3] ; Alejandro Lemor, M.D. [4]
Overview
An important test for making a diagnosis of pneumonia is a chest x-ray. Chest x-rays can reveal areas of opacity (seen as white) which represent consolidation. Pneumonia is not always seen on x-rays, either because the disease is only in its initial stages, or because it involves a part of the lung not easily seen by x-ray.
Chest X-Ray
Indications
Patients with the following conditions should be evaluated with a chest X-ray:[1]
- Fever (>37.8° C / 100° F)
- Tachypnea (> 20 breaths/min)
- Tachycardia (> 100 bpm)
- Decreased breath sounds and crackles in the physical exam
Findings
- X-rays of the chest reveal areas of opacity.
- A normal chest x-ray makes community-acquired pneumonia (CAP) less likely; however, CAP is sometimes not seen on x-rays because the disease is either in its initial stages or involves a part of the lung not easily seen by x-ray.
- X-rays can be misleading, because other problems, like lung scarring and congestive heart failure, can mimic pneumonia on x-ray.[2] Chest x-rays are also used to evaluate for complications of pneumonia.
- Chest x-ray findings are usually nonspecific in viral pneumonia.
- Computed tomography is used in situations when the diagnosis is not clear with a chest x-ray
Hospital Acquired
- The American Thoracic Society recommends that all patients with a suspicion of nosocomial pneumonia should have a chest x-ray to confirm diagnosis and determine the severity of the disease.[3]
- A chest X-ray also helps to determine pleural effusions or cavitations, as a possible complication.
- Ideally, the chest X-ray should be posteroanterior and lateral, but this will depend on the patient's condition.
- Findings include the following:[4]
- Unilateral or bilateral consolidation
- Air bronchogram
- Pleural effusion
- Cavitation
- Ground glass opacities
- Chest x-ray is also used to assess improvement or lack of clinical response in hospitalized patients.
Chest X-ray Gallery
Image courtesy of Dr Aditya Shetty, Radiopedia. (original file here). Creative Commons BY-SA-NC
Videos
{{#ev:youtube|uhRIu8bDYA0}} {{#ev:youtube|zDOFzw0Cmp4}}
References
- ↑ Watkins RR, Lemonovich TL (2011). "Diagnosis and management of community-acquired pneumonia in adults". Am Fam Physician. 83 (11): 1299–306. PMID 21661712.
- ↑ Syrjala H, Broas M, Suramo I, et al. High resolution computed tomography for the diagnosis of community-acquired pneumonia. Clin Infect Dis 1998; 27:358-363 PMID 9709887
- ↑ "Guidelines for the Management of Adults with Hospital-acquired, Ventilator-associated, and Healthcare-associated Pneumonia". American Journal of Respiratory and Critical Care Medicine. 171 (4): 388–416. 2005. doi:10.1164/rccm.200405-644ST. ISSN 1073-449X.
- ↑ Koenig, S. M.; Truwit, J. D. (2006). "Ventilator-Associated Pneumonia: Diagnosis, Treatment, and Prevention". Clinical Microbiology Reviews. 19 (4): 637–657. doi:10.1128/CMR.00051-05. ISSN 0893-8512.