Tuberculosis chest x ray

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor-in-Chief: Somal Khan

Overview

A posterior-anterior chest radiograph is used to detect chest abnormalities. Lesions may appear anywhere in the lungs and may differ in size, shape, density, and cavitation. These abnormalities may suggest TB, but cannot be used to definitively diagnose TB. However, a chest radiograph may be used to rule out the possibility of pulmonary TB in a person who has had a positive reaction to a TST or QFT-G and no symptoms of disease.

Common findings of early tuberculosis

Infiltration

• It is soft, nodular cotton like fluffy tiny opacities that merge into each other
• Most common location for early lesions are the apico-posterior part (behind the outer borders of clavicle)

Cavity

• Circular, smooth, well defined, thin (acute) or thick walled (chronic), radiolucent area with no air-fluid levels with surrounding infiltrations.
• Commonly seen in the upper zone. Atypical cavities may be seen in lower zones. The common conditions in which lower zone cavities can be found are diabetes and HIV infections
• Sometimes a radiolucent cavity may be seen within the tuberculosis cavity and is due to the presence of the fungal balls (commonly aspergillosis) within the cavities

Common finding in healing tuberculosis

Fibrosis

• Defined as opaque linear streak radiating towards the hilum of the lung.
• Compared to infiltrations, fibrotic changes are more opaque, well defined and may lead to mediastinal shifting or diaphragm pulling toward the affected lesions. A fibrotic lesion near to diaphragm may cause tenting of the diaphragm.
• Compensatory emphysema in cases with extensive fibrosis may be seen.
• Lung volume reduction may be seen.

Advanced lesions in pulmonary tuberculosis

• A combination of all the lesions may be seen commonly termed as fibrocavitatory lesions

Video showing chest xray findings in pulmonary tuberculosis

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Video showing chest xray in miliary tuberculosis

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Chest x ray images in pulmonary tuberculosis

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  Chest x-ray: Disseminated Tuberculosis
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  Chest x-ray: Disseminated Tuberculosis

References

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