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Chest X-Ray
 
 

Interstitial Changes

 
 
 
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Reticular Opacities

  • Look For

  • Linear opacities on the chest x-ray.
  • Example

  • Interstitial lung markings in a patient with interstitial lung disease
  • Interstitial lung markings in a patient with interstitial lung disease
     
  • Causes of Reticular Change

  • Interstitial oedema
  • Interstitial pneumonia - viral pneumonitis, mycoplasma, pneumocystis
  • Usual interstitial pneumonia - connective tissue disease, asbestosis
  • Neoplasia - lymphangitis carcinomatosis, lymphoma
  • Medications - bleomycin, methotrexate, amiodarone, nitrofurantoin

Kerley Lines

The interlobular septa are not normally seen on chest x-rays. Thickening of interlobular septa seen on chest x-ray is referred to as Kerley lines, of which there are three types.
  • Interpretation

  • Kerley A lines - 5-10cm lines extending from the hila to the periphery (fluid in the deep septa)
  • Kerley B lines - 1-2cm lines seen in the periphery of the lower lung extending into the pleura (interlobular septal thickening)
  • Kerley C lines - small, fine lines not in keeping with A or B lines
  • Causes of Kerley Lines

  • Pulmonary oedema
  • Interstitial pneumonia - viral pneumonitis, mycoplasma, pneumocystis
  • Neoplasia  - lymphangitis carcinomatosis, lymphoma
  • Sarcoidosis
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