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Chest X-Ray

Mediastinal Position

February 15th, 2021

Mediastinal shift

  • Look For

  • Deviation of the mediastinum toward one side of the chest.
  • Causes of Mediastinal Shift

  • Mediastinal mass - tumour, lymphadenopathy
  • Lung volume loss - lobectomy, pneumonectomy, significant atelectasis
  • Lung volume expansion - tension pneumothorax, large pleural effusion
  • Interpretation

  • Tracheal deviation - a sign of upper mediastinal shift
  • Deviation of the cardiac shadow - a sign of lower mediastinal shift


  • Look For

  • Inversion of the cardiac shadow, with the apex pointing toward the right side.
  • No Overlay
Detrocardia commonly coexists with situs invertus, where the intraabdominal organs are on the contralateral side.
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