Pleural Effusion
February 15th, 2021
Overview
Chest X-Ray Signs of Pleural Effusion
- Loss of the costophrenic angle
- Increased density of the affected hemithorax
- Pseudo-elevation of the diaphragm
- Loss of lower lobe vessels
Examples
- Small bilateral pleural effusions evidenced by bibasal costophrenic blunting
![Small bilateral pleural effusions evidenced by bibasal costophrenic blunting]()
- Left-sided pleural effusion
![Left-sided pleural effusion]()
- Large right-sided pleural effusion
![Large right-sided pleural effusion]()
Causes of Pleural Effusion
Exudative
- Malignancy
- Infection - parapneumonic effusion, empyema, viral, fungal, TB, ruptured abscess / cyst
- Pulmonary embolism (90% exudative)
- Autoimmune disease - rheumatoid pleuritis, SLE
- Pancreatitis
- Haemothorax
- Chylothorax
- Asbestosis
- Uraemia
- Oesophageal rupture
Transudative
- Heart failure
- Cirrhosis
- Hypoalbuminaemia
- Nephrotic syndrome
- Pulmonary embolism (10% transudative)
- Myxoedema
- Meig's syndrome
- Constrictive pericarditis
- SVC obstruction
- Urinothorax
Pleural effusions should only be assessed for on an erect film as they are difficult to diagnose on a supine or prone film.
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