Adult chest radiograph common exam pathology

Last revised by Joshua Yap on 26 Mar 2024

Adult chest radiograph common exam pathology is essential to consider in the build up to radiology exams. The list of potential diagnoses is apparently endless, but there are some favorites that seem to appear with more frequency.

When dealing with the adult chest radiograph in the exam setting, it is key to determine where the pathology is and separate your lists out from there.

The lungs

If the pathology is parenchymal, consider which pattern it fits into.

Lobar collapse

An old favorite and often used as a starting film to get you settled. Don't muck it up! And don't try and make it more difficult than it is. While there are five classic lobar collapses to choose from, it would appear that three are commonly used:

Air-space opacification

Make sure that you use correct chest radiograph terminology when describing pathology and remember that there is more than one differential for air-space opacification - in real life, it will almost always be pneumonia, but in the exam... think again.

Remember also that air-space opacification starts as ground-glass change, progresses to airspace nodules that tend to confluence and finally result in confluent consolidation.

It is very unlikely that you will be given a simple lobar pneumonia so look more closely - is there associated pleural fluid, cavitation or associated pathology, e.g. rib destruction. Remember that consolidation is just air-space filled with solid material.

Also remember the classic features of lobar consolidation and the silhouette sign to localize the pathology:

Cavitating lung lesion

The cavitating lung lesion is a common film to be shown in the exam, and you need to get your eye in to spot it. Cavitation can often be subtle, so double check any area of airspace opacification closely - it will change your differential completely.

This is a bit of a mammoth project, which will be completed soon:

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