Citation, DOI, disclosures and article data
Citation:
Manickam A, Hacking C, McEniery J, et al. Assessment of pulmonary hila on chest x-ray (approach). Reference article, Radiopaedia.org (Accessed on 29 Mar 2024) https://doi.org/10.53347/rID-62199
Disclosures:
At the time the article was last revised Craig Hacking had the following disclosures:
- Philips Australia, Paid speaker at Philips Spectral CT events (ongoing)
These were assessed during peer review and were determined to
not be relevant to the changes that were made.
View Craig Hacking's current disclosures
The assessment of the pulmonary hila on chest x-ray is important for detecting potential mediastinal and lung pathology.
Several features of the hilum and hilar point can be assessed:
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shape
normally appear as K or C-shapes on either side
contents: pulmonary arteries and veins, bronchi, lymph nodes
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position
left hilum is normally 1-2 cm higher than the right
low left/right hilum could mean that it is either displaced, usually due to volume loss in atelectasis
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size
vascular enlargement: appear like "elephants trunks", typically bilaterally enlarged
nodal enlargement: appears craggy; maybe due to rotation or skeletal abnormality (e.g. scoliosis)
an apparent hilar mass may not be hilar in origin (see: hilum overlay sign)
change: for any suspected pathology, comparison to previous imaging is the first step to further evaluation
density: pathological hila are often more dense/solid
See also
Systematic chest radiograph assessment:
projection
assessment of the technical adequacy
tubes and lines
cardiomediastinal contours
hila
airways, lungs and pleura
bones and soft tissue
review areas
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1. Elizabeth Puddy, Catherine Hill; Interpretation of the chest radiograph, Continuing Education in Anaesthesia Critical Care & Pain, Volume 7, Issue 3, 1 June 2007, Pages 71–75, https://doi.org/10.1093/bjaceaccp/mkm014
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