Gaillard F, Ranchod A, Niknejad M, et al. Bulging fissure sign (lobar consolidation). Reference article, Radiopaedia.org (Accessed on 13 Mar 2025) https://doi.org/10.53347/rID-9228
The bulging fissure sign refers to lobar consolidation where the affected portion of the lung is expanded, causing displacement of the adjacent fissure. Any type of pneumonia or space-occupying process can lead to bulging (sagging) fissure sign. Classically, it has been described in right upper lobe (RUL) consolidation secondary to Klebsiella pneumonia. It is now rarely seen due to prompt antibiotic therapy for suspected pneumonia.
A 30-year-old woman presents with fever, shortness of breath and a productive cough. Based on the chest x-ray appearance, what sign is most helpful for localizing the left-sided radiographic abnormality to the lung?
2. Tan MJ, Tan JS, Hamor RH et-al. The radiologic manifestations of Legionnaire's disease. The Ohio Community-Based Pneumonia Incidence Study Group. Chest. 2000;117 (2): 398-403. doi:10.1378/chest.117.2.398 - Pubmed citation
3. Lucas RS, Kuzmowych TV, Spagnolo SV. Legionella pneumonia presenting as a bulging fissure on chest roentgenogram. Chest. 1991;100 (2): 567-8. doi:10.1378/chest.100.2.567 - Pubmed citation
4. Adler B, Padley S, Miller RR et-al. High-resolution CT of bronchioloalveolar carcinoma. AJR Am J Roentgenol. 1992;159 (2): 275-7. AJR Am J Roentgenol (abstract) - Pubmed citation