Unilateral hypertransradiancy is the correct term for the chest radiograph appearance of increased blackness affecting one lung. Hyperlucency is a commonly used alternative but is inaccurate; the chest is not penetrated by light!
A logical approach begins by checking for:
technical factors
patient rotation
chest wall abnormalities
ipsilateral pneumothorax
contralateral pleural opacity
primary decrease in lung perfusion
secondary decrease in lung perfusion due to air-trapping
Mnemonics for a unilateral hypertransradiant hemithorax include:
CRAWLS
SAFE POEM
ACROSSS
Mnemonics
CRAWLS
C: contralateral lung increased density (e.g. supine pleural effusion)
R: rotation
A: air (pneumothorax)
W: wall (chest wall mass, mastectomy, polio, Poland syndrome, surgical removal of the pectoralis major muscle)
L: lungs (airway obstruction, emphysema, Swyer-James syndrome, unilateral large bullae, large pulmonary embolus)
S: scoliosis
SAFE POEM
O: obstruction (airway)
M: mucous plug
ACROSSS
A: air (pneumothorax), artery (pulmonary aplasia or hypoplasia)
C: chest wall (mastectomy, polio, Poland syndrome)
R: rotation
O: obstructive causes (airway obstruction, foreign body, unilateral emphysema, large embolus)
S: scoliosis
S: surrounding (increased density in contralateral lung, e.g. pleural effusion in the opposite lung in a recumbent patient)
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