Hemithorax white-out - pleural effusion

Case contributed by Henry Knipe
Diagnosis certain


Shortness of breath.

Patient Data

Age: 85 years
Gender: Male

White-out of the left hemithorax. Mediastinal shift to the right. Left midzone and diaphragmatic dome calcific pleural plaques. 

Case Discussion

The key to deciding the underlying cause in hemithorax white-out is mediastinal shift. Positive mediastinal shift (away from side of white-out) means pleural effusion is the likely cause, and negative mediastinal shift (towards side of white-out) indicates atelectasis as the likely cause. The underlying cause fof the pleural effusion in this patient is not known. 

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