Pulmonary hepatisation, parapneumonic effusion

Case contributed by Bálint Botz

Presentation

Elevated inflammatory markers, cough, dypsnea.

Patient Data

Age: 85
Gender: Female

Supine AP CXR

x-ray

Right-sided pleural effusion, ill-defined reduced transparency of the right lung zones, however no immediately obvious consolidation can be identified. Incidentally a degenerative scoliosis and marked atherosclerosis are also visible.

Lung US performed in a sitting position

ultrasound

Focused ultrasound examination revealed an essentially complete consolidation of the right lower lobe with air bronchograms and parapneumonic effusion. The thoracic spine sign is also demonstrated.

Case Discussion

The case shows the added value of focused ultrasound in case of suspected pathology in the lower lung zones, where the complete lobar hepatisation was masked by the associated effusion in the radiograph.

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