Consolidation: Chest Abnormalities With Hetal Verma, MD

Consolidation
Chest Abnormalities
With Hetal Verma, MD
Pablo Maria Peralta Lorca, pablo@peraltalorca.com

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Learning Objectives
• You will learn what causes consolidation

and how this appears on a chest
radiograph.
• You will learn the different radiographic

signs of consolidation.
• You will learn how to localize the area of

consolidation.
• You will be able to discuss the differences

between consolidation and atelectasis.

Consolidation

Consolidation
• Airspace disease
• Filling of the alveoli space
• Indistinct margins
• Fluffy opacities
• Confluent over time
© by Hetal Verma, MD
Consolidation
Blood Pus Water Cells

(hemorrhage) (pneumonia) (edema) (carcinoma)

Air Bronchograms

Air Bronchograms
• May contain air bronchograms
• Air normally surrounding the High-yield

bronchi becomes opacified
while the bronchi remain air-
filled, where they appear as
black tubular structures within
an area of consolidation
William Herring, Learning Radiology, 3rd Edition, 2016, p. 68 Saunders (Elsevier)

Silhouette Sign

Silhouette Sign
This occurs when 2

objects of the same High-yield
density touch each

other so that the margin
between the two can
no longer be visualized.
Spine Sign

Spine Sign
• The thoracic spine generally gets

darker the closer it is to the
diaphragm.
• In cases of lower lobe consolidation,

the x-ray beam has to penetrate the
consolidation and the spine, making it
appear whiter.

Pneumonia

Pneumonia
Localized or Diffuse
Airspace or Interstitial

Right Upper Lobe Consolidation
Abuts the major fissure, often

producing a sharp margin
Right Middle Lobe Consolidation
Silhouettes the right

heart border on the
frontal view and
overlaps the heart on
the lateral view
Right Lower Lobe Consolidation
Silhouettes the right hemidiaphragm

Left Upper Lobe Consolidation
Silhouettes the upper left mediastinum

Lingular Consolidation
Silhouettes the left heart border

Left Lower Lobe Consolidation
Silhouettes the left hemidiaphragm

Interstitial Pneumonia

Interstitial Pneumonia
• Produces a fine reticular pattern
• Often spreads to the alveoli over Central line

time
• Often seen in viral or atypical

pneumonias such as Mycoplasma
and Pneumocystis

Central line

Describe the Findings

High-yield
Cavitary Lesions
• Mass-like areas of consolidation with

central lucency
High-yield
• Thick-walled
• Varying sizes
• Caused by abscess, tuberculosis,

carcinoma
Round Pneumonia
• Most often seen in children
• Usually seen posteriorly
• Most commonly in the upper

segments of the lower lobes
• Can appear mass-like
• Organisms include
Haemophilus influenzae,
Streptococcus and
Pneumococcus
Aspiration Pneumonia

Aspiration Pneumonia
• Dependent portions of the

lungs
• More often on the right
due to right main
bronchus being more
directly aligned with the
trachea
Learning Outcomes
 You have learned the causes of

consolidation and how it appears on a
chest radiograph.
 You have learned the different radiographic

signs of consolidation.
 You have learned how to localize the area

of consolidation.
 You are able to discuss the differences

between consolidation and atelectasis.

This document is a property of: Pablo Maria Peralta Lorca
Note: This document is copyright protected. It may not be copied, reproduced, used, or
distributed in any way without the written authorization of Lecturio GmbH.


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Consolidation

With Hetal Verma, MD

Pablo Maria Peralta Lorca, pablo@peraltalorca.com

• You will learn what causes consolidation

• You will learn the different radiographic

• You will learn how to localize the area of

• You will be able to discuss the differences

Pablo Maria Peralta Lorca, pablo@peraltalorca.com

Pablo Maria Peralta Lorca, pablo@peraltalorca.com

• Filling of the alveoli space

• Confluent over time

Blood Pus Water Cells

Pablo Maria Peralta Lorca, pablo@peraltalorca.com

Pablo Maria Peralta Lorca, pablo@peraltalorca.com

• May contain air bronchograms

• Air normally surrounding the High-yield

William Herring, Learning Radiology, 3rd Edition, 2016, p. 68 Saunders (Elsevier)

Pablo Maria Peralta Lorca, pablo@peraltalorca.com

This occurs when 2

density touch each

Pablo Maria Peralta Lorca, pablo@peraltalorca.com

• The thoracic spine generally gets

• In cases of lower lobe consolidation,

William Herring, Learning Radiology, 3rd Edition, 2016, p. 78 Saunders (Elsevier)

Pablo Maria Peralta Lorca, pablo@peraltalorca.com

William Herring, Learning Radiology, 3rd Edition, 2016, p. 70 Saunders (Elsevier)

Abuts the major fissure, often

Silhouettes the right

Silhouettes the right hemidiaphragm

William Herring, Learning Radiology, 3rd Edition, 2016, p. 73 Saunders (Elsevier)

Silhouettes the upper left mediastinum

William Herring, Learning Radiology, 3rd Edition, 2016, p. 72 Saunders (Elsevier)

Silhouettes the left heart border

William Herring, Learning Radiology, 3rd Edition, 2016, p. 72 Saunders (Elsevier)

Silhouettes the left hemidiaphragm

William Herring, Learning Radiology, 3rd Edition, 2016, p. 72 Saunders (Elsevier)

Pablo Maria Peralta Lorca, pablo@peraltalorca.com

• Produces a fine reticular pattern

• Often spreads to the alveoli over Central line

• Often seen in viral or atypical

William Herring, Learning Radiology, 3rd Edition, 2016, p. 78 Saunders (Elsevier)

William Herring, Learning Radiology, 3rd Edition, 2016, p. 78 Saunders (Elsevier)

Pablo Maria Peralta Lorca, pablo@peraltalorca.com

• Mass-like areas of consolidation with

• Caused by abscess, tuberculosis,

• Usually seen posteriorly

• Most commonly in the upper

• Can appear mass-like

Pablo Maria Peralta Lorca, pablo@peraltalorca.com

• Dependent portions of the

 You have learned the causes of

 You have learned the different radiographic

 You have learned how to localize the area

 You are able to discuss the differences

Pablo Maria Peralta Lorca, pablo@peraltalorca.com

Pablo Maria Peralta Lorca, pablo@peraltalorca.com

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