Date: 26 November 2013
D Sinusitis radiology with fluid level
Copyright:
Fungal Infection Trust
Notes:
Bronchography (A & B)is an old technique for visualising the bronchial tree, by introducing radio-opaque dye into the airways and then taking a chest Xray. It was the first means used to diagnose bronchiectasis, seen in these examples below. An historical description of the technique from 1922 can be seen here
Nowadays CT scanning of the chest is used for this purpose with 3D reconstruction in some cases.
White cell scan (C) This pair of white cell scans from different people show almost no white cells in the lungs on the left, as in a healthy person (the spleen is the ‘hottest area). The scan on the right shows grossly increased update, especially in the left lung (seen on the right). This is the typical feature of severe bronchiectasis with large amounts of neutrophils and other phagocytes present.
Sinusitis Plain X-ray (D) of the face showing the maxillary sinuses. The right maxillary sinus is complete fluid filled and the left side (seen on the right) has a fluid level. These features may be seen with severe acute bacterial sinusitis, but also other causes of sinusitis, including allergic rhinosinusitis.
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Mr RM is 80 and an ex-coal miner.He developed pneumoconiosis from exposure to coal dust. He also developed rheumatoid arthritis and the combination of this disease and pneumoconiosis is called Caplan’s syndrome.
His chest Xray in early 2015 shows extensive bilateral pulmonary shadowing with solid looking nodules superimposed on abnormal lung fields, contraction of his left lung with an elevated diaphragm and a large left upper lobe aspergilloma, displaying a classic air crescent. His CT scan from mid 2014 demonstrates a large aspergilloma in a cavity on the left, with marked pleural thickening around it, which is partially ‘calcified’ towards its base. Inferiorly on other images,remarkable pleural thickening and fibrotic irregular and spiculated nodules are seen, most partially calcified.
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