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4/28/2010
1
Silhouette Sign
Frontal X-ray Signs of Lobar Consolidation
• RUL – loss of upper right mediastinalborder
• RML – loss of right heart border• RLL – loss of right hemidiaphram• LUL – loss of upper left mediastinal
border• LINGULA loss of left heart border• LINGULA – loss of left heart border• LLL – loss of left hemidiaphram
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Frontal X-ray Signs of Lobar Consolidation
• SILHOUETTE SIGN – for localizing lesion from frontal chest film Intra-thoracic airfrom frontal chest film. Intra-thoracic air space occupying lesions touching a soft tissue structure will obliterate the air soft tissue interface
• Examples include:– Atelectasis– Pneumonia– Neoplasm
RLL Pneumonia
Densit at the• Density at the right lateral diaphragm
• Obliteration of lateral diaphragm border
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RLL Pneumonia
• Density at the mid diaphragmmid diaphragm
• Sharp margination at the major fissure (arrows)( )
Right Middle Lobe Pneumonia
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LUL Lingular
Pneumonia
• Obliterated left cardiac border
LULLingular
Pneumonia Lateral
• Consolidation anterior to the major fissure
• Compare to PA exam
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LLL Pneumonia
• Air space diseaseAir space diseaseleft lower lobe
• Density behind heart
• Obliteration of leftdiaphragm atdiaphragm at edge of heart
• Left heart border preserved
LLL Pneumonia• Note
obliteration of the posterior portion of the left diaphragm (arrows)( )
• Right diaphragm clearly seen