🫁 CXR Pearl #1-1

 

👨Case: 45M, cough and shortness of breath for 5 days
🫁 CXR finding: Complete white-out of the right hemithorax.
❓ Question: What is the most likely diagnosis?

⚡ Key Radiographic Clues
Complete opacification of the right hemithorax
Mediastinum shifted to the opposite side
No visible air bronchograms

🎯 Diagnosis
Massive right pleural effusion

❓ Why?

• When a hemithorax is completely white, look at the mediastinum.
• When mediastinum shift away from white lung, most likely massive pleural effusion
• When mediastinum shift towards while lung, most likely lung collapse
• When there is no mediastinal shift, most likely pneumonia or consolidation

 
⚡ In this case:
Mediastinum pushed to the left → Mass effect → Pleural effusion

⭐CXR Pearl
 “White lung + mediastinum pushed away = Massive pleural effusion.”

Case courtesy: KMI Tawau, Sabah, Malaysia