Condition Specific Radiology: Pneumonia

OVERVIEW

This page is dedicated to covering how pneumonia will appear on different types of radiological imaging studies.

BASIC CHARACTERISTICS

A pneumonia refers to an inflammatory proces in the lungs that results in the accumulation of fluid within the structures of the lung. As a result of this increased fluid (in a space that traditionally is mostly occupied by air), pneumonias will have some base characteristics that appear across radiological studies.

Figure depicting pneumonia (source).
Figure depicting pneumonia (source).

Here are some features of pneumonia  that can be observed across all imaging studies:

  • Increased opacity/signal: pneumonia is characterized by the presence of inflammatory infiltrates that can appear as increased opacity/signal across radiological studies.
  • Location: this condition will be present in the lungs.

CHEST X-RAY

Features of pneumonia that can be seen on a chest X-ray:

  • Hazy opacities can be appreciated in pneumonia that involves the airspaces.
  • Air bronchograms can be present as well if the fluid of the pneumonia has not filled the bronchi themselves.
RIGHT UPPER LOBE PNEUMONIA

Features of this type of pneumonia (on a chest X-ray) include:

  • Right upper lung opacities: these should not obscure either the right border of the heart or the border of the right diaphragm.
  • Abutting major fissure: this pneumonia can outline the major fissure given its anatomical location.
Right Upper Lobe Pneumonia: Chest X-Ray
RIGHT MIDDLE LOBE PNEUMONIA

Features of this type of pneumonia (on a chest X-ray) include:

  • Opacity obscures the right border of the heart: this can often be appreciated on a frontal view.
  • Right hemidiaphragm is not obscured: this border should be visible unless the right lower lobe is also involved
  • Opacity over the location of the heart on the lateral view: the lateral view will also help in localizing the opacity. If it is located over the heart on the lateral view, this is likely the right middle lobe that is involved.
Right Middle Lobe Pneumonia: Chest X-Ray
RIGHT LOWER LOBE PNEUMONIA

Features of this type of pneumonia (on a chest X-ray) include:

  • Opacity obscures the right hemidiaphragm: this can often be appreciated on a frontal view.
  • Opacity over the location of the thoracic spine on the lateral view: the lateral view can also help in localizing the opacity. If the opacity is located over the spine on the lateral view, then the right lower lobe may be involved.
Right Lower Lobe Pneumonia: Chest X-Ray
LEFT UPPER LOBE PNEUMONIA

Features of this type of pneumonia (on a chest X-ray) include:

  • Opacity can obscure border of upper mediastinum: this can be appreciated on the frontal view.
Left Upper Lobe Pneumonia: Chest X-Ray
LINGULAR  PNEUMONIA

Features of this type of pneumonia (on a chest X-ray) include:

  • Opacity can obscure border of the lower heart border: this can be appreciated on the frontal view.
Lingular Pneumonia: Chest X-Ray
LEFT LOWER LOBE PNEUMONIA

Features of this type of pneumonia (on a chest X-ray) include:

  • Opacity obscures the left hemidiaphragm: this can often be appreciated on a frontal view.
  • Left heart border not obscured: this border should be visible unless the left upper lobe is also involved.
  • Opacity over the location of the thoracic spine on the lateral view: the lateral view can also help in localizing the opacity. If the opacity is located over the spine on the lateral view, then the left lower lobe may be involved.
Left Lower Lobe Pneumonia: Chest X-Ray
INTERSTITAL PNEUMONIA

Features of this type of pneumonia (on a chest X-ray) include:

  • Reticular pattern: interstitial pneumonia results in a fine reticular pattern of opacities over the lung fields.
  • Can spread to alveoli and produce a more uniform consolidation.
Interstitial Pneumonia: Chest X-Ray
ROUND PNEUMONIA

Features of this type of pneumonia (on a chest X-ray) include:

Round Pneumonia: Chest X-Ray

COMPUTIRIZED TOMOGRAPHY (CT-SCAN)

 

MAGNETIC REASONANCE IMAGING (MRI)

 

Page Updated: 10.14.2016