Fundamental Radiological Findings: Widened Mediastinum

OVERVIEW

This page is dedicated to covering the important radiological finding of a widened mediastinum. Look here for more radiological findings.

WHAT IS IT?

A widened mediastinum refers to a finding on a chest X-ray where literally the mediastinum of the patient is wider then expected. Size cutoffs can sometimes vary, however more then 6 cm on supine PA chest X-ray or more then 8 cm on a supine AP chest X-ray may constitute a widened mediastinum.

Example of a widened mediastinum (> 8 cm on a supine AP film, source)
DIFFERENTIAL DIAGNOSIS FOR THIS FINDING

When seeing a widened mediastinum, it is important too keep in mind the following possible causes of this finding:

Aortic Conditions

  • Aortic dissection
  • Thoracic aortic aneurysm 
  • Aortic rupture 
  • Aortic unfolding 
KEY FEATURES TO LOOK FOR WHEN CHARACTERIZING THE FINDING

When seeing a widened mediastinum, there are a few important radiological features one should look at to try and characterize the finding. These features can help navigate the differential diagnosis above.

 

Page Updated: 01.07.2017