Assessment of pulmonary hila on chest x-ray (approach)
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Assessment of pulmonary hila on CXRchest x-ray (approach)
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Described here are points on to consider when approaching the assessment of thepulmonaryhila on chest radiographs.x-ray:
Hila- shape
1. Shape
- normally appear as gentle C
shapes-shapes on either sidewithout lumps or bumps - contents: pulmonary arteries
+and veins, bronchi, lymph nodes
2. Position
- left
hila ishilum is normally(< 2cm)1-2cm higher than the right -
alow left/right hilum could mean that it is eitherpushed/pulled up or downdisplaced, usually due to volume loss in atelectasis
3. Size - Nodal vs. Vascular enlargement
- vascular enlargement
-: appear like‘elephants’"elephants trunks",bilateraltypically bilaterally enlarged - nodal enlargement
-: appears craggy. May be; maybe due to rotation or skeletal abnormality(scoliosis)(e.g.Beware: the lesionscoliosis) -
an apparent hilar mass may not be hilar in
the hilaorigin (see: hilum overlay sign)
4. Interval change
- change: for any suspected pathology, comparison to previous imaging is the first step to further evaluation
-<p>Described here are points on assessment of <strong>hila on chest radiographs.</strong></p><h4>Hila<strong> </strong>-</h4><h5>1. Shape</h5><ul>-<li>normally appear as gentle C shapes on either side without lumps or bumps</li>-<li>contents: pulmonary arteries + veins, bronchi, lymph nodes</li>-</ul><h5>2. Position</h5><ul>-<li>left hila is normally (< 2cm) higher than the right</li>-<li>a low left/right hilum could mean that it is either pushed/pulled up or down</li>-</ul><h5>3. Size - Nodal vs. Vascular enlargement</h5><ul>-<li>vascular enlargement - appear like ‘elephants’ trunks, bilateral</li>-<li>nodal enlargement - appears craggy. May be due to rotation or skeletal abnormality (scoliosis). Beware: the lesion may not be in the hila</li>-</ul><h5>4. Interval change</h5><ul><li>for any suspected pathology, comparison to previous imaging is the first step to further evaluation</li></ul>- +<p>Described here are points to consider when approaching the <strong>assessment of the</strong> <strong>pulmonary</strong> <strong>hila on chest x-ray</strong>:</p><ul>
- +<li>
- +<strong>shape</strong><ul>
- +<li>normally appear as gentle C-shapes on either side</li>
- +<li>contents: pulmonary arteries and veins, bronchi, lymph nodes</li>
- +</ul>
- +</li>
- +<li>
- +<strong>position</strong><ul>
- +<li>left <a title="Pulmonary hilum" href="/articles/pulmonary-hilum-2">hilum</a> is normally 1-2cm higher than the right</li>
- +<li>low left/right hilum could mean that it is either displaced, usually due to volume loss in <a title="Atelectasis" href="/articles/lung-atelectasis">atelectasis</a>
- +</li>
- +</ul>
- +</li>
- +<li>
- +<strong>size</strong><ul>
- +<li>vascular enlargement: appear like "elephants trunks", typically bilaterally enlarged</li>
- +<li>nodal enlargement: appears craggy; maybe due to rotation or skeletal abnormality (e.g. scoliosis)</li>
- +<li>an apparent hilar mass may not be hilar in origin (see: <a title="Hilum overlay sign" href="/articles/hilum-overlay-sign">hilum overlay sign</a>)</li>
- +</ul>
- +</li>
- +<li>
- +<strong>change</strong>: for any suspected pathology, comparison to previous imaging is the first step to further evaluation</li>
- +</ul>
References changed:
- 1. Elizabeth Puddy, Catherine Hill; Interpretation of the chest radiograph, Continuing Education in Anaesthesia Critical Care & Pain, Volume 7, Issue 3, 1 June 2007, Pages 71–75, https://doi.org/10.1093/bjaceaccp/mkm014
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