Features of 'Loculatedpleural effusion' on X-ray chest include all except: (A) Air bronchogram present, (B) In oblique view margins are diffuse in end on, (C) Not limited to one bronchopulmonary segmen t, (D) Superomedial margin of loculated pleural effusion forms obtuse angle with the mediastinum
Answer is A. (A) Air bronchogram present # Presence of air bronchogram excludes any pleural or mediastinal pathology.> Air bronchogram is visibility of bronchi with in parenchymal lesion, so it is found in alveolar pathology as Consolidation Infarction Contusion> Loculation should be considered when a density is considered to be fluid and does not correspond to anatomical location of fissures (loculation can occur within fissures).> It is not in the gravity dependant location.> Note in the upright film on right you are able to see the diaphragm medially, indicating that the fluid is not in the dependent portion.> Empyemas loculate> Consider all loculated effusions as empyema unless proven otherwise.