Factoid: Pneumonia Mimics on CXR

You’ve just seen a previously well 50 year old man with a cough and fever. A chest x-ray shows what you think is a pneumonia. Finally, a straightforward case! You are finishing up his charting and about to write ‘pneumonia’ as your diagnosis when you pause, is there anything else you could be missing?

  • Pulmonary embolism
  • Neoplasm/Cancer
  • Congestive heart failure
  • ARDS
  • Atelectasis/Lobar collapse
  • Pleural effusion
  • Bronchiolitis obliterans organizing pneumonia (BOOP)
  • Tuberculosis
  • Granulomatous disease (Wegner’s granulomatosis, Churg Strauss syndrome)
  • Collegen vascular diseases (Systemic Lupus Erythematosus, Mixed connective tissue disease)
  • Drug induced pulmonary disease (eg Amiodarone lung)
  • Pulmonary fibrosis
  • Eosinophillic pneumonia
  • Allergic/Hypersensitivity pneumonitis
  • Radiation pneumonitis
  • Foreign body obstruction

Factoid: CXR in aortic dissection

  • Widened mediastinum
  • Calcium sign (disruption of calcium ring, or change from previous CXR)
  • Apical cap
  • Left sided effusion
  • Loss of aortic knuckle
  • Obscured left hilum
  • Depression of left main stem bronchus
  • Loss of paratracheal stripe
  • Rightward tracheal deviation
  • Rightward deviation of gastric tube