Systemic lupus erythematosus x ray: Difference between revisions

Jump to navigation Jump to search
Line 27: Line 27:
* Small bowel wall thickening
* Small bowel wall thickening
|-
|-
| rowspan="2" |Pulmonary involvement
| rowspan="3" |Pulmonary involvement
|[[Pleural effusion]]
|[[Pleural effusion]]
|
|
Line 37: Line 37:
** Fluid within the horizontal or oblique fissures
** Fluid within the horizontal or oblique fissures
** Mediastinal shifts with large amounts of fluid
** Mediastinal shifts with large amounts of fluid
|-
|[[Pulmonary hypertension]]
|
*Elevated cardiac apex due to right ventricular hypertrophy
* Enlarged right atrium
* Prominent pulmonary outflow tract
* Enlarged pulmonary arteries
|-
|-
|[[Pneumonitis|Acute pneumonitis]]
|[[Pneumonitis|Acute pneumonitis]]
Line 91: Line 98:
* Calcified spleen may be visible in the left upper quadrant
* Calcified spleen may be visible in the left upper quadrant
|-
|-
| rowspan="5" |Pulmonary involvement
| rowspan="4" |Pulmonary involvement
|Respiratory muscle dysfunction
|Respiratory muscle dysfunction
|
|
Line 101: Line 108:
|
|
*Patchy bilateral and acinar areas of increased opacity, predominantly in the lower lungs
*Patchy bilateral and acinar areas of increased opacity, predominantly in the lower lungs
|-
|[[Pulmonary hypertension]]
|
*Elevated cardiac apex due to right ventricular hypertrophy
* Enlarged right atrium
* Prominent pulmonary outflow tract
* Enlarged pulmonary arteries
|-
|-
|[[Pulmonary emboli]]
|[[Pulmonary emboli]]

Revision as of 21:33, 17 July 2017

Systemic lupus erythematosus Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Systemic lupus erythematosus from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Lupus and Quality of Life

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Systemic lupus erythematosus x ray On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Systemic lupus erythematosus x ray

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

National Guidelines Clearinghouse

NICE Guidance

FDA on Systemic lupus erythematosus x ray

on Systemic lupus erythematosus x ray

Systemic lupus erythematosus x ray in the news

Blogs onSystemic lupus erythematosus x ray

Directions to Hospitals Treating Systemic lupus erythematosus

Risk calculators and risk factors for Systemic lupus erythematosus x ray

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

On X ray imaging, systemic lupus erythematosus (SLE) may be characterized by different features regarding the present complication. the most common characteristic findings of SLE in X ray include:

X Ray

On X ray imaging, systemic lupus erythematosus (SLE) may be characterized by the following features, based on the organ system involvement.

More common complications

Organ Disease Description
Gastrointestinal system Dysphagia
  • Barium swallow / esophagography
    • Esophageal stricture
      • Peptic strictures that appear as smooth, tapered narrowing in the distal esophagus
    • Esophageal dilatation 
Enteritis
  • Small bowel wall thickening
Pulmonary involvement Pleural effusion
  • Lateral decubitus graphy:
    • Can visualise small amounts of fluid layering against the dependent parietal pleura
  • PA and AP CXR:
    • Blunting of the costophrenic angle
    • Blunting of the cardiophrenic angle
    • Fluid within the horizontal or oblique fissures
    • Mediastinal shifts with large amounts of fluid
Pulmonary hypertension
  • Elevated cardiac apex due to right ventricular hypertrophy
  • Enlarged right atrium
  • Prominent pulmonary outflow tract
  • Enlarged pulmonary arteries
Acute pneumonitis
  • bilateral patchy airspace opacification
Cardiac involvement Cardiomegaly
    • Cardiac enlargement
Mitral stenosis
    • Cardiomegaly
    • Double right heart border (enlarged left atrium and normal right atrium)
    • Prominent left atrial appendage
    • Splaying of the subcarinal angle (>120 degrees)
Musculoskeletal involvement Arthritis
  • Soft tissue swelling of the involved joints
  • Normal joint spaces
  • Symmetric involvement of interphalangeal joints
    • Swan neck deformity
    • Boutonniere deformities
    • Subluxation with ulnar deviation at MCP joints
    • Subluxation of the 1st metacarpophalangeal joint
  • Widened forefoot
  • Hallux valgus
Osteoporosis
  • Periarticular osteoporosis
  • Insufficiency fracture:
    • Periosteal reaction progressing to callus formation in diaphyseal fractures
    • Linear sclerosis and cortical thickening more frequent in metaphyseal and epiphyseal fractures

Less common complications

Organ Disease Description
Gastrointestinal system Intestinal pseudo-obstruction
  • Dilated bowel loops with or without the presence of fluid levels
  • Erect chest radiographs for perforation evaluating
Autosplenectomy
  • Calcified spleen may be visible in the left upper quadrant
Pulmonary involvement Respiratory muscle dysfunction
  • Elevated hemidiaphragms at CXR
  • Linear atelectasis and an ill-defined juxtadiaphragmatic areas of increased opacity

PMC1742125

Pulmonary hemorrhage
  • Patchy bilateral and acinar areas of increased opacity, predominantly in the lower lungs
Pulmonary emboli
Shrinking lung syndrome
  • Small but clear lungs with diaphragmatic elevation
  • Basal atelectasis 
Cardiac involvement Mitral regurgitation
  • Left atrial enlargement
    • Convexity or straightening of the left atrial appendage just below the main pulmonary artery (along left heart border)
    • Double density sign: An addition contour superimposed over the right heart due to left atrium enlargement
    • Elevation of the left main bronchus and splaying of the carina
  • Upper zone venous enlargement due to pulmonary venous hypertension
  • Left ventricular enlargement is also eventually present due to volume overload
Pericardial effusion
  • Globular enlargement of the cardiac shadow giving a water bottle configuration
  • Lateral CXR:
    • Vertical opaque line (pericardial fluid) separating a vertical lucent line directly behind sternum (epicardial fat) anteriorly
Musculoskeletal involvement Osteonecrosis (Avascular necrosis)
  • Initial minor osteopenia, followed by variable density
  • Gradually microfractures of the subchondral bone accumulate in the dead bone
  • Collapse of the articular surface
  • Crescent sign of AVN

References

Template:WH Template:WS