Systemic lupus erythematosus x ray: Difference between revisions

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** Vertical opaque line ([[pericardial fluid]]) separating a vertical lucent line directly behind sternum (epicardial fat) anteriorly
** Vertical opaque line ([[pericardial fluid]]) separating a vertical lucent line directly behind sternum (epicardial fat) anteriorly
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|Musculoskeletal involvement
| style="background: #DCDCDC; " |Musculoskeletal involvement
|[[Osteonecrosis]] ([[Avascular necrosis]])
|[[Osteonecrosis]] ([[Avascular necrosis]])
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Revision as of 13:22, 24 July 2017

Systemic lupus erythematosus Microchapters

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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
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
Acute pneumonitis
  • Bilateral patchy airspace opacification
Cardiac involvement Cardiomegaly
Mitral stenosis
    • Cardiomegaly with widening the heart shadow
    • 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
Osteoporosis

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
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 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

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