Systemic lupus erythematosus x ray: Difference between revisions

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![[Pleural effusion]]
![[Pleural effusion]]
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* Lateral decubitus graphy:
* Lateral decubitus view:
** Can visualise small amounts of fluid layering against the dependent [[parietal pleura]]
** Visible small amounts of fluid layering against the dependent [[parietal pleura]]
* PA and AP CXR:
* PA and AP CXR:
** Blunting of the [[costophrenic angle]]
** Blunting of the [[costophrenic angle]]
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![[Mitral stenosis]]
![[Mitral stenosis]]
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*[[Cardiomegaly]] with [[Widened mediastinum|widening the heart shadow]]
*[[Cardiomegaly]]
*Double right heart border (enlarged [[left atrium]] and normal [[right atrium]])
*Double right heart border (enlarged [[left atrium]] and normal [[right atrium]])
*Prominent [[left atrial]] appendage
*Prominent [[left atrial]] appendage
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=== Less common findingss ===
=== Less common findings ===
{| class="wikitable"
{| class="wikitable"
! style="background: #4479BA; color: #FFFFFF; " |Organ
! style="background: #4479BA; color: #FFFFFF; " |Organ
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*Dilated [[bowel]] loops with or without the presence of fluid levels
*Dilated [[bowel]] loops with or without the presence of fluid levels
*Erect [[chest]] radiographs for [[perforation]] evaluating
*Upright [[chest]] radiographs for [[perforation]] evaluating
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[[File:Colonic-pseudo-obstruction-ogilvies-syndrome.jpg|thumb|300px|<SMALL><SMALL>''[https://radiopaedia.org/ Adapted from Radiopaedia]''</SMALL></SMALL>]]  
[[File:Colonic-pseudo-obstruction-ogilvies-syndrome.jpg|thumb|300px|<SMALL><SMALL>''[https://radiopaedia.org/ Adapted from Radiopaedia]''</SMALL></SMALL>]]  
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* Enlargement of liver silhouette
* Enlargement of liver silhouette
* Displacing bowel loops medially
* Medially displaced bowel loops
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[[File:Hepatomegaly-on-abdominal-x-ray.jpg|thumb|300px|<SMALL><SMALL>''[https://radiopaedia.org/ Adapted from Radiopaedia]''</SMALL></SMALL>]]  
[[File:Hepatomegaly-on-abdominal-x-ray.jpg|thumb|300px|<SMALL><SMALL>''[https://radiopaedia.org/ Adapted from Radiopaedia]''</SMALL></SMALL>]]  
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*[[Fleischner sign|Fleishner sign]]: Enlarged [[pulmonary artery]]
*[[Fleischner sign|Fleishner sign]]: Enlarged [[pulmonary artery]]
*[[Hampton's hump|Hampton hump]]: Peripheral wedge of airspace opacity and implies [[lung infarction]]
*[[Hampton's hump|Hampton hump]]: Peripheral wedge of airspace opacity and implied [[lung infarction]]
*[[Westermark sign]]: Regional oligoemia
*[[Westermark sign]]: Regional oligoemia
*[[Pleural effusion]]
*[[Pleural effusion]]
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*[[Left atrial enlargement]]
*[[Left atrial enlargement]]
**Convexity or straightening of the [[left atrial appendage]] just below the main [[pulmonary artery]] (along left heart border)
**Convexity or straightening of the [[left atrial appendage]] just below the main [[pulmonary artery]] (along with left heart border)
**Double density sign: An addition contour superimposed over the [[right heart]] due to [[Left atrial enlargement|left atrium enlargement]]
**Double density sign: An addition contour superimposed over the [[right heart]] due to [[Left atrial enlargement|left atrium enlargement]]
**Elevation of the left main [[bronchus]] and splaying of the [[carina]]
**Elevation of the left main [[bronchus]] and splaying of the [[carina]]

Revision as of 15:06, 4 August 2017

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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: thumb printing sign in the abdominal graphy, blunting of the costophrenic angle due to pleural effusion, cardiomegaly, hepatomegaly, osteoprosis, tenosinovitis, and other manifestations based on the complications.

X Ray

Findings on an X ray imaging for systemic lupus erythematosus (SLE) depends on the organ system involvement and may include the following features.[1][2][3][4][5][6][7][8][9][10][11][12]

More common findingss

Organ Disease Description Preview
Gastrointestinal system Enteritis
Adapted from Radiopaedia
Pulmonary involvement Pleural effusion
Adapted from Radiopaedia
Pulmonary fibrosis
Adapted from Radiopaedia
Pulmonary hypertension
Adapted from Radiopaedia
Acute pneumonitis
Adapted from Radiopaedia
Cardiac involvement Cardiomegaly
Adapted from Radiopaedia
Mitral stenosis
Musculoskeletal involvement Arthritis
Adapted from Radiopaedia
Osteoporosis
Adapted from Radiopaedia

Less common findings

Organ Disease Description Preview
Gastrointestinal system Intestinal pseudo-obstruction
  • Dilated bowel loops with or without the presence of fluid levels
  • Upright chest radiographs for perforation evaluating
Adapted from Radiopaedia
Autosplenectomy
  • Calcified spleen may be visible in the left upper quadrant
Hepatomegaly
  • Enlargement of liver silhouette
  • Medially displaced bowel loops
Adapted from Radiopaedia
Pulmonary involvement Respiratory muscle dysfunction
  • Elevated hemidiaphragms at CXR
  • Linear atelectasis and an ill-defined juxtadiaphragmatic areas of increased opacity
Adapted from Radiopaedia
Pulmonary hemorrhage
  • Patchy bilateral and acinar areas of increased opacity, predominantly in the lower lungs
Adapted from Radiopaedia
Pulmonary emboli
Adapted from Radiopaedia
Shrinking lung syndrome
Cardiac involvement Mitral regurgitation
Adapted from Radiopaedia
Pericardial effusion
  • Globular enlargement of the cardiac shadow giving a water bottle configuration
  • Lateral CXR:
Adapted from Radiopaedia
Musculoskeletal involvement Osteonecrosis (Avascular necrosis)
  • Initial minor osteopenia, followed by variable density
  • Gradually micro-fractures of the subchondral bone accumulate in the dead bone
  • Collapse of the articular surface
  • Crescent sign of AVN
Adapted from Radiopaedia

References

  1. Appenzeller S (2013). "Magnetic resonance imaging in systemic lupus erythematosus: where do we stand?". Cogn Behav Neurol. 26 (2): 53–4. doi:10.1097/WNN.0b013e31829d5b60. PMID 23812167.
  2. Thurman JM, Serkova NJ (2015). "Non-invasive imaging to monitor lupus nephritis and neuropsychiatric systemic lupus erythematosus". F1000Res. 4: 153. doi:10.12688/f1000research.6587.2. PMC 4536614. PMID 26309728.
  3. Lin K, Lloyd-Jones DM, Li D, Liu Y, Yang J, Markl M, Carr JC (2015). "Imaging of cardiovascular complications in patients with systemic lupus erythematosus". Lupus. 24 (11): 1126–34. doi:10.1177/0961203315588577. PMC 4567427. PMID 26038342.
  4. Sarbu N, Bargalló N, Cervera R (2015). "Advanced and Conventional Magnetic Resonance Imaging in Neuropsychiatric Lupus". F1000Res. 4: 162. doi:10.12688/f1000research.6522.2. PMC 4505788. PMID 26236469.
  5. Qin H, Guo Q, Shen N, Huang X, Wu H, Zhang M, Bao C, Chen S (2014). "Chest imaging manifestations in lupus nephritis". Clin. Rheumatol. 33 (6): 817–23. doi:10.1007/s10067-014-2586-2. PMID 24696368.
  6. Goh YP, Naidoo P, Ngian GS (2013). "Imaging of systemic lupus erythematosus. Part II: gastrointestinal, renal, and musculoskeletal manifestations". Clin Radiol. 68 (2): 192–202. doi:10.1016/j.crad.2012.06.109. PMID 22901453.
  7. Gal Y, Twig G, Mozes O, Greenberg G, Hoffmann C, Shoenfeld Y (2013). "Central nervous system involvement in systemic lupus erythematosus: an imaging challenge". Isr. Med. Assoc. J. 15 (7): 382–6. PMID 23943987.
  8. Shirato M, Hisa N, Fujikura Y, Ohkuma K, Kutsuki S, Hiramatsu K (1992). "[Imaging diagnosis of lupus enteritis--especially about sonographic findings]". Nihon Igaku Hoshasen Gakkai Zasshi (in Japanese). 52 (10): 1394–9. PMID 1448334.
  9. Adachi JD, Lau A (2014). "Systemic lupus erythematosus, osteoporosis, and fractures". J. Rheumatol. 41 (10): 1913–5. doi:10.3899/jrheum.140919. PMID 25275093.
  10. Curiel R, Akin EA, Beaulieu G, DePalma L, Hashefi M (2011). "PET/CT imaging in systemic lupus erythematosus". Ann. N. Y. Acad. Sci. 1228: 71–80. doi:10.1111/j.1749-6632.2011.06076.x. PMID 21718325.
  11. Goh YP, Naidoo P, Ngian GS (2013). "Imaging of systemic lupus erythematosus. Part I: CNS, cardiovascular, and thoracic manifestations". Clin Radiol. 68 (2): 181–91. doi:10.1016/j.crad.2012.06.110. PMID 22901452.
  12. Rockall AG, Rickards D, Shaw PJ (2001). "Imaging of the pulmonary manifestations of systemic disease". Postgrad Med J. 77 (912): 621–38. PMC 1742125. PMID 11571369.

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