Systemic lupus erythematosus x ray

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

Overview

X Ray

Shrinking lung (radiograph):  unexplained dyspnoea. restrictive pattern onpulmonary function tests.

Chest x-ray often shows small but clear lungs with diaphragmatic elevation. Occasional basal atelectasis may be present. 

Pleural fibrosis: Pleural thickening

Pulmonary infarct
  • wedge-shaped (less often rounded) juxtapleural opacification (Hampton hump) without air bronchograms
  • more often in the lower lobes
Pulmonary hypertension
  • elevated cardiac apex due to right ventricular hypertrophy
  • enlarged right atrium
  • prominent pulmonary outflow tract
  • enlarged pulmonary arteries
  • pruning of peripheral pulmonary vessels

Plumonary alveolar hemorrhage:

Patchy bilateral and acinar areas of increased opacity, predominantly in the lower lungs

Respiratory muscle dysfunction

elevated hemidiaphragms at chest radiography

linear atelectasis and an ill-defined juxtadiaphragmatic areas of increased opacity 

Wiedemann HP, Matthay RA. Pulmonary manifestations of collagen vascular diseases.Clin Chest Med 1989; 10:677-696

Mesentric vascuitis:
  • Plain radiographic studies:
    • Thumb-printing sign: Due to bowel wall edema or intramural hemorrhage
    • Segmental bowel dilatation
    • Air-fluid levels, pneumatosis
    • Narrowing of the lumen
    • Pseudo-obstruction
    • Portal venous gas

References

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