Right lower zone pneumoniaWhat is the diagnosis?

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X-ray 1 / 1

Frontal chest radiograph with an arrow from the original source.

Image: Mikael Häggström, M.D., CC0 — source

Answer hidden. Review the images and history, decide on your diagnosis, then reveal.

Findings

Airspace opacity in the right mid to lower zone (arrow)
The right heart border remains visible, favouring the right lower lobe over the middle lobe
No significant volume loss; costophrenic angles clear
Left lung clear

Case discussion

Airspace consolidation in a patient with fever and productive cough is most likely pneumonia. Because the right heart border is preserved, the opacity is probably posterior, in the lower lobe — a lateral view would confirm this.

Consolidation keeps lung volume, unlike collapse. Radiographic resolution lags behind clinical recovery; a follow-up film at about six weeks is often advised in smokers and older adults to exclude an underlying lesion.

Encyclopedia

Lobar pneumoniaInfection filling the alveoli of an entire lobe or segment, producing homogeneous consolidation with air bronchograms.Silhouette signLoss of a normal border between soft tissue and air when an adjacent structure fills with fluid or tissue, used to localise chest disease.

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