right middle lobe atelectasis

[anhtran]

This case is a right middle lobe atelectasis i found on learningradiology.com
http://www.learningradiology.com/archives2008/COW 301-RML Atelectasi

s/rmlatelectasiscorrect.html
i notice larger 7th and 8th intercostal space of the right lung,is this caused

by the atelectasis?because i think if there's atelectasis,the intercostal space should be narrower??

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[colbgw02]

They look symmetric to me (shrugs shoulders).

 

[anhtran]

Don't you see the lateral of 8th right intercostal space very larger than the left? ...

 

[colbgw02]

Not really. Besides, middle lobe collapse is an anterior process and the lobe is pretty small. I would expect its impact on the posterior intercostal spaces to be negligible.

 

[shark2000]

Not really. Besides, middle lobe collapse is an anterior process and the lobe is pretty small. I would expect its impact on the posterior intercostal spaces to be negligible.

1+.

 

[Shifty B]

Atelectasis has not changed the position of the ribs (at least significantly enough to see).

What does change the appearance of that spacing is positioning. The patient is very slightly rotated to the right, so the right posterior ribs are slightly further from the detector. The magnification from being a little bit further away makes that space look bigger.

Hope this helps.

 

[fun8stuff]

The only people that really try and look at changes in intercostal spaces are clinicians/ non-radiologists, tee-hee 😛

 

[jazzman84]

The only time I mention intercostal spaces is if there's blatant post-thoracotomy change.

It really is funny how you obsess over little details on cxr, even portables, before residency...then once you have 100+ of them crowding the list, you only care about things that will imminently kill someone.