SONOWORLD : Consolidation of the lung

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Chest » General

Consolidation of the lung

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Author(s) :

Vikas Arora, MD

Presentation A young man presents with cough, right sided chest pain and fever. An ultrasound of the chest was performed.

Caption: Ultrasound of the right lower chest

Description: This is a labelled self-explanatory image of right lower chest. There is a mild pleural effusion. A wedge shaped area of the lung appears solid and uniformly hypoechoic, suggestive of consolidation of the lung.

Differential Diagnosis Consolidation of right lung

Final Diagnosis Consolidation of right lung

Discussion A common clinical scenario of lung consolidation is uniform opacification on the chest radiographs without the help of further characterization by plain radiography alone. Ultrasound in such a situation can help to distinguish between the presence of fluid, consolidation and atelectasis. Pleural tumors and peripheral lung tumors may also be seen on ultrasound.

The following points quoted in the Textbook of Diagnostic Ultrasound by Rumack, et al aptly summarize the ultrasound findings suggestive of lung consolidation:
1. solidification of lung tissue
2. the area of the solidified lung tissue appears wedge-shaped and appears uniformly hypoechoic
3. sharp peripheral margins of the consolidated lung
4. sonographic air and fluid bronchograms and air alveolograms
5. visualization of intra-parenchymal pulmonary arteries and veins
6. motion with respiration

Case References 1. William Brant in Rumack C, Wilson S, et al. Textbook of Diagnostic Ultrasound, Second Edition. Chapter 16 -The Thorax. pgs 575-597.