Localizing lesions

Published on 23/05/2015 by admin

Filed under Internal Medicine

Last modified 23/05/2015

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CHAPTER 2 Localizing lesions

2.1 The lungs 18
2.2 The heart 21

2.1 The lungs

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This pair of films shows a right upper zone mass lesion. The PA film shows that it lies above the horizontal fissure (1) and the lateral film that it lies in front of the oblique fissure, as well as above the horizontal fissure (2), so the mass lies in the right upper lobe.

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As well as knowing what a lesion is it is often important to know its position within the lung. To accurately localize a lesion on a chest X-ray you need to look at both the PA and lateral films. First look at the PA film:

1. The position of the lesion can be described in terms of zones. The upper zone lies above the right anterior border of the 2nd rib, the middle zone between the right anterior borders of the 2nd and 4th ribs, and the lower zone between the right anterior border of the 4th rib and the diaphragm. Although this is useful descriptively it does not give any information about the lobes of the lung.
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