Thursday 21 November 2013

Double diaphragm sign

Q1.' Double diaphragm sign 'is noted in

a.subpulmonic effusion

b.pneumothorax

c.hydrothorax

d.diaphragmatic palsy

Q2.All are sign of diaphragmatic injury except

a.dependent viscera sign

b.thick crus sign

c.collar sign

d.crescent sign

ANS--1===b ===pneumothorax

2===d===crescent sign

Atypical signs of pneumothorax

Atypical sign arise when the patient is supine or the pleural space partly obliterated.
In the supine position, pleural air rises and collects anteriorly, particularly medially and basally, and may not extend far enough posteriorly to separate lung from thechest wall at the apex or laterally.

	1•	ipsilateral transradiancy, either generalized or hypochondrial
	2•	a deep, finger-like costophrenic sulcus laterally
	3•	a visible anterior costophrenic recess seen as an oblique line or interface in the hypochondrium; when the recess is manifest as an interface it mimics the adjacent diaphragm (‘double diaphragm sign’)
	4•	a transradiant band parallel to the diaphragm and/or mediastinum with undue clarity of the mediastinal border
	5•	visualization of the undersurface of the heart, and of the cardiac fat pads as rounded opacities suggesting masses
	6•	diaphragm depression. Double diaphragm signwww.diendanykhoa.com Diaphragmatic rupture The MDCT diagnosis of diaphragmatic rupture is largely based on the fact that abdominal organs are seen in the pleural space outside the diaphragm The identification of the diaphragm on standard CT images can be very difficult; multiplanar CT reconstructions can help to show the defect directly. CT signs of diaphragmatic rupture include^; 1. discontinuity of the diaphragm with direct visualization of the diaphragmatic injury; 2. herniation of abdominal organs with liver, bowel or stomach in contact with the posterior ribs (‘dependent viscera sign’); 3.thickening of the crus (‘thick crus sign’); 4.constriction of the stomach or bowel (‘collar sign’);