Radiology – Integrated Training Initiative (R-ITI) | Paediatrics | Assessment of Bilateral Hyperlucent Hemithoraces

Assessment of Bilateral Hyperlucent Hemithoraces
Session Overview
Description
This session describes the systematic assessment of bilateral hyperlucent hemithoraces, and distinguishes between the two main causes of hyperlucency hemithoraces; pathology and technical factors.

Learning Objectives
By the end of this session you will be able to:

• Demonstrate how to assess a chest x-ray (CXR) for increased translucency and hyperinflation
• List the common causes of bilateral hyperlucency of the paediatric CXR

Prerequisites
Before commencing this session you should:

• Have a basic understanding of paediatric chest pathology
• Recognise normal appearances of the paediatric CXR

Increased translucency of both hemithoraces is commonly associated with hyperinflation of the lungs and may be related to:

Technical factors

• Overexposure
• Exuberant inspiration

Pathological factors

• Hyperinflated lungs

• Non-obstructive (physiological), e.g. acidosis, dehydration, cyanotic congenital heart disease
• Obstructive, e.g. central and peripheral air trapping

• Decreased pulmonary blood flow (may be normal lung expansion)
• Free intrathoracic air

It is useful to develop a strategy to evaluate the translucency of the hemithoraces.