Abnormal hilar position
Notice : The left hilum is large, dense and pulled laterally and upwards to the left
The trachea is deviated (pulled) towards the left, indicating loss of lung volume in the left hemithorax
Clinical details
History of left hilar malignancy treated with radiotherapy
Dx - Radiation fibrosis
Signs of loss of lung volume : as seen in this x-ray :
- Generalized shift of the mediastinum
-The trachea and heart gets shifted towards the atelectatic lung .
Elevation of the diaphragm : the diaphragm moves up and the normal relationship between left and right side gets altered .
-Drooping of the shoulder .
-Crowding of ribs : the interspace between ribs is narrower compared to the opposite side
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