CTICasesRadiographic Overcall of Pleural Effusion
Imaging findings
Portable chest radiograph in a patient with necrotizing pancreatitis shows diffuse bilateral hazy opacities obscuring both hemidiaphragms, suggesting bilateral pleural effusions. CT shows a medium effusion on the left, but only passive atelectasis and pneumonia on the right with no fluid.
Key takeaways
Portable supine or semi-erect radiography cannot reliably differentiate pleural fluid from consolidated or atelectatic lung. Overcalling pleural effusions is common because both processes appear as baseline hemithorax opacification.
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