File:The American journal of roentgenology, radium therapy and nuclear medicine (1906) (14755114974).jpg

Identifier: americanjournroen07ameruoft (find matches)
Title: The American journal of roentgenology, radium therapy and nuclear medicine
Year: 1906 (1900s)
Authors: American Radium Society American Roentgen Ray Society
Subjects: Radiotherapy X-rays
Publisher: Springfield, Ill. C.C. Thomas
Contributing Library: Gerstein - University of Toronto
Digitizing Sponsor: University of Toronto

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he mid-chest is H Radiographic Findings in Pericarditis with Effusion occupied by a large triangular shadow, theapex of which is upward and which from itsshape and position resembles very closely thedistended pericardium. The shadow of theheart can be seen distinctly through it. Thelesion may be anterior or posterior, unilat-eral or bilateral, and may be combined withdiaphragmatic pleurisy or pericardial effu-sion. But he states it is characteristic of thiscondition that the abnormal shadow isalways superadded to the median shadow. The point which Destot makes of theabsence of pulsation in the margins of theshadow when it is due to fluid outside of thepericardium seems to me a good one. Theshadow of the dilated heart resembles veryclosely that of pericarditis with effusion.Usually the pulsations are so rapid or faintthat they are invisible at the fluoroscopicobservation. The shape of the heart shadowis rounded and the costophrenic angle maybe acute, obtuse or obliterated, but there is
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Fig. 5.\. Shows Extreme Dilatation of the HeartIN A Case of Pneumonia. Note the obliteration ofthe cardio-hepatic angle. The outline of the normalheart curves is rather indistinct but not as markedas in the plates of Pericarditis with Effusion.Careful tracings failed to show any evidence ofchange of level with change of position, and a drytap was made. The shadow to the right of theheart is due to consolidation in the lung. and refers to the work of Devic and Savywho report their studies of mediastinalpleurisy, including a chapter on radioscopicexamination by Destot. A point in diagnosisto which Destot calls attention is the dis-appearance of the heart-beat in mediastinalpleurisy and its presence in pericardialeffusion. If these observations by Barjon are true,mediastinal pleurisy or empyema wouldaccount for some of the radiographs inwhich the heart shadow is distinctly seenwithin a triangular shadow. Personally, Ihave never seen such a case. Fig. 5B. Same Patient. Shows marked decrea

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