Question 1605
{"accessible":true,"alternatives":[{"id":7993,"text":"acute pulmonary edema"},{"id":7994,"text":"atypical (viral) pneumonia"},{"id":7995,"text":"lobar pneumonia"},{"id":7996,"text":"sarcoidosis"},{"id":7997,"text":"usual interstitial pneumonia"}],"archived":false,"correctAlternativeId":7993,"explanation":"\u003cp\u003eAlthough this is a supine AP projection, there are still enough features here to support a diagnosis of pulmonary edema.\u003c/p\u003e\u003cp\u003eThe opacification is predominantly central or perihilar\u0026nbsp;and the vessels in the upper zones are engorged (upper lobar venous diversion). Heart size cannot be accurately assessed on this projection. The costophrenic recesses are blunted bilaterally (and remember these pleural effusions may appear larger when imaged erect).\u003c/p\u003e\u003cp\u003eLobar pneumonia is typically more confluent and unilateral with air bronchograms. \u003c/p\u003e\u003cp\u003eViral pneumonia can be a diffuse abnormality, but all the above features are more in keeping with pulmonary edema. \u003c/p\u003e\u003cp\u003eSarcoidosis and UIP have different appearances (with nodal enlargement in sarcoid, and volume loss in UIP).\u003c/p\u003e","id":1605,"imageUrl":"https://prod-images-static.radiopaedia.org/multiple_choice_questions/135/bickle_26492_big_gallery.jpeg","imageAttribution":{"kind":"case","rID":26492},"imageAttributionCaseInfo":{"title":"Bat's wings of pulmonary edema","contributor_name":"Ian Bickle","contributor_param":"clonvara","case_rid":26492,"case_param":"bats-wings-of-pulmonary-oedema"},"firstQuestionPath":"/questions/1605","nextQuestionPath":"/articles/lobar-pneumonia/questions/448","relatedArticles":[{"id":4997,"title":"Thoracic sarcoidosis (staging)","link":"/articles/thoracic-sarcoidosis-staging?lang=us"},{"id":27535,"title":"Atypical pneumonia","link":"/articles/atypical-pneumonia?lang=us"},{"id":16256,"title":"Pulmonary edema","link":"/articles/pulmonary-oedema?lang=us"},{"id":16895,"title":"Usual interstitial pneumonia","link":"/articles/usual-interstitial-pneumonia?lang=us"}],"alsoUsedIn":[],"stem":"\u003cp\u003eWhat is the most likely cause of breathlessness in this elderly patient?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/1605"}],"attemptsPercentages":[{"alternativeId":"7996","percentage":12},{"alternativeId":"7995","percentage":5},{"alternativeId":"7994","percentage":13},{"alternativeId":"7997","percentage":9},{"alternativeId":"7993","percentage":60}],"promptToLogin":false,"questionManager":false,"articleId":"lobar-pneumonia"}