Pleural effusion. Click image to enlarge. |
CT of same patient demonstrating left pleural effusion. |
A couple features suggest pleural effusion over other causes:
- homogeneous opacity with no air bronchograms
- concave upper surface producing a meniscus
- while not really notable with this pleural effusion, some large pleural effusions will displace the mediastinum towards the contralateral side
Pneumonia is also an unlikely cause. For one, there is a second area of consolidation at the left lung base (also a pleural effusion). While multifocal pneumonia does exist, non-infective pathology takes a higher place in the differential when there are multiple areas of consolidation. Additionally, pneumonia generally has a more inhomogeneous opacification with air bronchograms and ill-defined margins. Click here to view a large pneumonia.
Source
Jenkins, P. Making Sense of the Chest X-Ray: A Hands-On Guide, 1st ed.
Lisle, D. Imaging for Students, 3rd ed.
Schwartz, D. Emergency Radiology: Case Studies