Answers
What can you see?
The whole of the right hemithorax is opacified - 'a white out'. The mediastinum is shifted to the right i.e. towards the 'white out'.
What diagnoses could explain the appearances?
This could be a collapsed right lung. A mass in the right main bronchus causing occlusion and collapse of the whole of the right lung could cause this appearance. A large pleural effusion could also look like this but would usually push the mediastinum the other way i.e. away from the white out. However, in both these cases the patient would usually be unwell. There is no air at all in the right hemithorax so an alternative explanation is that the right lung has been been removed i.e. a pneumonectomy.
In terms of radiology, what would be the next most helpful step to assist diagnosis ?
Old radiographs would be useful.
Review previous radiographs
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