Pneumonia as seen on chest X-ray. A: Normal chest X-ray. B: Abnormal chest X-ray with consolidation from pneumonia in the right lung, middle or inferior lobe (white area, left side of image).
A pulmonary consolidation is a region of normally compressible
lung tissue that has filled with liquid instead of air.[1] The condition is marked by induration[2] (swelling or hardening of normally soft tissue) of a normally aerated lung. It is considered a
radiologic sign. Consolidation occurs through accumulation of inflammatory cellular exudate in the
alveoli and adjoining ducts. The liquid can be
pulmonary edema, inflammatory
exudate,
pus, inhaled water, or blood (from bronchial tree or
hemorrhage from a
pulmonary artery). Consolidation must be present to diagnose
pneumonia: the signs of lobar pneumonia are characteristic and clinically referred to as consolidation.[3]
Signs
Signs that consolidation may have occurred include:
Expansion of the thorax on inspiration is reduced on the affected side
Possible medium, late, or pan-inspiratory
crackles
Vocal resonance is increased. Here, the patient's voice (or whisper, as in
whispered pectoriloquy) can be heard more clearly when there is consolidation, as opposed to the healthy lung where speech sounds muffled.
Typically, an area of white lung is seen on a standard X-ray.[5] Consolidated tissue is more radio-opaque than normally aerated lung parenchyma, so that it is clearly demonstrable in
radiography and on
CT scans. Consolidation is often a middle-to-late stage feature/complication in
pulmonary infections.
^Metlay JP, Kapoor WN, Fine MJ (1997). "Does this patient have community-acquired pneumonia? Diagnosing pneumonia by history and physical examination". JAMA: The Journal of the American Medical Association. 278 (17): 1440–5.
doi:
10.1001/jama.278.17.1440.
PMID9356004.
^Talley, Nicholas Joseph (2001). Clinical Examination, a Clinical Guide to Physical Diagnosis, Wiley, 4th ed., p. 121,
ISBN0632059710.
^Corne, Jonathan; Carroll, Mary; Delany, David (2002). Chest X-Ray Made Easy. Churchill Livingstone.
ISBN978-0-443-07008-2.