Opaque Hemithorax: Re-Visiting The Causes

Background: Whitening out of half of the lung field on a chest x-ray is known as Opacification of a hemithorax and its presence usually indicates a significant disease in patient. This study was done with an aim of finding different etiologies as the cause of complete opacification of a hemithorax on chest radiograph.Methods: A prospective study of patients whose Chest radiograph had opaque hemithorax were included and after clinical and laboratory investigation of these patients the diagnosis responsible for the complete opacification of half the lung field in chest X-ray was recorded.Results: A Total of 104 patients (69 males and 34 females) were enrolled for the study. Out of 100 patients 62 involved left and 42 involved right hemithorax. 74 patients had massive pleural effusion, 19 had destroyed lung secondary to tuberculosis, 8 had lung consolidation and 3 had collapse due to lung mass. Of 74 patients of pleural effusion 46 were diagnosed as empyema, 22 as malignant effusions and 6 as tubercular pleural effusion. Mediastinal shift to contra lateral side was seen only in 40 out of 74 patients having massive pleural effusion.Conclusion: Massive pleural effusion was found as most common etiology in our study. Other rarer causes that may present as opaque hemithorax could not be found in our study. A larger study may be done to find out the prevalence of these rare differential diagnoses of opaque hemithorax in chest radiograph