This is the final #xrayoftheweek of 2015 - what has caused the dense opacities in the lung bases on this chest x-ray?
There are dense nodular opacities clustered within the medial aspects on the lower hemithoraces bilaterally. No similar change is seen elsewhere in the lungs. There is a small right sided pleural effusion and some background chronic lung changes, and a pacemaker.
The changes are due to previous barium aspiration - the barium enters the most dependent portions of the lungs when erect, which are the medial aspects. The following is a still image from the barium study on which the aspiration occurred, showing barium outlining airways bilaterally, as well as the oesophagus and stomach.
I hope you have enjoyed reading through some of the #xrayoftheweek cases this year, and learnt something along the way. It's been an educational experience for me too, and I am happy to have contributed to the #FOAMRad movement this year by posting weekly blogs and sharing this content on all my social media channels. I hope 2016 brings me some new exciting opportunities for radiology education!