3: RADIOGRAPHIC AND ULTRASONOGRAPHIC SIGNS

PART 3
RADIOGRAPHIC AND ULTRASONOGRAPHIC SIGNS


3.1 Thoracic radiography


3.1.1 Artefactual causes of increased lung opacity



  • Chemical stains/dirty cassettes
  • Dirty or wet fur
  • Forelimbs not pulled sufficiently forwards
  • Movement blur
  • Obesity
  • Poorly inflated lungs

    • Abdominal distension
    • Expiratory film
    • Upper airway obstruction

  • Underdevelopment
  • Underexposure

3.1.2 Increased bronchial pattern


Normal variation*



  • Chondrodystrophic breeds
  • Older dogs

Bronchial wall oedema, e.g.



  • Congestive heart failure*

Bronchiectasis


Chronic bronchitis*



  • Primary ciliary dyskinesia (D)

Endocrine


  • Hyperadrenocorticism

Infection


  • Bacterial*
  • Fungal, e.g.

    • Pneumocystis carinii

  • Parasitic, e.g.

    • Crenosoma vulpis (D)

  • Protozoal, e.g.

    • Toxoplasmosis

  • Viral

Inflammation, e.g.


  • Eosinophilic bronchopneumopathy (pulmonary infiltrate with eosinophilia) (D)
  • Feline asthma (C)
  • Idiopathic

Neoplasia


  • Bronchogenic carcinoma
  • Lymphoma

3.1.3 Increased alveolar pattern


Atelectasis


  • Airway obstruction
  • Chronic pleural or pulmonary disease*
  • Collapse of the lung lobes under general anaesthesia*
  • Extra-pulmonary thoracic mass
  • Feline asthma* (C)
  • Lack of surfactant (newborn, acute respiratory distress syndrome)
  • Lung lobe torsion
  • Pleural effusion* q.v.
  • Pneumothorax* q.v.
  • Recumbency

Inflammation/immune mediated


  • Eosinophilic bronchopneumopathy (pulmonary infiltrate with eosinophilia)

Neoplasia


  • Malignant histiocytosis
  • Primary lung tumour, e.g.

    • Bronchoalveolar carcinoma

  • Pulmonary lymphomatoid granulomatosis

Pneumonia

Aspiration pneumonia


  • Aspirated foreign body*
  • Aspirated secretions
  • Cleft palate
  • Gastrobronchial fistula
  • Generalised weakness
  • Iatrogenic, e.g.

    • Anaesthetic complication
    • Force feeding
    • Incorrectly placed stomach tube

  • Oesophagotracheal/bronchial fistula
  • Regurgitation, e.g.

    • Megaoesophagus

  • Swallowing disorders
  • Vomiting

Bronchopneumonia, e.g.


  • Canine distemper virus with secondary bacterial infection* (D)
  • Tracheobronchitis*

Bacterial, e.g.


  • Tuberculosis
  • Tularaemia

Fungal, e.g.


  • Pneumocystis carinii

Parasitic, e.g.


  • Aelurostrongylus abstrusus (C)
  • Angiostrongylus vasorum (D)
  • Dirofilaria immitis
  • Oslerus osleri (D)

Miscellaneous


  • Kartagener’s syndrome
  • Primary ciliary dyskinesia
  • Radiation therapy

Pulmonary haemorrhage


  • Coagulopathy q.v.
  • Exercise induced
  • Idiopathic
  • Neoplasia*
  • Trauma*

Pulmonary oedema


  • Acute dyspnoea in Swedish hunting dogs
  • Acute pancreatitis*
  • Airway obstruction
  • Brain trauma
  • Congestive heart failure*
  • Electrocution
  • Hypoalbuminaemia
  • Hypostatic congestion*
  • Iatrogenic

    • Aspirated hypertonic contrast media
    • IV contrast media
    • Over-hydration

  • Inhalation of irritant gases/smoke
  • Lung lobe torsion
  • Near drowning
  • Obstruction of pulmonary drainage mechanisms, e.g.

    • Hilar mass

  • Post-ictal
  • Re-expansion, e.g.

    • Post pneumothorax

  • Seizures
  • Other CNS disease
  • Uraemia q.v.

Acute respiratory distress syndrome


  • Iatrogenic, e.g.

    • Over-hydration
    • Oxygen therapy

  • Infection
  • Inhalation pneumonia
  • Pancreatitis
  • Trauma

Toxins


  • Alpha-napthylthiourea
  • Endotoxin
  • Ethylene glycol
  • Paracetamol
  • Snake venom

Pulmonary thromboembolism

3.1.4 Increased interstitial pattern


Nodular

Artefact


  • End-on view of blood vessels
  • Nipples
  • Objects adhering to coat
  • Ossification of costochondral junctions
  • Thoracic wall nodules

Infection


  • Abscesses
  • Feline infectious peritonitis* (C)
  • Granulomata

    • Bacterial
    • Foreign body*
    • Fungal

  • Hydatid cysts
  • Parasitic

    • Aelurostrongylus abstrusus (C)
    • Crenosoma vulpis (D)
    • Oslerus osleri (D)
    • Paragonimus kellicotti (D)
    • Tularaemia
    • Visceral larva migrans

  • Pneumonia

    • Fungal pneumonia
    • Haematogenous bacterial pneumonia
    • Mycobacterial pneumonia

  • Protozoal, e.g.

    • Toxoplasmosis

Neoplasia


  • Lymphoma*
  • Metastatic tumours*
  • Primary lung tumours

Miscellaneous


  • Calcified pleural plaques*
  • Disseminated intravascular coagulation
  • Haematomata
  • Idiopathic mineralisation
  • Pulmonary osteomata (heterotopic bone)*

Diffuse/unstructured


  • Artefact, e.g.
  • Expiratory film
  • Neoplasia
  • Oedema (early) q.v.

Drugs/toxins


  • Chronic glucocorticoid administration
  • Paraquat

Endocrine


  • Hyperadrenocorticism

Infection


  • Bacterial
  • Fungal, e.g.

    • Blastomycosis
    • Coccidioidomycosis
    • Cryptococcosis
    • Histoplasmosis
    • Pneumocystis carinii (D)

  • Mycoplasmosis
  • Parasitic

    • Aelurostrongylus abstrusus (C)
    • Angiostrongylus vasorum (D)
    • Babesiosis
    • Dirofilariasis

  • Protozoal, e.g.
  • Rickettsial, e.g.

    • Rocky Mountain spotted fever (D)

  • Toxoplasmosis
  • Viral, e.g.

    • Canine distemper virus* (D)
    • Feline infectious peritonitis* (C)

Inhalation


  • Dust
  • Irritant gases

Miscellaneous


  • Acute respiratory distress syndrome
  • Pancreatitis
  • Pulmonary thromboembolism
  • Radiation therapy
  • Uraemia* q.v.
  • Very old animals
  • Very young animals

Pulmonary fibrosis


  • Idiopathic
  • Secondary to chronic respiratory disease

Pulmonary haemorrhage


  • Coagulopathy q.v.
  • Exercise induced
  • Idiopathic
  • Neoplasia
  • Trauma

Reticular pattern


  • Normal ageing*
  • Chronic fibrosis
  • Fungal pneumonia
  • Lymphoma*
  • Metastatic neoplasia*

3.1.5 Increased vascular pattern


Increased size of pulmonary arteries


  • Aelurostrongylus abstrusus (C)
  • Angiostrongylus vasorum (D)
  • Dirofilariasis
  • Large left-to-right shunts, e.g.

    • Atrial septal defect
    • Endocardial cushion defects
    • Patent ductus arteriosus
    • Ventricular septal defect

  • Pulmonary hypertension
  • Pulmonary thromboembolism

Increased size of pulmonary veins


  • Left-sided heart failure*
  • Left-to-right shunts, in some cases

Increased size of pulmonary arteries and veins


  • Left-to-right shunts, e.g.

    • Atrial septal defect
    • Endocardial cushion defects
    • Patent ductus arteriosus
    • Ventricular septal defect

3.1.6 Decreased vascular pattern


Generalised

Pericardial disease, e.g.


  • Pericardial effusion* q.v.
  • Restrictive pericarditis

Pulmonary hypoperfusion


  • Hypoadrenocorticism (D)
  • Localised hypoperfusion due to pulmonary thromboembolism
  • Pulmonic stenosis
  • Severe dehydration*
  • Shock*
  • Tetralogy of Fallot

Pulmonary overinflation


  • Air trapping

    • Chronic bronchitis* (D)
    • Feline asthma* (C)
    • Upper respiratory tract obstruction, e.g.

      • Foreign body*
      • Nasopharyngeal polyp* (C)

  • Compensatory

    • Following lobectomy
    • Secondary to atelectasis of another lobe
    • Secondary to congenital lobar atresia/agenesis

  • Emphysema
  • Iatrogenic

    • Anaesthesia

Right-to-left cardiac shunts, e.g.


  • Atrial septal defect
  • Reverse-shunting patent ductus arteriosus
  • Tetralogy of Fallot
  • Ventricular septal defect

Localised


  • Emphysema
  • Pulmonary thromboembolism

3.1.7 Cardiac diseases that may be associated with a normal cardiac silhouette



  • Bacterial endocarditis
  • Congestive heart failure overzealously treated with diuretics
  • Constrictive pericarditis
  • Functional murmurs*
  • Hypertrophic cardiomyopathy* (C)
  • Neoplasia
  • Small atrial septal defect
  • Small ventricular septal defect

3.1.8 Increased size of cardiac silhouette


Generalised cardiomegaly


  • Normal variation, e.g.
  • Greyhound*
  • Artefact
  • Bacterial endocarditis
  • Bradycardia* q.v.
  • Chronic anaemia* q.v.
  • Concurrent mitral and tricuspid valve deficiency
  • Dysplasia
  • Intrapericardial fat
  • Mediastinal fat
  • Myxomatous degeneration* (D)
  • Congenital cardiac disease, e.g.

    • Peritoneopericardial diaphragmatic hernia

  • Enlargement of specific chamber sizes q.v.
  • Pericardial effusion* q.v.

Myocardial disease


  • Inflammatory

    • Immune mediated, e.g. rheumatoid arthritis
    • Infectious, e.g.

      • Bacterial
      • Fungal
      • Parvovirus
      • Protozoal

  • Ischaemic

    • Arteriosclerosis

  • Noninflammatory

    • Dilated cardiomyopathy*
    • Hypertrophic cardiomyopathy (C)*
    • Restrictive cardiomyopathy (C)

  • Secondary

    • Acromegaly
    • Amyloidosis
    • End-stage mitral valve insufficiency* (D)
    • Glycogen storage disease
    • Hypertension* q.v.
    • Hyperthyroidism* (C)
    • Mucopolysaccharidosis
    • Neoplasia
    • Neuromuscular disease
    • Nutrition

      • l-Carnitine deficiency
      • Taurine deficiency

    • Trauma
    • Drugs/toxins

      • Doxorubicin
      • Heavy metals

Volume overload


  • Iatrogenic
  • Left-sided heart failure

    • Bacterial endocarditis
    • Dilated cardiomyopathy*
    • Mitral valve dysplasia
    • Myxomatous degeneration of the mitral valve* (D)

3.1.9 Decreased size of cardiac silhouette



  • Atrophic myopathies
  • Constrictive pericarditis
  • Hypoadrenocorticism (D)
  • Post thoracotomy

Artefact


  • Deep-chested dogs
  • Deep inspiration
  • Heart displaced from sternum, e.g.

    • Mediastinal shift
    • Pneumothorax

  • Pulmonary overinflation, e.g.

    • Emphysema
    • Hyperventilation

Decrease in muscle mass


  • Chronic systemic disease
  • Malnutrition
  • Myopathies

Shock* q.v., e.g.


  • Hypovolaemia, e.g.

    • Blood loss
    • Severe dehydration

3.1.10 Abnormalities of the ribs


Congenital disorders


  • Absence of the xiphisternum
  • Agenesis/hypoplasia of the 13th rib*
  • Pectus excavatum
  • Supernumerary ribs

New bone


  • Cartilaginous exostoses
  • Healed fractures
  • Mineralisation of the costal cartilages*
  • Neoplasia
  • Non-union fractures
  • Periosteal reaction to soft tissue mass

Osteolysis


  • Metastatic tumours
  • Osteomyelitis
  • Primary tumours

    • Chondrosarcoma
    • Fibrosarcoma
    • Haemangiosarcoma
    • Multiple myeloma
    • Osteoma
    • Osteosarcoma

Thoracic wall trauma*

3.1.11 Abnormalities of the oesophagus


OESOPHAGEAL DILATATION


Generalised

Acquired megaoesophagus


  • Idiopathic
  • Immune-mediated neuromuscular disease

    • Myasthenia gravis
    • Polymyositis
    • Polyradiculoneuritis
    • Systemic lupus erythematosus

  • Metabolic/endocrine

    • Hypoadrenocorticism (D)
    • Hypothyroidism* (D)

  • Miscellaneous

    • Dysautonomia
    • Gastric dilatation/volvulus*
    • Hypertrophic muscular dystrophy
    • Oesophageal foreign body
    • Reflux oesophagitis
    • Thiamine deficiency

  • Toxic

    • Botulinum toxin
    • Chlorinated hydrocarbons
    • Heavy metals
    • Herbicides
    • Organophosphates
    • Snake venom
    • Tetanus

Congenital megaoesophagus


  • Canine giant axonal neuropathy (D)
  • Glycogen storage disease
  • Hereditary megaoesophagus
  • Hereditary myopathy
  • Vascular ring anomaly, e.g.

    • Double aortic arch
    • Normal aorta with aberrant right subclavian artery
    • Persistent right aortic arch
    • Persistent right ductus arteriosus
    • Right aortic arch with aberrant right subclavian artery

Transient megaoesophagus


  • Hiatal hernia
  • Respiratory infection
  • Sedation/anaesthesia*

Localised


  • Redundant oesophagus

Acquired


  • Dilatation cranial to a gastro-oesophageal intussusception
  • Dilatation cranial to acquired stricture, e.g.

    • Extraluminal compression
    • Granuloma
    • Mucosal adhesion
    • Neoplasia
    • Post general anaesthesia

  • Dilatation cranial to an oesophageal foreign body*
  • Oesophagitis
  • Scar tissue post trauma

Congenital


  • Dilatation cranial to a congenital stenosis
  • Dilatation cranial to oesophageal hiatal hernia
  • Segmental oesophageal hypomotility
  • Vascular ring anomaly, e.g.

    • Double aortic arch
    • Normal aorta with aberrant right subclavian artery
    • Persistent right aortic arch
    • Persistent right ductus arteriosus
    • Right aortic arch with aberrant right subclavian artery
    • Oesophageal diverticulum

Transient


  • Aerophagia*
  • Dyspnoea*
  • Swallowing*

INCREASED OESOPHAGEAL OPACITY


Bony density


  • Foreign body*
  • Megaoesophagus with collection of food
  • Osteosarcoma, e.g.

    • Secondary to Spirocerca lupi (D)

Soft tissue density


  • Megaoesophagus with collection of food/water
  • Normal variation, e.g.

    • Fluid in the oesophagus*
    • Superimposition of the trachea*

Soft tissue mass


  • Intraluminal

    • Food-containing oesophageal diverticulum
    • Foreign body*
    • Gastro-oesophageal intussusception
    • Oesophageal hiatal hernia

  • Intramural

    • Abscess
    • Foreign body
    • Granuloma, e.g.

      • Spirocerca lupi (D)

    • Neoplasia

      • Metastatic
      • Primary oesophageal, e.g.

        • Leiomyoma/sarcoma
        • Squamous cell carcinoma

      • Secondary to Spirocerca lupi (D)

  • Extraluminal

    • Abscess
    • Neoplasia
    • Paraoesophageal hiatal hernia

3.1.12 Abnormalities of the trachea


Dorsal displacement


  • Artefact

    • Expiration
    • Rotation
    • Ventroflexion

  • Breed variation*
  • Cardiomegaly*
  • Cranioventral mediastinal mass
  • Heart base tumour
  • Tracheobronchial lymphadenopathy*

Ventral displacement


  • Craniodorsal mediastinal mass
  • Megaoesophagus
  • Oesophageal foreign body*
  • Post-stenotic aortic dilatation
  • Vertebral spondylosis

Lateral displacement


  • Artefact

    • Expiration
    • Rotation
    • Ventroflexion

  • Breed variation*
  • Cranial mediastinal mass
  • Heart base tumour
  • Mediastinal shift q.v.
  • Megaoesophagus
  • Vascular ring anomaly

Narrowing


  • Congenital hypoplasia

Artefact


  • Hyperextension of the neck
  • Superimposition of the muscle/oesophagus

External compression


  • Cranial mediastinal mass
  • Megaoesophagus
  • Oesophageal foreign body*
  • Vascular ring anomaly

Mucosal thickening


  • Feline infectious peritonitis* (C)
  • Inflammation, e.g.

    • Allergy*
    • Infection*
    • Irritant gases

  • Submucosal haemorrhage, e.g.

    • Coagulopathy

Stricture/stenosis


  • Congenital
  • Excessive pressure from the cuff of endotracheal tube
  • Focal intramural mass
  • Post-traumatic injury

Tracheal collapse*


  • Acquired, e.g.

    • Secondary to chronic bronchitis

  • Congenital

Opacification of the lumen


  • Abscess
  • Aspiration of positive contrast agents
  • Foreign body*
  • Granuloma
  • Oslerus osleri
  • Polyp

Neoplasia


  • Adenocarcinoma
  • Chondrosarcoma
  • Leiomyoma
  • Lymphoma
  • Mast cell tumour
  • Osteochondroma
  • Osteosarcoma

3.1.13 Pleural effusion


Bile pleuritis


  • Ruptured biliary tree with diaphragmatic hernia

Blood


  • Autoimmune disorders, e.g.

    • Immune-mediated thrombocytopenia

  • Angiostrongylus vasorum infection
  • Coagulopathy
  • Neoplasia, e.g.

    • Haemangiosarcoma

  • Trauma

Chyle


  • Congenital duct malformation (D)
  • Constrictive pleuritis
  • Cranial mediastinal mass
  • Diaphragmatic rupture*
  • Feline dirofilariasis (C)
  • Idiopathic*
  • Lung lobe torsion
  • Neoplasia
  • Peritoneopericardial diaphragmatic hernia
  • Post pacemaker implantation (C)
  • Rupture of the thoracic duct

Heart disease*


  • Dilated cardiomyopathy (C)
  • Hypertrophic cardiomyopathy (C)*
  • Pericardial disease
  • Right-sided heart failure (C)

Obstruction of the thoracic duct


  • Intraluminal

    • Granuloma
    • Neoplasia

  • Extraluminal

    • Increased intrathoracic pressure

Exudate


  • Actinomycosis
  • Autoimmune disorders, e.g.

    • Rheumatoid arthritis
    • Systemic lupus erythematosus

  • Feline infectious peritonitis* (C)
  • Fungal infection
  • Neoplasia*
  • Nocardiosis
  • Pneumonia*
  • Pyothorax*

    • Extension from pulmonary parenchymal lesion

  • Foreign body

    • Haematogenous spread
    • Penetrating thoracic wound
    • Penetration of the trachea/oesophagus

  • Tuberculosis

Transudate/modified transudate


  • Congestive heart failure*
  • Diaphragmatic rupture*
  • Foreign body
  • Hyperthyroidism* (C)
  • Hypoproteinaemia q.v.*

    • Liver disease*
    • Protein-losing enteropathy*
    • Protein-losing nephropathy*

  • Idiopathic
  • Lung lobe torsion
  • Neoplasia, e.g.

    • Lymphoma*

  • Pancreatitis
  • Pneumonia*
  • Thromboembolism

3.1.14 Pneumothorax


Artefact


  • Overdevelopment
  • Overexposure*
  • Overinflation of the lungs
  • Skin folds*
  • Undercirculation

Iatrogenic


  • Cardiopulmonary resuscitation
  • Leaking chest drain
  • Lung aspiration/biopsy
  • Thoracocentesis
  • Thoracotomy

Spontaneous


  • Bacterial pneumonia
  • Parasites

    • Dirofilariasis
    • Oslerus osleri
    • Paragonimus

  • Pleural adhesions
  • Rupture of congenital or acquired bullae, cysts or blebs
  • Tumours*

Trauma


  • Perforation of the lung*
  • Perforation of the oesophagus
  • Perforation of the thoracic wall*
  • Perforation of the trachea/bronchi*

3.1.15 Abnormalities of the diaphragm


Cranial displacement


  • Diaphragmatic rupture/hernia*

Abdominal causes


  • Abdominal neoplasia*
  • Ascites*
  • Gastric dilatation*
  • Obesity*
  • Organomegaly*, e.g.

    • Liver
    • Spleen

  • Pneumoperitoneum
  • Pregnancy*
  • Pyometra*

Thoracic causes


  • Atelectasis
  • Diaphragmatic paralysis
  • Diaphragmatic tumour
  • Expiratory film*
  • Lung lobectomy
  • Pleural adhesions
  • Pulmonary fibrosis

Caudal displacement

Abdominal causes


  • Abdominal body wall rupture/hernia leading to abdominal organ displacement
  • Poor body condition

Thoracic causes


  • Chronic dyspnoea*
  • Deep inspiration*
  • Intrathoracic mass*
  • Pleural effusion*
  • Pneumothorax*

Irregular diaphragmatic contour


  • Diaphragmatic rupture/hernia*
  • Hypertrophic muscular dystrophy
  • Pleural masses, e.g.

    • Granuloma
    • Neoplasia

  • Severe lung hyperinflation

Lack of visualisation of diaphragmatic border


  • Artefact, e.g.

    • Expiratory film

  • Diaphragmatic hernia*
  • Increased lung density, e.g.

    • Alveolar pattern*

  • Neoplasia adjacent to diaphragm*
  • Peritoneopericardial diaphragmatic hernia
  • Pleural effusion*

3.1.16 Mediastinal abnormalities


Mediastinal masses


  • Aortic aneurysm
  • Cyst
  • Granuloma

    • Actinomycosis
    • Nocardiosis

  • Haematoma
  • Hiatal hernia
  • Oesophageal dilatation
  • Oesophageal foreign body*
  • Oesophageal granuloma

    • Spirocerca lupi (D)

  • Thymus

Artefact


  • Left or right atrial enlargement
  • Lung lobe tip
  • Pleural fluid
  • Post-stenotic dilatation of the aorta or pulmonary artery

Lymphadenopathy


  • Bacterial

    • Actinomycosis
    • Nocardiosis
    • Tuberculosis

  • Eosinophilic pulmonary granulomatosis
  • Fungal

    • Blastomycosis
    • Coccidioidomycosis
    • Cryptococcosis
    • Histoplasmosis

  • Neoplasia

    • Lymphoma*
    • Malignant histiocytosis
    • Metastatic neoplasia*

Neoplasia


  • Ectopic parathyroid tumour
  • Ectopic thyroid tumour
  • Fibrosarcoma
  • Heart base tumours
  • Lipoma*
  • Lymphoma*
  • Malignant histiocytosis
  • Rib tumour
  • Thymoma

Mediastinal shift

Away from affected hemithorax


  • Diaphragmatic rupture/hernia*
  • Lobar emphysema
  • Lung mass*
  • Oblique view
  • Pleural mass*
  • Unilateral pleural effusion*
  • Unilateral pneumothorax*

Towards affected hemithorax


  • Atelectasis

    • Feline asthma* (C)
    • Foreign body*
    • Mass*
    • Radiation

  • Hypostatic congestion*, e.g.

    • General anaesthesia
    • Illness resulting in prolonged lateral recumbency

  • Lobar agenesis/hypoplasia
  • Lobectomy
  • Lung lobe torsion
  • Oblique view
  • Radiation-induced fibrosis
  • Unilateral phrenic nerve paralysis

Pneumomediastinum


  • Emphysematous mediastinitis
  • Iatrogenic
  • Secondary to severe dyspnoea*

Air from neck


  • Gas-forming bacteria
  • Trauma*, e.g.

    • Jugular venepuncture
    • Oesophagus
    • Pharynx
    • Soft tissue
    • Trachea

Air from bronchi/lungs, e.g.


  • Lung lobe torsion
  • Spontaneous
  • Trauma*

Widened mediastinum


  • Normal variation*

    • Bulldogs

  • Abscess

    • Foreign body

  • Masses (see succeeding text)
  • Megaoesophagus q.v.
  • Obesity*

Mediastinal effusions, e.g.


  • Chylomediastinum
  • Haemorrhage

    • Coagulopathy
    • Neoplasia
    • Trauma*

Mediastinitis/mediastinal abscess


  • Feline infectious peritonitis (C)
  • Lymphadenitis
  • Oesophageal/tracheal perforation
  • Penetrating neck wound*
  • Pleuritis*
  • Pneumonia*

Oedema*


  • Congestive heart failure*
  • Hypoproteinaemia* q.v.
  • Neoplasia*
  • Trauma*

3.2 Abdominal radiography


3.2.1 Liver


Focal enlargement

Infection/inflammation


  • Abscess
  • Granuloma

Miscellaneous


  • Biliary pseudocyst
  • Cyst
  • Haematoma
  • Hepatic arteriovenous fistula
  • Hyperplastic/regenerative nodule*
  • Liver lobe torsion

Neoplasia*


  • Biliary cystadenoma
  • Haemangiosarcoma
  • Hepatocellular carcinoma*
  • Hepatoma
  • Lymphoma*
  • Malignant histiocytosis
  • Metastatic*

Generalised enlargement

Endocrine disease


  • Acromegaly
  • Diabetes mellitus*
  • Hyperadrenocorticism

Infection/inflammation


  • Abscess
  • Feline infectious peritonitis* (C)
  • Fungal infection
  • Granuloma
  • Hepatitis*
  • Lymphocytic cholangitis*

Neoplasia, e.g.


  • Haemangiosarcoma
  • Lymphoma*
  • Malignant histiocytosis
  • Mast cell infiltration (mastocytosis/mast cell tumour)
  • Metastatic tumours*

Venous congestion


  • Caudal vena cava occlusion (post caval syndrome)

    • Adhesions
    • Cardiac neoplasia
    • Congenital cardiac disease
    • Diaphragmatic rupture/hernia*
    • Dirofilariasis
    • Pericardial disease
    • Thoracic mass
    • Thrombosis
    • Trauma*

  • Right-sided congestive heart failure, e.g.

    • Dilated cardiomyopathy*
    • Pericardial disease, e.g. pericardial effusion q.v.
    • Tricuspid regurgitation

Miscellaneous


  • Amyloidosis
  • Cholestasis q.v.*
  • Cirrhosis (early)*
  • Hepatic lipidosis (C)
  • Nodular hyperplasia*
  • Storage diseases

Drugs


  • Glucocorticoids

Reduced liver size


  • Breed variation (e.g. apparent microhepatica in deep-chested dogs)
  • Cirrhosis
  • Diaphragmatic rupture/hernia*
  • Hypoadrenocorticism (D)
  • Idiopathic hepatic fibrosis
  • Portosystemic shunt

    • Acquired
    • Congenital

3.2.2 Spleen


Enlargement

Normal, e.g.


  • Breed related*

Congestion


  • Gastric dilatation/volvulus*
  • Portal hypertension
  • Right-sided congestive heart failure
  • Sedation and general anaesthesia*
  • Splenic thrombosis
  • Splenic torsion

Haematoma*


  • Idiopathic
  • Secondary to neoplasia
  • Trauma

Hyperplasia*


  • Chronic anaemia q.v.
  • Chronic infection
  • Lymphoid

Inflammation/immune mediated


  • Hypereosinophilic syndrome
  • Immune-mediated haemolytic anaemia
  • Systemic lupus erythematosus

Infection


  • Abscess
  • Babesiosis
  • Bacteraemia
  • Ehrlichiosis
  • Feline infectious peritonitis* (C)
  • Fungal infections
  • Infectious canine hepatitis (D)
  • Leishmaniasis
  • Mycobacteria
  • Mycoplasma
  • Toxoplasmosis
  • Salmonellosis
  • Septicaemia*

Neoplasia


  • Fibrosarcoma
  • Haemangioma
  • Haemangiosarcoma*
  • Leiomyosarcoma
  • Leukaemia
  • Lymphoma*
  • Malignant histiocytosis
  • Multiple myeloma
  • Systemic mastocytosis

Miscellaneous


  • Amyloidosis
  • Extramedullary haematopoiesis*
  • Infarction
  • Splenic myeloid metaplasia

Trauma


  • Foreign body
  • Penetrating wound

Reduction in size


  • Dehydration*
  • Shock* q.v.

Absence


  • Artefact
  • Displacement through hernia/rupture
  • Splenectomy

3.2.3 Stomach


Abnormal contents

Gas


  • Aerophagia*
  • Gastric dilatation/volvulus*

Mineral opacity


  • Foreign body*
  • Gravel sign (outflow obstruction)*
  • Iatrogenic

    • Barium
    • Bismuth
    • Kaolin

Soft tissue opacity


  • Blood clot
  • Food/ingested liquid*
  • Foreign body*
  • Intussusception
  • Neoplasia
  • Polyp

Caudal displacement


  • Enlargement of the thoracic cavity, e.g.

    • Overinflation of the lungs
    • Pleural effusion* q.v.

  • Hepatomegaly* q.v.

Cranial displacement


  • Diaphragmatic hernia/rupture*
  • Hiatal hernia
  • Late pregnancy*
  • Microhepatica
  • Neoplasia/mass, e.g.

    • Colonic
    • Mesenteric
    • Pancreatic

  • Peritoneopericardial diaphragmatic hernia

Delayed gastric emptying


  • Gastritis*
  • General anaesthesia/sedation*

Functional disorders


  • Adynamic ileus*
  • Dysautonomia
  • Pancreatitis*
  • Primary dysmotilities
  • Uraemia* q.v.

Pyloric outflow obstruction


  • Chronic hyperplastic gastropathy
  • Fibrosis/scar tissue
  • Foreign body*
  • Granuloma
  • Neoplasia

    • Biliary
    • Duodenal
    • Gastric
    • Pancreatic

  • Pyloric hypertrophy

    • Mucosal
    • Muscular

  • Ulceration

Pylorospasm


  • Anxiety
  • Stress

Ulceration


  • Duodenal
  • Gastric

Distended


  • Acute gastritis*
  • Gastric dilatation volvulus*
  • Pancreatitis*

Aerophagia*


  • Bolting food
  • Dyspnoea
  • Pain

Iatrogenic


  • Anticholinergic drugs
  • Endoscopic inflation
  • Misplaced endotracheal tube
  • Stomach tube

Outflow obstruction


  • Fibrosis/scarring
  • Foreign body*
  • Granuloma
  • Muscular or mucosal hypertrophy
  • Neoplasia
  • Pylorospasm
  • Ulceration

Increased wall thickness (contrast radiography)

Diffuse


  • Inflammation

    • Chronic gastritis*
    • Eosinophilic gastritis*

  • Neoplasia

    • Lymphoma
    • Pancreatic tumour

  • Chronic hyperplastic gastropathy

Focal


  • Artefact

    • Empty stomach

  • Hypertrophy

    • Mucosal
    • Muscular

  • Inflammation

    • Eosinophilic
    • Fungal infection
    • Granulomatous

  • Neoplasia

    • Adenocarcinoma
    • Leiomyoma
    • Leiomyosarcoma
    • Lymphoma

3.2.4 Intestines


SMALL INTESTINE


Bunching


  • Adhesions*
  • Linear foreign body*
  • Obesity*

Displacement

Caudal displacement


  • Distended stomach*
  • Empty urinary bladder*
  • Hepatomegaly* q.v.
  • Hernias*

    • Inguinal*
    • Perineal*

Cranial displacement


  • Empty stomach*
  • Enlarged urinary bladder* q.v.
  • Enlarged uterus*

    • Pregnancy*
    • Pyometra*

  • Microhepatica

Diaphragmatic disorders


  • Peritoneopericardial diaphragmatic hernia
  • Rupture/hernia*

Lateral displacement


  • Hepatomegaly* q.v.
  • Prolonged lateral recumbency*
  • Renomegaly* q.v.
  • Splenomegaly* q.v.

Increased width of small intestinal loops

Artefact


  • Mistaking colon for small intestine

Related posts:

  1. 5: ELECTRODIAGNOSTIC TESTING
  2. 2: PHYSICAL SIGNS
  3. 4: LABORATORY FINDINGS
  4. 1: HISTORICAL SIGNS

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Sep 3, 2017 | Posted by in SMALL ANIMAL | Comments Off on 3: RADIOGRAPHIC AND ULTRASONOGRAPHIC SIGNS

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