Chest imaging: lateral decubitus view: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Chest imaging: lateral decubitus view

Sample item

In which situation is a lateral decubitus chest radiograph especially useful?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Detecting a small pleural effusion and distinguishing free fluid from loculated fluid

On a decubitus film with the affected side down, free fluid layers along the dependent chest wall, and as little as 50 mL may be detected. Fixed fluid indicates loculation. Ultrasound is also sensitive and guides thoracentesis.

Option by option

  • A. Detecting a rib fracture

    Rib fractures are better seen on dedicated rib views or CT.

  • B. Measuring heart size

    Heart size is measured on a PA erect film.

  • C. Diagnosing pulmonary fibrosis

    Fibrosis is assessed with HRCT.

  • D. Detecting a small pleural effusion and distinguishing free fluid from loculated fluid (correct)

    Correct. Layering of fluid on decubitus views detects small free effusions.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, Detecting a small pleural effusion and distinguishing free fluid from loculated fluid. On a decubitus film with the affected side down, free fluid layers along the dependent chest wall, and as little as 50 mL may be detected.

Why is "Detecting a rib fracture" not the answer?

Rib fractures are better seen on dedicated rib views or CT.

Why is "Measuring heart size" not the answer?

Heart size is measured on a PA erect film.

Why is "Diagnosing pulmonary fibrosis" not the answer?

Fibrosis is assessed with HRCT.

What concept does this question test?

It tests Chest imaging: lateral decubitus view in Radiology. Fixed fluid indicates loculation. Ultrasound is also sensitive and guides thoracentesis.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Chest imaging: lateral decubitus view?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.