Golden S sign

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Golden S sign
Differential diagnosis lung collapse

In medicine, the Golden S sign is a sign seen on imaging of the chest that suggests a central lung mass or lung collapse. [1] It was first described by Dr. Ross Golden (1889-1975) in 1925 in association with bronchial carcinoma, [2] but it is also seen in metastatic cancer, enlarged lymph nodes, and collapse of the right upper lobe of the lung. [1]

Medicine The science and practice of the diagnosis, treatment, and prevention of physical and mental illnesses

Medicine is the science and practice of establishing the diagnosis, prognosis, treatment, and prevention of disease. Medicine encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Contemporary medicine applies biomedical sciences, biomedical research, genetics, and medical technology to diagnose, treat, and prevent injury and disease, typically through pharmaceuticals or surgery, but also through therapies as diverse as psychotherapy, external splints and traction, medical devices, biologics, and ionizing radiation, amongst others.

Radiologic sign medical sign from radiology

A radiologic sign is an objective indication of some medical fact that is detected by a physician during radiologic examination with medical imaging.

Medical imaging technique and process of creating visual representations of the interior of a body

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Dr. Golden became the first professor of radiology when he joined Columbia Presbyterian Medical Center in 1922. It was there that he became the first chairman of the Department of Radiology until his retirement in 1954. He then became the visiting professor of radiology at UCLA Medical, 1954-1975. Dr. Golden is considered a pioneer in the field of Diagnostic Radiology when it was in its infancy, and was the author of many books, journals and periodicals on the subject. He was (twice) president of the Roentgen Ray Society as well as a trustee of the New York Academy of Medicine, and chairman of Radiological Services for the American Medical Association. Among his many honors and accolades, he was honored by President Nehru of India in 1956 for his assistance in improving radiological services throughout that country.

Appearance

The Golden S sign can be seen on plain radiographs as well as on computed tomography (CT) scans of the chest. [1] [3] The sign is seen in the right lung as a distorted minor fissure, whose lateral aspect is concave inferiorly and whose medial aspect is convex inferiorly. [1] This produces a "reverse S" appearance, responsible for the sign being occasionally called the reverse S sign of Golden. [1]

Chest radiograph

A chest radiograph, called a chest X-ray (CXR), or chest film, is a projection radiograph of the chest used to diagnose conditions affecting the chest, its contents, and nearby structures. Chest radiographs are the most common film taken in medicine.

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Radiography imaging technique

Radiography is an imaging technique using X-rays, gamma rays, or similar ionizing radiation and non-ionizing radiation to view the internal form of an object. Applications of radiography include medical radiography and industrial radiography. Similar techniques are used in airport security . To create an image in Conventional Radiography, a beam of X-rays is produced by an X-ray generator and is projected toward the object. A certain amount of the X-rays or other radiation is absorbed by the object, dependent on the object's density and structural composition. The X-rays that pass through the object are captured behind the object by a detector. The generation of flat two dimensional images by this technique is called projectional radiography. In computed tomography an X-ray source and its associated detectors rotate around the subject which itself moves through the conical X-ray beam produced. Any given point within the subject is crossed from many directions by many different beams at different times. Information regarding attenuation of these beams is collated and subjected to computation to generate two dimensional images in three planes which can be further processed to produce a three dimensional image.

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A pleural effusion is excess fluid that accumulates in the pleural cavity, the fluid-filled space that surrounds the lungs. This excess fluid can impair breathing by limiting the expansion of the lungs. Various kinds of pleural effusion, depending on the nature of the fluid and what caused its entry into the pleural space, are hydrothorax, hemothorax (blood), urinothorax (urine), chylothorax (chyle), or pyothorax (pus) commonly known as pleural empyema. In contrast, a pneumothorax is the accumulation of air in the pleural space, and is commonly called a "collapsed lung".

Tomography Imaging by sections or sectioning using a penetrative wave

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The Hounsfield scale, named after Sir Godfrey Hounsfield, is a quantitative scale for describing radiodensity. It is frequently used in CT scans, where its value is also termed CT number.

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Hemothorax Blood accumulation in the pleural cavity

A hemothorax is an accumulation of blood within the pleural cavity. The symptoms of a hemothorax include chest pain and difficulty breathing, while the clinical signs include reduced breath sounds on the affected side and a rapid heart rate. Hemothoraces are usually caused by an injury but may occur spontaneously: due to cancer invading the pleural cavity, as a result of a blood clotting disorder, as an unusual manifestation of endometriosis, in response to a collapsed lung, or rarely in association with other conditions.

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Air crescent sign radiologic sign

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Willi A. Kalender is a German Medical Physicist and Professor and Chairman of the Institute of Medical Physics of the University of Erlangen-Nuremberg. He is a Fellow of the American Association of Physicists in Medicine (AAPM) and Honorary Fellow of the British Institute of Radiology (BIR) and of the Institute of Physics and Engineering in Medicine (IPEM).

In chest radiography, the Westermark sign is a sign that represents a focus of oligemia (hypovolemia) seen distal to a pulmonary embolism (PE). While the chest x-ray is normal in the majority of PE cases, the Westermark sign is seen in 2% of patients.

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The National Lung Screening Trial was a United States-based clinical trial which recruited research participants between 2002-2004. It was sponsored by the National Cancer Institute and conducted by the American College of Radiology Imaging Network and the Lung Screening Study Group. The major objective of the trial was to compare the efficacy of low-dose helical computed tomography and standard chest X-ray as methods of lung cancer screening. The primary study ended in 2010, and the initial findings were published in November 2010, with the main results published in 2011 in the New England Journal of Medicine.

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References

  1. 1 2 3 4 5 Gupta P (December 2004). "The Golden S sign". Radiology. 233 (3): 790–1. doi:10.1148/radiol.2333021407. PMID   15564409.
  2. Golden R (1925). "The effect of bronchostenosis upon the roentgen ray shadow in carcinoma of the bronchus". Am J Roentgenol. 13 (21).
  3. Reinig JW, Ross P (July 1984). "Computed tomography appearance of Golden's "S" sign". J Comput Tomogr. 8 (3): 219–23. doi:10.1016/0149-936X(84)90065-1. PMID   6744924.