Ellis curve is seen in –
Correct Answer: Pleural effusion
Description: Ans. is 'b' i.e., Pleural effusion o On chest X-rays, pleural effusion presents as homogenous opacity.o Typically this opacity has a fairly well defined concave upper edge, is higher laterally than medially and obscures the diaphragmatic shadow.Other physical findings in pleural effusion -Inspectiono Diminished movement of the chestPalpationo Diminished movement of the chesto Diminished vocal fremituso Movement of trachea opposite to the side of effusionPercussiono Stony dullness on percussionAuscultationo Diminished vesicular breath soundo Diminished vocal resonanceo Decreased heart soundsHorizontal fluid level and succussion splash are hallmarks of hydropneumothorax.Succussion splash in the chest is always pathological and is found in# Hydropneumothorax# Herniation of stomach in the thorax# Rarely, over a large cavity in the lung partially filled with exudate.Horizontal fluid level -o This is classically found in hydropneumothorax. In sitting position percussion is done from above downwards in the front {along MCL) lateral chest wall {along MAL) and back (along scapular line) in the conventional method.o During percussion from above downwards a point of dullness is reached in front, lateral chest wall and back where markings are done.o The three points are joined transversely and a horizontal line is drawn encircling the affected chest wall. This is the upper horizontal border of fluid level.REMEMBERo Ellis's S-shaped curve in pleural effusions does not exist today. Actually, it is a radiological observation (highest level of fluid in axilla).o Previously the belief was that the highest level of dullness (elicited by percussion) is present in the axilla (so called Ellis s S-shaped curve), though it is not true.o The upper limit of fluid in pleural effusion is horizontal like hydropneumothorax but it is not easily demonstrable.o In hydropneumothorax, the difference in the note of percussion (from above downwards, it is tympanitic to stony dullness) is very distinct in comparison to pleural effusion (from above downwards, it is resonant note to stony dullness). So the term horizontal fluid level is classically used in hydropneumothorax.
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