Lobar consolidation: documented pneumonia

Consolidation reflects replacement of alveolar air by denser material. Pneumonia combines this appearance with an infectious clinical context.

Check projection, rotation and inspiration; compare both lungs, cardiac margins, diaphragmatic domes and costophrenic angles.

Describe the focal right-sided opacity, margins and presumed location. The source caption identifies right middle lobe involvement.

Fever, cough and a new radiographic abnormality support pneumonia. Appearance alone cannot distinguish bacterial from viral infection.

Atelectasis, pulmonary infarction or a tumour may produce an opacity; reassess when the clinical course is unusual.

Assess respiratory rate, oxygenation, blood pressure, confusion and comorbidities; look for an associated pleural effusion.

Hypoxaemia, circulatory instability or confusion warrants urgent assessment. Opacity size cannot replace clinical assessment.

Do not infer the pathogen from the radiograph. Persistent opacity requires individualised clinical and imaging reassessment.

Describe consolidation, relate it to symptoms and assess severity. Arrange follow-up according to symptoms and risk factors.

• Metlay et al. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. ATS/IDSA (2019) ↗
• NICE NG250. Pneumonia: diagnosis and management — Recommendations (2025) ↗

Documentary review: 2026-10-15