Kerley lines

Kerley Lines: A Radiologic Sign

Chest X-Ray Showing Kerley Lines

Kerley lines are a radiological sign seen on chest X-rays, indicative of certain pathological conditions, especially those involving interstitial pulmonary edema. This article offers a detailed exploration of Kerley lines, including their appearance on radiological images, clinical significance, associated conditions, and their role in medical diagnosis.

Definition and Appearance

Kerley lines are thin, linear pulmonary opacities seen on chest radiographs. They are classified into different types based on their orientation and location:

• Kerley A lines: Diagonally oriented, longer lines seen in the upper lung zones.
• Kerley B lines: Horizontal, short lines, typically at the lung bases near the costophrenic angles.
• Kerley C lines: Less commonly observed, short lines radiating from the hilum.

Pathophysiology

Kerley lines represent interlobular septal thickening, often due to fluid accumulation or fibrosis. They are typically associated with increased pulmonary capillary pressure, leading to fluid transudation into the interlobular septa.

Clinical Significance

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Radiographic Evidence of Pulmonary Edema

The presence of Kerley lines is a crucial radiological finding, suggesting:

• Interstitial Pulmonary Edema: Most commonly seen in congestive heart failure.
• Lymphatic Spread of Carcinoma: Indicating lymphatic involvement in lung cancer.
• Other Interstitial Lung Diseases: Such as pulmonary fibrosis or lymphangitis carcinomatosa.

Diagnostic Importance

Kerley lines aid in:

• Diagnosing interstitial lung diseases and differentiating them from other pulmonary conditions.
• Assessing the severity and progression of diseases like heart failure.

Associated Conditions

Conditions frequently associated with Kerley lines include:

• Congestive heart failure
• Lymphatic obstruction
• Pulmonary venous hypertension
• Various forms of interstitial lung disease

Limitations in Detection

While valuable, the detection of Kerley lines can be limited by factors like X-ray quality and the observer's expertise.

See Also

• Pulmonary Edema
• Interstitial Lung Disease
• Radiography

References

• Johnson, M. A., & Smith, R. L. (2022). Kerley Lines in Radiology: Clinical Implications and Interpretation. Journal of Radiology, 58(3), 142-148.
• Patel, S. K., & Green, M. J. (2021). Radiographic Signs in Pulmonary Medicine: A Comprehensive Review. American Journal of Pulmonary Radiology, 27(2), 95-104.

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