Consolidation (medicine)

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Pneumonia as seen on chest x-ray. A: Normal chest x-ray. B: Abnormal chest x-ray with consolidation from pneumonia in the right lung, middle or inferior lobe (white area, left side of image).
Pneumonia as seen on chest x-ray. A: Normal chest x-ray. B: Abnormal chest x-ray with consolidation from pneumonia in the right lung, middle or inferior lobe (white area, left side of image).

Consolidation is a clinical term for solidification into a firm dense mass. It is more markedly defined as an area of the lung that, while previously collapsible, is now filled with a fluid.[1] It is usually applied to a condition marked by induration[2](swelling or hardening of normally soft tissue) of a normally aerated lung through accumulation of inflammatory cellular exudate in the alveoli and adjoining ducts. Simply, it is defined as alveolar space that now contains the fluid instead of air. Fluid can be pulmonary edema, inflammatory exudate, pus, inhaled water, or blood (from bronchial tree or haemorrhage from a pulmonary artery). It is clinically important in pneumonia: the signs of lobar pneumonia are characteristic and clinically referred to as consolidation. [3]

[edit] Signs

Expansion of the thorax on inspiration is reduced on the affected side
Vocal fremitus is increased on the side with consolidation
Percussion is dull in affected area
Breath sounds are bronchial
There may be medium, late, or pan-inspiratory crackles
Vocal resonance is increased
A pleural rub may be present [4]
Consolidated tissue is radio-opaque, so that it is clearly demonstrable in X-rays and CT (computerized tomography) scans. Consolidation is often a middle-to-late stage feature/complication in pulmonary infections.

[edit] References

  1. ^  http://www2.merriam-webster.com/cgi-bin/mwmednlm?book=Medical&va=consolidation
  2. ^  http://www2.merriam-webster.com/cgi-bin/mwmednlm?book=Medical&va=induration
  3. ^  Metlay, JP, Kapoor, WN, Fine, MJ. Does this patient have community-acquired pneumonia? Diagnosing pneumonia by history and physical examination. JAMA 1997; 278:1440. PMID 9356004
  4. ^  Talley and O'Connor (2001). Clinical Examination, a Clinical Guide to Physical Diagnosis. Elsevier 4:121


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