pneumatosis
{{Short description|Abnormal presence of air or other gas within tissues}}
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Pneumatosis is the abnormal presence of air or other gas within tissues.{{cite web |title=Medical Definition of PNEUMATOSIS |url=https://www.merriam-webster.com/medical/pneumatosis |website=www.merriam-webster.com |access-date=31 July 2021 |language=en}}
In the lungs, emphysema involves enlargement of the distal airspaces,[https://books.google.com/books?id=ZsBMr_jz0F8C&pg=PA64 page 64] in: {{cite book|title=The Washington Manual Pulmonary Medicine Subspecialty Consult, Washington manual subspecialty consult series|author=Adrian Shifren|publisher=Lippincott Williams & Wilkins|year=2006|isbn=9780781743761}} and is a major feature of chronic obstructive pulmonary disease (COPD). Other pneumatoses in the lungs are focal (localized) blebs and bullae, pulmonary cysts and cavities.
Pneumoperitoneum (or peritoneal emphysema) is air or gas in the abdominal cavity, and is most commonly caused by gastrointestinal perforation, often the result of surgery.
Pneumarthrosis, the presence of air in a joint, is rarely a serious sign.
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Lung cysts
File:CT of lymphocytic interstitial pneumonia.jpg of lymphocytic interstitial pneumonia with pulmonary cysts.]]
A lung cyst, or pulmonary cyst, encloses a small volume of air, and has a wall thickness of up to 4 mm.{{cite web|url=https://radiopaedia.org/articles/pulmonary-cyst|title=Pulmonary cyst|author=Dr Daniel J Bell and Dr Yuranga Weerakkody|website=Radiopaedia|access-date=2019-05-01}} A minimum wall thickness of 1 mm has been suggested, but thin-walled pockets may be included in the definition as well.{{cite journal|last1=Araki|first1=Tetsuro|last2=Nishino|first2=Mizuki|last3=Gao|first3=Wei|last4=Dupuis|first4=Josée|last5=Putman|first5=Rachel K|last6=Washko|first6=George R|last7=Hunninghake|first7=Gary M|last8=O'Connor|first8=George T|last9=Hatabu|first9=Hiroto|title=Pulmonary cysts identified on chest CT: are they part of aging change or of clinical significance?|journal=Thorax|volume=70|issue=12|year=2015|pages=1156–1162|issn=0040-6376|doi=10.1136/thoraxjnl-2015-207653|pmid=26514407|pmc=4848007}} Pulmonary cysts are not associated with either smoking or emphysema.{{Cite web|url=https://thorax.bmj.com/content/thoraxjnl/early/2015/10/29/thoraxjnl-2015-207653.full.pdf|title=Pulmonary cysts identified on chest CT:are they part of ageing change or of clinical significance|last=Araki|first=Tetsuo|access-date=19 January 2019}}
A lung cavity has a wall thickness of more than 4 mm.
=Other thoracic=
- Pneumothorax, air or gas in the pleural space
- Pneumomediastinum, air or gas in the mediastinum
- Also called mediastinal emphysema or pneumatosis/emphysema of the mediastinum
=Abdominal=
File:Pneumatosis cystoides intestinalis - low mag.jpg of pneumatosis intestinalis in bowel wall.]]
- Pneumoperitoneum (or peritoneal emphysema), air or gas in the abdominal cavity. The most common cause is a perforated abdominal viscus, generally a perforated peptic ulcer, although any part of the bowel may perforate from a benign ulcer, tumor or abdominal trauma.
- Pneumatosis intestinalis, air or gas cysts in the bowel wall
- Gastric pneumatosis (or gastric emphysema) is air or gas cysts in the stomach wall{{cite web |title=Gastric emphysema {{!}} Radiology Reference Article {{!}} Radiopaedia.org |url=https://radiopaedia.org/articles/gastric-emphysema-1 |website=Radiopaedia |access-date=28 June 2019}}
=Joints=
Pneumarthrosis is the presence of air in a joint. Its presentation on radiography is a radiolucent cleft often called a vacuum phenomenon, or vacuum sign. Pneumarthrosis is associated with osteoarthritis and spondylosis.
Pneumarthrosis is a common normal finding in shoulders{{cite web|url=https://radiopaedia.org/articles/vacuum-phenomenon-in-shoulder|title=Vacuum phenomenon in shoulder|author=Abhijit Datir|display-authors=etal|website=Radiopaedia|access-date=2018-01-03}} as well as in sternoclavicular joints.{{cite journal|last1=Restrepo|first1=Carlos S.|last2=Martinez|first2=Santiago|last3=Lemos|first3=Diego F.|last4=Washington|first4=Lacey|last5=McAdams|first5=H. Page|last6=Vargas|first6=Daniel|last7=Lemos|first7=Julio A.|last8=Carrillo|first8=Jorge A.|last9=Diethelm|first9=Lisa|title=Imaging Appearances of the Sternum and Sternoclavicular Joints|journal=RadioGraphics|volume=29|issue=3|year=2009|pages=839–859|issn=0271-5333|doi=10.1148/rg.293055136|pmid=19448119|doi-access=}} It is believed to be a cause of the sounds of joint cracking. It is also a common normal post-operative finding at least after spinal surgery.{{cite journal|last1=Mall|first1=J C|last2=Kaiser|first2=J A|title=The usual appearance of the postoperative lumbar spine.|journal=RadioGraphics|volume=7|issue=2|year=1987|pages=245–269|issn=0271-5333|doi=10.1148/radiographics.7.2.3448634|pmid=3448634}} Pneumarthrosis is extremely rare in conjunction with fluid or pus in a joint, and its presence can therefore practically exclude infection.[https://books.google.com/books?id=WlXvBQAAQBAJ&pg=PA60 Page 60] in: {{cite book|title=Musculoskeletal Radiology|author=Harry Griffiths|publisher=CRC Press|year=2008|isbn=9781420020663}}
File:X-ray of hip prosthesis with pneumarthrosis.jpg|X-ray of a hip with hip replacement and pneumarthrosis, in this case aseptic.
File:X-ray of shoulder with vacuum sign - annotated.jpg|A vacuum sign, or vacuum phenomenon, is a normal finding on shoulder X-rays.
=Other=
File:Subcutaneous emphysema abdomen arrows2.jpg of subcutaneous emphysema.]]
Subcutaneous emphysema is found in the deepest layer of the skin. Emphysematous cystitis is a condition of gas in the bladder wall. On occasion this may give rise to secondary subcutaneous emphysema which has a poor prognosis.{{cite journal | vauthors = Sadek AR, Blake H, Mehta A | title = Emphysematous cystitis with clinical subcutaneous emphysema | journal = International Journal of Emergency Medicine | volume = 4 | issue = 1 | pages = 26 | date = June 2011 | pmid = 21668949 | pmc = 3123544 | doi = 10.1186/1865-1380-4-26 | doi-access = free }}
Pneumoparotitis is the presence of air in the parotid gland caused by raised air pressure in the mouth often as a result of playing wind instruments. In rare cases air may escape from the gland and give rise to subcutaneous emphysema in the face, neck, or mediastinum.{{cite journal|last1=McCormick|first1=Michael E.|last2=Bawa|first2=Gurneet|last3=Shah|first3=Rahul K.|title=Idiopathic recurrent pneumoparotitis|journal=American Journal of Otolaryngology|volume=34|issue=2|year=2013|pages=180–182|issn=0196-0709|doi=10.1016/j.amjoto.2012.11.005|pmid=23318047}}{{cite book|author1=Joiner MC|author2=van der Kogel A|title=Basic Clinical Radiobiology, Fifth Edition|url=https://books.google.com/books?id=Xp4YtqM7Ef8C&pg=PA1908|date=15 June 2016|publisher=CRC Press|isbn=978-0-340-80893-1|page=1908}}
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Terminology
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External links
{{Wiktionary|pneumatosis}}
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