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).

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. Consolidation appears 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

Signs that consolidation may have occurred include:

• 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
• Possible medium, late, or pan-inspiratory crackles
• Vocal resonance is increased. Vocal resonance testing can be done with a stethoscope. Here, the patient's voice can be heard more clearly when there is consolidation, as opposed to in the healthy lung where speech sounds muffled.
• 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

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