TB – Chest X-Rays

The following are examples of how Active TB may look on CXR:


Large RUL Nodule


Small R Apical Nodule


RUL Cavity


RUL Cavity


Obvious Bilateral Upper Lobe Infiltrates


Subtle Left Apical Infiltrate (fuzzy spot overlying clavicle)

Primary LLL Infiltrate

Primary TB – LLL Infiltrate.
Mimics any pneumonia; occurs in debilitated pts, when Mtb first enters lung, and innate immune system unable to contain it.

AIDS Adenopathy

TB in advanced AIDS
Paratracheal / Mediastinal Adenopathy. Clear lungs.

A CXR reading of “calcified granulomas” is NOT active.  Merely the burnt-out remnants of where Mtb first entered the lungs.  Simply Latent TB Infection; address the same as a positive PPD / IGRA with “normal CXR”.

Calcified Nodules.Curry

Calcified nodules in a) periphery of lower aspect of RUL; and b) R hilum.

A reading of “old scar” or “old granulomatous disease, not active” is WRONG unless there’s mention of a prior comparison film with “no change” or “stability”.

Old Scar.RUL.Curry

Impossible to distinguish R apical “old scar” from “active TB” w/o a prior comparison.