Breast, Chest Wall, and Thoracic Surgery Practice Test

Imaging to detect pleural effusion is typically done first with chest radiography. On an upright view, fluid often presents as blunting of the costophrenic angles and, with larger effusions, a visible meniscus. Small effusions may be better seen on a lateral decubitus view, where the fluid layers out and is easier to identify. Chest X-ray is widely available, quick, and inexpensive, which is why it remains the common initial modality to detect pleural effusion. If suspicion persists or more detail is needed, ultrasound offers higher sensitivity and can guide drainage, while CT provides detailed anatomy in complex cases. The other options—echocardiography, sputum culture, and spirometry—are not primarily used to detect pleural effusion.