. The American journal of roentgenology, radium therapy and nuclear medicine . of its develop-ment by coalescence of honeycombedareas resulting from softening can befollowed easily by serial .v-ray stereo-scopic plates. Screening gives no definition,but admits of study of an expansile andcontractile movement of a cavity wallwith cough, and flat plates are very oftenmisleading. Even physical signs have to beweighed with the greatest care. In ourexperience, the increase or appearance ofrales after cough following expiration is oneof the most dependable signs, whenweighed with impaired resonance,


. The American journal of roentgenology, radium therapy and nuclear medicine . of its develop-ment by coalescence of honeycombedareas resulting from softening can befollowed easily by serial .v-ray stereo-scopic plates. Screening gives no definition,but admits of study of an expansile andcontractile movement of a cavity wallwith cough, and flat plates are very oftenmisleading. Even physical signs have to beweighed with the greatest care. In ourexperience, the increase or appearance ofrales after cough following expiration is oneof the most dependable signs, whenweighed with impaired resonance, but itmay be so simulated by pleural sounds as tomake differential diagnosis dependent onthe best of .v-ray plates. 450 Annular Shadows: Are they Cavities or Spontaneous Pneumothoraces? In spite ot the frequency of cavitationwithout pathognomonic signs, and in spiteof the inabiHty to depend on our mostclassical signs, and in spite of the great adjunct to interpretation, their ownwritings testify. The reasons for believing that theinterpretation of certain, or any, annular. Fig. II. Two annular shadows at right apex. Plate Fig. 12. Same patient, Oct., 1922, nine years later taken in 1913. Upper cavity under the clavicle, showing deviated trachea, high diaphragm, heart lower one from the center of the hilus out toward the and mediastinum distortion. Cavities still present in upper axilla. markedly contracted right upper lobe. contribution of the .v-ray plate, physical shadows as localized pneumothoraces is examination is and will undoubtedly wrong are these: remain in the hands of well-trained physi- i. In a critical examination of many cians, the best means ot determining hundreds ot such cases, no such shadow,


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