On an erect posteroanterior chest radiograph, thin 1 to 2 cm horizontal lines perpendicular to the pleural surface at the lung bases are seen. These Kerley B lines indicate which abnormality?

• A Thickened interlobular septa from pulmonary venous congestion ✓
• B Alveolar filling from pulmonary oedema
• C Enlarged bronchovascular bundles from emphysema
• D Subpleural fibrosis from asbestosis

Explanation

Kerley B lines represent thickened interlobular septa due to fluid or cellular infiltration within them; in congestive cardiac failure they reflect raised pulmonary venous pressure. Alveolar oedema produces fluffy airspace opacities such as the bat-wing pattern rather than discrete septal lines, which is the distinction that eliminates option B.

Reference: Grainger and Allison's Diagnostic Radiology, 7th ed.

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