The costodiaphragmatic recess, also called the costophrenic recess or phrenicocostal sinus,
Retrieved May 2011 is the posterolateral fringe of the

pleural space The pleural cavity, pleural space, or interpleural space is the potential space between the pleurae of the pleural sac that surrounds each lung. A small amount of serous pleural fluid is maintained in the pleural cavity to enable lubrication bet ...

, a

potential space In anatomy, a potential space is a space between two adjacent structures that are normally pressed together (directly apposed). Many anatomic spaces are potential spaces, which means that they are potential rather than realized (with their realiz ...

around the lung inside the

pleural cavity The pleural cavity, pleural space, or interpleural space is the potential space between the pleurae of the pleural sac that surrounds each lung. A small amount of serous pleural fluid is maintained in the pleural cavity to enable lubrication b ...

. It is located at the acutely angled junction ("reflection") between the costal and diaphragmatic pleurae, and is interpreted

two-dimensional In mathematics, a plane is a Euclidean ( flat), two-dimensional surface that extends indefinitely. A plane is the two-dimensional analogue of a point (zero dimensions), a line (one dimension) and three-dimensional space. Planes can arise as ...

ly on plain X-rays as the costophrenic angle. It measures approximately vertically and extends from the eighth to the tenth rib along the

mid-axillary line The axillary lines are the anterior axillary line, midaxillary line and the posterior axillary line. The anterior axillary line is a coronal line on the anterior torso marked by the anterior axillary fold. It's the imaginary line that runs dow ...

Function

The

lungs The lungs are the primary organs of the respiratory system in humans and most other animals, including some snails and a small number of fish. In mammals and most other vertebrates, two lungs are located near the backbone on either side ...

expand into this recess during forced inspiration; however, the recess never gets filled completely. During expiration, it contains nothing apart from gravitated

serous fluid In physiology, serous fluid or serosal fluid (originating from the Medieval Latin word ''serosus'', from Latin ''serum'') is any of various body fluids resembling serum, that are typically pale yellow or transparent and of a benign nature. The fl ...

Clinical significance

Pleural effusion A pleural effusion is accumulation of excessive fluid in the pleural space, the potential space that surrounds each lung. Under normal conditions, pleural fluid is secreted by the parietal pleural capillaries at a rate of 0.6 millilitre per k ...

s collect in the costodiaphragmatic recess when in

standing position Anatomical terminology is a form of scientific terminology used by anatomists, zoologists, and health professionals such as doctors. Anatomical terminology uses many unique terms, suffixes, and prefixes deriving from Ancient Greek and Latin. ...

, and present on plain X-rays as "blunting" of the costophrenic angle. A

thoracocentesis Thoracentesis , also known as thoracocentesis (from Greek ''thōrax'' 'chest, thorax'—GEN ''thōrakos''—and ''kentēsis'' 'pricking, puncture'), pleural tap, needle thoracostomy, or needle decompression (often used term), is an invasive med ...

(pleural tap) is often performed here while a patient is in full expiration because of less risk of puncturing the lungs and thereby causing

pneumothorax A pneumothorax is an abnormal collection of air in the pleural space between the lung and the chest wall. Symptoms typically include sudden onset of sharp, one-sided chest pain and shortness of breath. In a minority of cases, a one-way valve i ...

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Retrieved May 2011

Imaging

anatomy Anatomy () is the branch of biology concerned with the study of the structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old science, having it ...

, the costophrenic angles are the places where the diaphragm (''-phrenic'') meets the ribs (''costo-''). Each costophrenic angle can normally be seen as on chest x-ray as a sharply-pointed, downward indentation (dark) between each hemi-diaphragm (white) and the adjacent chest wall (white). A small portion of each lung normally reaches into the costophrenic angle. The normal angle usually measures thirty degrees.

Pleural effusion

With

pleural effusion A pleural effusion is accumulation of excessive fluid in the pleural space, the potential space that surrounds each lung. Under normal conditions, pleural fluid is secreted by the parietal pleural capillaries at a rate of 0.6 millilitre per k ...

, fluid often builds up in the costophrenic angle (due to gravity). This can push the lung upwards, resulting in "blunting" of the costophrenic angle. The posterior angle is the deepest. Obtuse angulation is sign of disease. Chest x-ray is the first test done to confirm the presence of pleural fluid. The lateral upright chest x-ray should be examined when a pleural effusion is suspected. In an upright x-ray, 75 mL of fluid blunts the posterior costophrenic angle. Blunting of the lateral costophrenic angle usually requires about 175 mL but may take as much as 500 mL. Larger pleural effusions opacify portions of the hemithorax and may cause mediastinal shift; effusions > 4 L may cause complete opacification of the hemithorax and mediastinal shift to the contralateral side.

References

External links