Spends too long considering quality
Does not mention 'pleural effusion'
Attempts to assess heart size
Demonstrates systematic approach
Mentions rotation should be assessed prior to consideration of tracheal displacement
Mentions 'pleural effusion' and shift of trachea/mediastinum
Fluently describes radiological features and explains all physical signs and symptoms
Offers coherent differential and management plan
The term 'meniscus sign' is often used to describe the upper edge of a pleural effusion. This term is really a misnomer as pleural fluid does not form a true meniscus within the thorax. Rather fluid is displaced by the partially aerated lung, giving the appearance of a meniscus. In this case the 'meniscus' is nearly vertical. This is because fluid is lying in the major/oblique fissure and forms an interface with the partially aerated and displaced upper lobe.