Pneumothorax chest x ray

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2]

Overview

A chest x-ray may be helpful in the diagnosis of pneumothorax. Findings on an x-ray suggestive of pneumothorax include absent lung markings, white pleural lines, mediastinal shift to the opposite side, atelectasis, air fluid levels in pleural space, and deep sulcus sign. X-ray challenges for pneumothorax include air trapped between chest wall and arm will be seen as a lucency rather than a visceral pleural white line, scapula edge should be followed to make sure it does not project over chest, skin fold appear thicker than the thin visceral pleural white line, and emphysematous bullae can be seen as convexity laterally.

X Ray

X-Ray challenges

  • Skin fold appear thicker than the thin visceral pleural white line
  • Air trapped between chest wall and arm will be seen as a lucency rather than a visceral pleural white line
  • Follow scapula edge to make sure it does not project over chest
  • Emphysematous bullae seen as convexity laterally
Pneumothorax Source:Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 8250

References

  1. Sharma, Anita; Jindal, Parul (2008). "Principles of diagnosis and management of traumatic pneumothorax". Journal of Emergencies, Trauma and Shock. 1 (1): 34. doi:10.4103/0974-2700.41789. ISSN 0974-2700.

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