Saturday, November 09, 2013

Interesting CXR (10)

A patient was admitted for fluid overload. HO called as he found patient to have increased coughing with the abnormal findings on the CXR. He is worried of right pneumothorax and whether he should proceed with chest tube insertion.

What do you think?


Chong E said...

I still think it is right pneumothorax? There is a clear demarcation..or is it not?

Darrenmagic said...

It is called the "Skin fold sign". The "demarcation" you see is an arterfact from a prominent skin fold due to patient's habitus.

It is also sometimes being called "pseudopneumothorax", which can be relatively common. A closer look will reveal the presence of bronchovascular markings beyond the "line".

Further reading:

Parker RJ. Pneumothorax following central venous catheterisation? Emerg Med 2005; 22:826

Torre Ramos MA. Pneumothorax and skin fold. Emergencias 2007; 19:286

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