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Simple Pneumothorax: Explanation of Chest X-ray Findings

A pneumothorax refers to the presence of gas or air in the pleural space. It is considered a simple pneumothorax when there isn’t any mediastinal shift to the contralateral side and patients are stable. In regards to detecting a pneumothorax, the most important aspect is simply looking for it. The x-ray may be almost entirely normal, except for a small crescent of lucency next to the lung, which can be easy to miss. Can you see a crescent of increased transradiancy in this x-ray? You may need to look closely. This area of increased blackness represents free air. Notice the lack of bronchovesicular markings within this region. A very helpful sign of a pneumothorax is the demarcation of the visceral pleura on the x-ray, which is identified by a thin, sharp, white line. This fine hairline opacity occurs between the lateral border of the lung and the free air in the pleural space. Again, notice the lack of pulmonary vascular markings in the area beyond the pleural line. Now, if the lung is consolidated, then the visceral pleura won’t be distinguishable as a separate line, but rather as the edge of the consolidation. Within the confines of the visceral pleural lines you can see lung tissue, which can be identified by the presence of lung markings. The contralateral lung may appear to have more prominent lung markings due to increased vascular flow. As mentioned earlier, with a simple pneumothorax the heart and mediastinal structures remain in their natural positions. For example, notice the central position of the trachea in this x-ray. 📺 Subscribe To My Channel and Get More Great Quizzes and Tutorials    / @med4vl   #FOAMrad #MedEd #radiology Disclaimer: All the information provided by Medical Education for Visual Learners and associated videos are strictly for informational purposes only. It is not intended as a substitute for medical advice from your health care provider or physician. It should not be used to overrule the advice of a qualified healthcare provider, nor to provide advice for emergency medical treatment. If you think that you or someone that you know may be suffering from a medical condition, then please consult your physician or seek immediate medical attention. Music: https://www.bensound.com