Pneumothorax Signs

By Dr Deepu

Atypical signs of pneumothorax

Atypical sign  arise when the patient is supine or the pleural space partly obliterated.
In the supine position, pleural air rises and collects anteriorly, particularly medially and basally, and may not extend far enough posteriorly to separate lung from thechest wall at the apex or laterally.

Signs that suggest a pneumothorax under these conditions are

1.ipsilateral transradiancy, either generalized or hypochondrial
 2.a deep, finger-like costophrenic sulcus laterally
3. a visible anterior costophrenic recess seen as an oblique line or interface in the hypochondrium; when the recess is manifest as an interface it mimics the adjacent diaphragm (‘double diaphragm sign’)
4.a transradiant band parallel to the diaphragm and/or mediastinum with undue clarity of the mediastinal border
5. visualization of the undersurface of the heart, and of the cardiac fat pads as rounded opacities suggesting masses
6.diaphragm  depression.