Wednesday, October 8, 2008


Challenge: You should never see this. What is wrong with this X-Ray?

Image shown under fair use.


Alex said...


Craig Chen said...

close, except one lung has no pulmonary markings.

This is a tension pneumothorax, an emergency life-threatening situation characterized by increased intrathoracic air in the pleural cavity that causes mediastinal shift and compression of the contralateral lung and great vessels. It is diagnosed clinically by severe respiratory distress, ipsilateral hyperexpansion of the chest, absent breath sounds and hyper-resonance of affected side, and tracheal deviation to the contralateral side. It should be treated immediately by thoracentesis and a chest tube; you should not wait for a CXR to confirm.

Sources: UpToDate;

Alex said...

yeah, noticed that later