Monday, November 2, 2009


This is the first part of a three part case for CXR week.

Challenge: In the wording of the USMLE Step 2 exam, what is your first step in management?

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1 comment:

Craig Chen said...


In a tension pneumothorax, the intrapleural pressure exceeds atmospheric pressure in expiration creating a one-way valve. Here, the absence of lung markings on the left, the tracheal deviation, and the displaced cardiac silhouette all suggest tension pneumothorax. Note, tension pneumothorax should be a clinical diagnosis, not a radiologic one. Treatment is chest tube (tube thoracostomy).

Sources: UpToDate; Wikipedia.