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Pneumothorax in supine patient

Dr Yuranga Weerakkody and Dr Vinod G Maller et al.

A pneumothorax does not display classical signs when a patient is positioned supine for a chest radiograph. Instead, it may be demonstrated by looking for the following signs:

  • relative lucency of the involved hemithorax
  • deep, sometimes tongue like costophrenic sulcus - deep sulcus sign 2
  • increased sharpness of the adjacent mediastinal margin and diaphragm
  • increased sharpness of the cardiac borders
  • visualization of the anterior costophrenic sulcus - double diaphragm sign 3
  • visualization of the inferior edge of the collapsed lung above the diaphragm
  • depression of the ipsilateral hemidiaphragm
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