Hemithorax white-out (differential)

Last revised by Liz Silverstone on 24 Dec 2024

Complete white-out of a hemithorax on the chest x-ray has a limited number of causes. The differential diagnosis can be shortened further with one simple observation: the position of the trachea, heart and mediastinum. Are they central, or are they displaced towards or away from the opacified lung? Changes in volume of the opacified hemithorax will also affect rib spacing.

Volume loss
No change in volume
Increased volume

See also

Cases and figures

  • Case 1: collapse
  • Case 2: pleural effusion
  • Case 3: in an infant
  • Case 4: Ewing sarcoma
  •  Case 5: pneumonectomy
  • Case 6: metastatic pleural effusion
  • Case 7: pleural fibroma
  • Case 8: hemothorax
  • Case 9: pleural empyema
  • Case 10: right main stem intubation
  • Case 11: left hepatohydrothorax without ascites in a case of cirrhosis, portal hypertension and splenomegaly
  • Case 13: airway foreign body in child
  • Case 14: Hemithorax white-out (pneumonia)
  • Case 15: Diaphragmatic hernia
  • Case 16: Left lung aplasia
  • Case 17: Agenesis of right lung
  • Case 18: bilateral white out due to swine flu (H1N1 influenza)
  • Case 19: malignant pleural effusion
  • Case 20: pulmonary agenesis

Imaging differential diagnosis

  • Ruptured hemidiaphragm
  • Tension gastrothorax
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