Pneumothorax in supine projection

Changed by Craig Hacking, 21 Feb 2019

Updates to Article Attributes

Body was changed:

Show markup changes

A pneumothorax does not display classical signs when a patient is positioned supine for a chest radiograph. Instead, the pneumothorax 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 or diaphragm
visualisation of the anterior costophrenic sulcus: double diaphragm sign ³
visualisation of the inferior edge of the collapsed lung above the diaphragm
depression of the ipsilateral hemidiaphragm
lumpy appearance of the cardiac contour representing change in shape of the pericardial fat: pericardial fat tag sign

~~-<li>lumpy appearance of the cardiac contour representing change in shape of the pericardial fat: <a href="/articles/pericardial-fat-tag-sign">pericardial fat tag sign</a>~~
+<li>lumpy appearance of the cardiac contour representing change in shape of the pericardial fat: <a href="/articles/pericardial-fat-tag-sign-pneumothorax">pericardial fat tag sign</a>

Images Changes:

Image 12 X-ray (Frontal) ( create )

ADVERTISEMENT: Supporters see fewer/no ads

{"current_user":null,"inclusions":[{"imageId":8637856,"studyId":32306,"caseSlug":"pneumothorax-distribution-diagram","caption":"Figure 1: pneumothorax in supine position","isStack":false,"diagnosticCertainty":"not_applicable","thumbnail":"https://prod-images-static.radiopaedia.org/images/8637856/aaea6ab811938e0acccd2a99f357bf_big_gallery.jpg"},{"imageId":487394,"studyId":10581,"caseSlug":"pneumothorax-deep-sulcus-sign-3","caption":"Case 1 ","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/487394/361409f47321cdb1f545a7d5dec310_big_gallery.jpg"},{"imageId":15683416,"studyId":41748,"caseSlug":"supine-tension-pneumothorax","caption":"Case 2","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/15683416/5bd444d88549b701099f19b38c25cf_big_gallery.jpeg"},{"imageId":832243,"studyId":13267,"caseSlug":"deep-sulcus-sign-2","caption":"Case 3: with deep sulcus sign","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/832243/68909deed2d336d8144f65f3f9cd58_big_gallery.jpg"},{"imageId":5961341,"studyId":28028,"caseSlug":"pneumothorax-supine","caption":"Case 4: sharp right hemidiaphragm ","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/5961341/f5289b70306333abdb0f6d052c7cf7_big_gallery.JPG"},{"imageId":8592748,"studyId":32177,"caseSlug":"supine-pneumothorax","caption":"Case 5","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/8592748/9a8a5629c7f6f35beacb84352763f1_big_gallery.jpeg"},{"imageId":44584368,"studyId":73746,"caseSlug":"pneumothorax-supine-1","caption":"Case 6","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/44584368/7142d31d3de782ebb34b898a143325_big_gallery.jpeg"},{"imageId":46599195,"studyId":75525,"caseSlug":"pericardial-fat-tag-sign","caption":"Case 7: pericardial fat tag sign","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/46599195/e7c8c4c7ca1c31afc45c8fa804d330_big_gallery.jpeg"},{"imageId":46604463,"studyId":75528,"caseSlug":"bilateral-pericardial-fat-tag-signs","caption":"Case 8: bilateral pericardial fat tag signs","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/46604463/7c0bb51b4bd327b840acca03cd3b7b_big_gallery.jpeg"},{"imageId":46284450,"studyId":75316,"caseSlug":"traumatic-pneumothorax-subtle-supine-chest-radiograph","caption":"Case 9: sharp right hemidiaphragm","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/46284450/e38d1fde2ac11f3e6a5cc687e247ae_big_gallery.jpeg"},{"imageId":46692353,"studyId":75626,"caseSlug":"pneumothorax-and-skin-fold","caption":"Case 10: right apical PTX and skin fold","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/46692353/fb1d2ea62d748dfb75cc63c39e7e0a_big_gallery.jpeg"},{"imageId":46858551,"studyId":75755,"caseSlug":"retrodiaphragmatic-pericardial-fat-tag-sign","caption":"Case 11: right PTX, sharp diaphragm and retrodiaphragmatic pericardial fat tag sign","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/46858551/1e2f5ec7cfc079ae9c4cb5e343528f_big_gallery.jpeg"},{"imageId":52193048,"studyId":86217,"caseSlug":"paravertebral-haematoma-post-trauma-on-supine-cxr","caption":"Case 12: subtle bilateral PTX with paravertebral haematomata","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/52193048/ed06e832543fa0dc595f7b1424f83e_big_gallery.jpeg"}],"ddx_inclusions":[],"lang":"gb"}

Updating… Please wait.

Unable to process the form. Check for errors and try again.

Thank you for updating your details.

Pneumothorax in supine projection

Updates to Article Attributes

Image 12 X-ray (Frontal) ( create )

Articles

By Section:

By System:

Cases

Radiopaedia.org