The skin fold artifact can mimic a pneumothorax and is caused by the added density of a skin fold against the film appears as a broad opacity laterally, outlined by a lucent line (Mach band effect) 2.
The following features can help differentiate a skin fold from a pneumothorax:
- visceral pleural is thin and sharp in contrast to broad skin fold
- a skin fold does not follow the expected course of the pleura
- increased peripheral lucency is present in pneumothorax
- pneumothorax results in absent bronchovascular markings beyond the lung edge
- 1. M. Obadah Kattea, Omar Lababede. Differentiating Pneumothorax from the Common Radiographic Skinfold Artifact. (2015) Annals of the American Thoracic Society. 12 (6): 928-31. doi:10.1513/AnnalsATS.201412-576AS - Pubmed
- 2. Kishimoto K, Kishimoto WT, Kishimoto TY, Kishimoto. Pseudo-pneumothorax: skin fold is an excellent imitator. (2018) BMJ case reports. doi:10.1136/bcr-2018-226360 - Pubmed