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Deep sulcus sign

Case contributed by Justin Luke Yap
Diagnosis certain

Presentation

Patient was involved in a motor vehicular accident sustaining rib fractures.

Patient Data

Age: 55 years
Gender: Male

Chest

x-ray

Left sided tension pneumothorax secondary to multiple left rib fractures. Contralateral deviation of the mediastinum is appreciated.

Note of deep sulcus sign in AP supine view.

Case Discussion

Reversal of the diaphragmatic dome and rounding of the ipsilateral sulcus.

Hyperlucent region devoid of lung markings.

Features suggest pneumothorax with presence of a deep sulcus sign.

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