Two days pleuritic chest pain, no shortness of breath. Tachycardic, normal oxygen saturations.
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Small left apical pneumothorax.
Subcutaneous emphysema (vertical lucent stripes into neck) and "double bronchial wall sign" suggesting pneumomediastinum. Small rim of air at AP window.
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This is a classical appearance of pneumomediastinum.
With the imaging and the stable status of the patient, this was likely from alveolar rupture allowing air to track into the mediastinum which is a recognised cause of pneumomediastinum.
This can be managed conservatively.