Presentation
Sudden onset, left sided pleuritic chest pain
Patient Data
There is a small left sided pneumothorax with free gas noted in the lower zone and tracking along the lateral aspect of the left lung. There is associated bands of atelectasis in the left lower lobe. There are no features of tension.
Otherwise, the cardiomediastinal silhouette and hilar contours are normal. The right lung
and pleural spaces are normal. Osseous structures are within normal limits for
age, no rib fractures noted.
Case Discussion
This patient also reported a history of pleurodesis (unclear which type - mechanical or chemical) performed in a foreign country. As such, it is important to consider the radiographic changes, though non-specific, that may occur post pleurodesis. These include, pleural thickening, nodularity, and pleural effusion which may mimic malignancies. Further, the mediastinum may shift towards the side of pleurodesis which may be misinterpreted as a sign of tensioning 1.
This case highlights the importance of a systemic approach to evaluating the pleura and parenchyma of the lungs to ensure no subtle findings are missed or misinterpreted.
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