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Pneumothorax: inspiratory and expiratory films

Case contributed by J. Ray Ballinger
Diagnosis certain

Presentation

Skateboard accident.

Patient Data

Age: 40 years
Gender: Male

This is a nice example of the value of an expiratory film to improve the conspicuity of a pneumothorax. The image shows increase in apparent size of the pneumothorax on the expiratory view compared to the inspiratory view. Arrows show the pleura. Also seen is an acute clavicular fracture on the right. No rib fractures are seen though there may be an occult one.

Case Discussion

Pneumothoraces should become more visible on expiratory projections. They do not actually increase in volume but are more prominent because of the differential in pressures change from inspiration to expiration. 

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