Presentation
Oncology patient. Confirm CVL placement.
Patient Data
The CVL tip is projected in the lower SVC.
Thick band of atelectasis in the left lower zone. The pleural spaces are clear. A skin fold in the right apex is noted, no evidence of pneumothorax. The cardiothoracic ratio is normal allowing for supine projection. Cardiomediastinal contours are normal.
Mild scoliosis of the thoracic spine, and multilevel degenerative changes noted. Evidence of prior left shoulder surgery.
Case Discussion
In the right apex, a skin fold producing a radiodense band with a sharp outer edge that could be mistaken for a pneumothorax. A skin fold is a common finding and can can be differentiated from a true pneumothorax by:
the presence of lung markings beyond the band and
the thickness of the band compared to the thin line of the pleural edge in pneumothorax.
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