Spontaneous pneumomediastinum

Case contributed by Andrew Murphy
Diagnosis certain


Acute onset pleuritic chest pain shortness of breath. No trauma.

Patient Data

Age: 20 years
Gender: Male

A pneumomediastinum is outlining the cardiac contour.  It can be seen extending through to the soft tissues of the neck.

The pneumomediastinum extends to the diaphragm and extends into the retropharyngeal and carotid spaces of the partially imaged neck. There is no evidence as to the cause of this pneumomediastinum in this series.

Case Discussion

Spontaneous pneumomediastinum is rare, primarily seen in the young adult male population.

Patients will present with acute chest pain that can radiate anterior, posterior and/or superior to the jaw.

It is important to ensure the patient, has not suffered an esophageal perforation.

Computed tomography is the gold standard in the diagnosis of spontaneous pneumomediastinum, with some papers claiming up to 30% of chest x-rays with spontaneous pneumomediastinum reported as normal.

Treatment is often conservative, as was the plan for the above patient 1,2.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.