Presentation
Patient with traumatic pneumothorax.
On the CXR, a left-sided hydropneumothorax and chest tubes are seen.
Note the presence of extensive subcutaneous emphysema, outlining the fibers of the left pectoralis muscle.
Author: Emőke Dénes (2011)
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Case Discussion
In the extensive subcutaneous emphysema, air outlines the pectoralis major muscle fibers and creates a branching pattern known as the Ginkgo leaf sign.
The ginkgo tree is native to China and has fan-shaped leaves with prominently visible veins. The air between the muscle fibers of the pectoralis muscle mimic the appearances of these veins.