Subcutaneous emphysema with Ginkgo leaf sign

Case contributed by Bita Abbasi
Diagnosis certain


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.

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