Presentation
Difficulty breathing.
Patient Data
Age: 50 years
Gender: Male
From the case:
Supine pneumothorax - deep sulcus sign
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Left pneumothorax with deep sulcus sign seen on supine projection.
Case Discussion
Pneumothorax on an erect chest radiograph is easy to diagnose, but on supine films it is difficult because air in the pleural cavity takes a non dependent position.
Signs of pneumothorax on supine radiographs are:
- deep sulcus sign: air in the pleural cavity collects in the anterolateral pleural space outlining the deep costophrenic angle
- increased clarity or sharpness of the ipsilateral hemidiaphragm
- double diaphragm sign
- increased sharpness of the mediastinal or cardiac outline
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