Presentation
Incidental finding during imaging following a low-velocity motor vehicle accident.
Patient Data
A normal, erect, chest X-ray in a patient except for the unilateral hypertranslucent right hemithorax.
On technical adequacy analysis, there is a degree of rotation as demonstrated by the discrepant distances between the medial clavicles and thoracic spinous processes.
Case Discussion
Unilateral hypertranslucent hemithorax has many causes including technical inadequacy due to rotation, especially in a restless, confused, or non-compliant patient. The presence of scoliosis may also lead to rotation.
There are many pathological causes of hypertranslucent hemithorax. In a post-trauma setting haemothorax, pneumothorax, and airway obstruction need to be excluded especially if technical factors are adequate.
In this instance, the incident was of a low velocity and there was a low probability of any significant thoracic injury, nevertheless, a haemopneumothorax and/or endobronchial obstruction was absent on chest X-ray analysis and mild rotation (towards the right), was considered the cause of the unilateral hyper translucency of the right hemithorax.
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