'White out' of hemithorax

Case contributed by Dr Ian Bickle

Presentation

Shortness of breath. Fatigue. Cause?

Patient Data

Age: 75 years
Gender: Male
X-ray

A complete white out of the right hemithorax.

The trachea is pulled to the right side.

Left lung clear.

Case Discussion

This appearance is termed a complete 'white out' due to the whole of one side of the thoracic cavity is opacified.

If one receives a radiograph of this nature some practical points to consider

- are there any prior radiographs it was evident on - it might be a pneumonectomy from years ago. 

- are there any changes to the thoracic cage to suggest a thoracotomy to indicate a pneumonectomy

- which direction has the trachea gone.  Pulled towards suggests a pneumonectomy or total lung collapse, pushed suggests a large effusion or rarely a huge thoracic mass.

Typically if new a CT is performed and reveals all.

Check out the position of the trachea on the range of pathologies here:  https://radiopaedia.org/articles/hemithorax-white-out-differential

 

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Case information

rID: 56829
Case created: 24th Nov 2017
Last edited: 29th Nov 2017
System: Chest
Tag: rdgh
Inclusion in quiz mode: Included

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