Chest X-ray - Scenario 5
Scenario image interpretation
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Image Interpretation- Image 1
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Quality
- Projection - PA - scapula retracted
- Rotation - there is very minor rotation but heart size can still be assessed - don't spend too long on this as the image shows a clear potentially life-threatening abnormality
- Inspiration - normal
Findings
- Small left apical pneumothorax (asterisk)
- No evidence of tension
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Scenario Image Interpretation
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Quality
- Projection and rotation - as for image 1
- Inspiration - depressed hemidiaphragm on the left (red line) - a sign of early tension
Findings
- Increased size of pneumothorax (asterisks).
- According to British Thoracic Society guidelines this remains a 'small' pneumothorax; the pneumothorax width does not exceed 2 cm at the level of the hilum. However, the lung is not compressed in a uniform manner and depression of the left hemidiaphragm suggests early tension (the mediastinum is not pushed to the right). Some would, therefore, consider this to be a large pneumothorax.
- Note: In managing a pneumothorax the clinical features, such as breathlessness, are considered more important than the size of pneumothorax.