X-RayChestIntroductory

Tension pneumothorax

chesttraumaemergencypneumothoraxmediastinal shift

Clinical presentation

Trauma patient with acute severe dyspnoea, hypotension, distended neck veins and absent breath sounds on one side.

Key imaging findings

  • Large hyperlucent hemithorax with a visible visceral pleural line and no lung markings peripherally
  • Contralateral mediastinal shift
  • Depression/flattening of the ipsilateral hemidiaphragm
  • Widening of the intercostal spaces on the affected side

Form your diagnosis, then reveal the answer.

Educational teaching content only. Imaging appearances vary; always correlate clinically and confirm with a qualified radiologist.