CXR in pediatric patient showing large pneumothorax

Presentation & Findings: Young child presents with shortness of breath and distress. Chest X-Ray (CXR) demonstrates large left sided lucency relative to right hemithorax. Deep sulcus sign is also demonstrated on the left side. There is also slight rightward mediastinal shift. Splaying of ribs is not definite but there is suggestion of possible splaying at certain levels.

Key Points: Evaluation for tension pneumothorax would be critical which would include mediastinal shift, splaying of ribs for instance. Serial imaging would also be important to assess if pneumothorax is worsening.

Case submitted by Elie Goulding MD to radRounds Radiology Network