CXR Case 150

A 69 yo lady presents with a fall, productive cough, fever and dyspnoea

Describe and interpret this CXR


There is marked tracheal and mediastinal deviation to the left, reflecting collapse and volume loss of the left lower lobe.
There is a fracture of the 7th rib on the left side and a further fracture of the 7th rib on the right side.

* There are air bronchograms visible in the left mid zone suggesting consolidation
* There is a small left apical rim of air, probably a small pneumothorax


This lady may well require positive pressure…

Either NIV, mechanical ventilation or airway maneuvers from the physio to re-inflate the lung, which means that a CT would be indicated to establish if this is a pneumothorax


The pneumothorax is most likely from the rib fracture.

Secondary pneumothorax in the context of no (known) lung pathology prior is quite unusual.

*This may be a sign of underlying emphysema or necrosis of the visceral pleura


Prof Fraser Brims Curtin Medical School, acute and respiratory medicine specialist, immediate care in sport doc, ex-Royal Navy, academic| Top 100 CXR | Google Scholar | ICIS Course ANZ

One comment

  1. I highly appreciate the efforts for making these X. Rays available with explanation. It was of great help to me.

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