CXR Case 150
A 69 yo lady presents with a fall, productive cough, fever and dyspnoea
Describe and interpret this CXR
CHEST X-RAY INTERPRETATION
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
TOP 150 CXR SERIES
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
I highly appreciate the efforts for making these X. Rays available with explanation. It was of great help to me.