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 physios 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