 | Viet Tran A 61yo female has been brought in by ambulance having been involved in an MVA at 60 kph. She was sitting in the back & complains of a sore left chest. |
This is her chest x-ray:
What are the positive findings?
She has multiple displaced left lower rib fractures. Significantly, this is NOT complicated by any radiologically obvious haemopneumothorax, haemopneumoperitoneum, underlying pulmonary contusion or subcutaenous emphysema. This is however, an early x-ray...
She has a repeat Cxr whilst an inpatient
What has changed?
As expected, the displaced rib fractures have moved. More significantly is the deep sulcus sign on the left (the disappearance of the left hemi-diaphragm) - suggesting the presence of a basal pneumothorax. Surprisingly her lung parenchyma doesn't appear to have suffered given the degree of fractured/displaced ribs.
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