Pneumothorax in supine projection

Changed by Craig Hacking, 15 Feb 2019

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A pneumothorax does not display classical signs when a patient is positioned supine for a chest radiograph. Instead, the pneumothorax may be demonstrated by looking for the following signs:

relative lucency of the involved hemithorax
deep, sometimes tongue-like, costophrenic sulcus: deep sulcus sign ²
increased sharpness of the adjacent mediastinal margin and diaphragm
increased sharpness of the cardiac borders or diaphragm
visualisation of the anterior costophrenic sulcus: double diaphragm sign ³
visualisation of the inferior edge of the collapsed lung above the diaphragm
depression of the ipsilateral hemidiaphragm
lumpy appearance of the cardiac contour representing change in shape of the pericardial fat: pericardial fat tag sign

~~-<li>increased sharpness of the cardiac borders</li>~~
+<li>increased sharpness of the cardiac borders or diaphragm</li>

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Pneumothorax in supine projection

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