Bilateral deep sulcus signs of supine pneumothoraces

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Motor vehicle collision.

Patient Data

Age: 18 years
Gender: Male

Deep sulcus signs are seen bilaterally with crisp outlines of the hemidiaphragms. Pneumomediastinum is also evident with streaky lucency seen in the superior mediastinum. 

CT confirms pneumomediastinum and bilateral pneumothoraces. Minor right upper lobe opacification. 

Case Discussion

Deep sulcus sign is one of a supine pneumothorax, which at times is a difficult diagnosis to make. 

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