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Pneumothorax mimic - skin fold

Case contributed by Ian Bickle
Diagnosis almost certain

Presentation

Regular admission for an elderly patient with sepsis. Source to be identified.

Patient Data

Age: 85 years
Gender: Female
x-ray

Linear abnormality nearly parallel to the right chest wall extending from base to apex.

Lung marks are evident peripheral to this line, implying this is not air in the pleural space.

Case Discussion

There are a number of potential mimics for a pneumothorax. Perhaps the most common is a skin fold. These typically occur in:

  1. The elderly with loose skin as a result of aging.
  2. On an AP film

The appearances can catch the untrained eye - be sure to review the lucency / presence of lung markings peripherally.

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