Chest x rays made easy
In the third of a five part series, Elizabeth Dick looks at abnormalities of the lung fields
It is important to view around the periphery of the lungs to look for a pneumothorax (air in the pleural space with associated collapsed lung). It is very easy to miss a pneumothorax. Watch out for the following signs: One half of the lung may seem blacker - that is, more radiolucent - than the other, which will be more radio-opaque or whiter. In particular, the area beyond the collapsed lung will be very radiolucent because there are no pulmonary vessel markings.You should be able to identify the edge of the collapsed lung (see fig 1).
Having identified a pneumothorax you need to look for several more associated abnormalities: Most importantly - this is a pass or fail observation - is there evidence of a tension pneumothorax? This occurs when air can enter the pleural space (via a hole in the lung surface or the chest wall) but, because of